bluuebunny/crossref_metadata_2025_split huggingface dataset:
Starting ART following cryptococcal meningitis:The optimal time has yet to be defined
Authors: Bicanic T A , Jarvis J N , Loyse A , Harrison T S 
Published: June 2017

Ever since the public sector rollout of antiretroviral therapy (ART) in 2004, the question of the optimal time to start ART following diagnosis of an opportunistic infection has aroused controversy among South African HIV clinicians and researchers.
MRSA bacteraemia complicating amphotericin B treatment of cryptococcal meningitis
Authors: Scriven J , Cirota J , Viljoen C , Black M , Meintjes G 
Published: June 2017

Intravenous amphotericin B is a key component of the antifungal therapy for cryptococcal meningitis recommended in South African and international guidelines. Unfortunately, its use is associated with significant toxicity including deterioration in renal function, electrolyte disturbance, anaemia and infusion reactions. Chemical phlebitis is common following administration via peripheral cannulae. This can be complicated by bacterial infection, resulting in localised cellulitis or bacterial sepsis. Here we describe two patients with cryptococcal meningitis who developed methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia during, or shortly after treatment with amphotericin B. These cases illustrate the dangers of line-related sepsis in hospitalised individuals and some of the difficulties encountered during treatment of this condition.
Human papillomavirus infection and disease in men: Impact of HIV
Authors: Delany-Moretlwe Sinead , Chikandiwa A , Gibbs J 
Published: June 2017

There is growing evidence of a significant burden of human papillomavirus (HPV) infection and associated disease in men. High rates of HPV infection have been observed in men from sub-Saharan Africa where HIV prevalence is high. HIV infection increases HPV prevalence, incidence and persistence and is strongly associated with the development of anogenital warts and anal, penile and head and neck cancers in men. Despite increasing access to antiretroviral therapy, there appears to be little benefit in preventing the development of these cancers in HIV-positive men, making prevention of infection a priority. New prevention options that are being introduced in many African countries include male circumcision and HPV vaccination. However, more data are needed on the burden of HPV disease in men before boys are included in HPV vaccination programmes.
Expression of DC-SIGN and DC-SIGNRs in placentas of HIV-positive patients
Authors: Pillay Komala , Cloete M , McLeod H 
Published: June 2017

Background. Human dendritic cell-specific intracellular adhesion molecule-3 (ICAM3)-grabbing non-integrin (DC-SIGN) is a mannose-binding lectin that initiates interaction between dendritic cells and resting T-lymphocytes. DC-SIGN is highly expressed in placental tissue on dendritic cells and Hofbauer cells, and it is suggested that HIV may become adsorbed to DC-SIGN on Hofbauer cells as part of the mechanism of mother-to-child HIV transmission. A possible mechanism of transfer of the virus from the Hofbauer cells to the fetus is the subsequent adsorption to DC-SIGN-related molecules (DC-SIGNRs), present on immediately adjacent capillary vascular endothelium. However, data on DC-SIGN and DC-SIGNR expression in the placenta are few.Methods. Forty term placentas from HIV-positive mothers and 21 term placentas from HIV-negative mothers underwent immunohistochemistry staining for DC-SIGN and DC-SIGNR expression. Five random sets of 10 villi were assessed, and the average number of positive cells were counted in each case. In addition, where possible, maternal and cord blood viral loads and maternal CD4+ counts were performed in the HIV-positive group only.Results. The median maternal CD4+ count was 377 cells/µl and 27% of participants had undetectable viral loads; the median detectable viral load was 3.72 log. Most (97%) of the cord bloods tested in infants from HIV-positive mothers had lower than detectable viral loads. HIV-positive cases had significantly greater expression of both DC-SIGNRs (median values in HIV-positive cases, 14.5 positive cells/10 villi (pc/10villi), compared with 11 pc/10villi in HIV-negative cases, p=0.020) and DC-SIGN (median value in HIV-positive cases, 26.5 pc/10villi, compared with 23 pc/10villi in HIV-negative cases, p=0.037). DC-SIGNR expression was also noted in Hofbauer cells and decidual macrophages in addition to endothelium (reported currently). There was no difference in expression of DC-SIGN and DC-SIGNRs in patients with or without chorioamnionitis, but there was an inverse relationship between DC-SIGN and DC-SIGNR expression and maternal CD4+ counts in HIV-positive cases. Conclusion. Both DC-SIGN and DC-SIGNR expression were higher in placentas from HIV-positive mothers compared with HIV-negative cases. These lectins may be potential new therapeutic targets for preventing vertical transmission of HIV.
Physiotherapy students’ perceptions of an innovative approach to clinical practice orientation
Authors: Faure M. , Unger M. , Burger M. 
Published: June 2017

The transition from the classroom to clinical practice is stressful for many students. In the current situation in South Africawith the shortages of clinicians’ posts in hospitals, this transition is evenmore difficult given the reduced time that clinicians have for supervisingundergraduate students. The University of Stellenbosch initiated structured peer-led introduction to clinical education (SPLICE), duringwhich senior physiotherapy students orientate second year students toclinical practice.The aim of this study was to investigate the perceptions of all of thesecond, third and fourth year students who took part in these SPLICEsessions. This information was captured using a questionnaire with open and closed questions. The response of all of the students was extremely positive. Common to all cohorts of students was the opinion of themotivational benefits of the sessions as well as the opinion that their confidence increased. Students in the variousyears of study differed in the ways in which they felt more confident. Closely linked were those comments referring to a sense of increased preparedness for clinical practice and a positive learning environment. A positive change inattitude towards clinical practice was also noted in many second year students.Further research is needed into the effect that SPLICE might have had on the second year students when they enterclinical practice as third year students. The role and opinions of patients during these sessions, and indeed during anyclinical education sessions, including clinical examinations, needs further investigation.
The Cardiopulmonary effect of passive movement
Authors: Loram L. , De Charmoy S. 
Published: June 2017

Eleven articles were reviewed on the cardiopulmonary effects of passive movements. These included two articles on theneurological effects of passive movements. Of the eleven articles, four were considered to have level II evidence in accordance with Sackett’s rules of evidence. There was little consensus regarding the rate or duration of passive movements. There were some suggestions that upper limb movement produces a greater ventilatory response than lower limb movement. There was a statistically significant increase (p< 0.05) in minute ventilation when the movement was done at a rate of 40 repetitions per minute or more, but this change may not be clinically significant. Passive movements were not detrimental to neurosurgical patients with a normal or slightly elevated intracranial pressure, although the values of the intracranial pressure were not stated. The studies were limited in that eight of the eleven had small sample sizes and most studies were conducted using normal subjects. Further studies with higher levels of evidence need to be conducted to verify any results reported to date in the literature. Studies that are relevant to clinical practice also need to be conducted in populations such as sedated intensive care patients.
Effects if co2-baths in the combined concept of the early functional therapy in the cases of reflex sympathetic dystrophy
Authors: Mucha C. 
Published: June 2017

Objective: The effects of the application of CO2-baths for the purposes of the specific early functional combined therapy in cases of reflexsympathetic dystrophy should be differentiated.Subjects: Forty patients suffering from acute post-traumatic reflex sympathetic dystrophy in the hand.Design: A four weeks’ omission test was carried out in group B. The resultswere contrasted to group A. The relevant parameters in the process of regeneration were statistically calculated as a chronological serial analysis.Results: In regard of the multi-variable design the results demonstrated highly significant group differences in the case of the progression of regeneration, at which group A was definitely superior to group B. Group B displayed an additional effect of delay. Conclusion: The potential influences with regard to the effects of the CO2-bath are: better organisation of the exercises and superior progression of regeneration. Obviously there are beneficial effects of the combination therapy.
A comparative sudy of two pressure relieving techniques on three different wheelchair cushions
Authors: Eksteen C. , Cilliers P. , Swanepoel A. , Vermaak E. , Trollip Q , Wilford T. , Van Dyk P. M. 
Published: June 2017

Introduction: Pressure relief done by a spinal cordinjured patient is of utmost importance in order to prevent pressuresore formation. Some pressure-relieving techniques are describedin previous literature, but their effectivity has not yet been deter-mined on different wheelchair cushions.Null Hypothesis (H0): The null hypothesis (H0) stated for thistudy is that there is no difference in the effectivity of forwardleaning and forward leaning towards the left as pressure relievingtechniques for quadriplegic wheelchair users over the differenwheelchair cushions.Design: An analytical experimental study design using a convenient sample group of ten complete lesion quadriplegics (C6 to T1) was performed at the Physiotherapy Department,University of Pretoria.Method: Interface pressure (in mmHg) over the ischial tuberosities and upper thigh areas was measured using theTalley Oxford Pressure Monitor MKII with a 12-way matrix cell system.Results and Conclusion: The Friedman test for associated observations indicated statistically that the leaning diagonally forward pressure relieving technique is more effective for all three wheelchair cushions used in this study.
Reliability of diagnostic tests in rotator cuff muscle pathology
Authors: Sadenbergh R. , Marais A. 
Published: June 2017

Background: Several tests to assist it in the diagnoses of rota-tor cuff impairment have been described in the literature but controversystill exists as to the accuracy of these tests. A study was therefore conducted to determine the reliability of the rotator cuff muscle tests (empty can, full can, lift off and external rotation) as a diagnostic tool.Methodology: Fifty three patients experiencing shoulder pain were assessedusing manual muscle tests (empty can; full can; lift off and external rotationtests). Both pain and weakness were recorded using numerical scales adapted from tests performed by Itoi et al, (1999). These results were compared to ultrasonic diagnoses made by a surgeon. Informed consent was obtained and anonymity was ensured for all participants.Results: A test was false positive when ultrasonic diagnosis indicated no tear in the muscle (although oedema or calcification may have been present), but the manual muscle test was positive regarding pain and weakness. A test on the other hand was false negative when the ultrasonic diagnosis indicated a muscle tear but the manual muscle tests indicated no pain or muscle weakness. Reliability was tested using sensitivity and specificity tests. The sensitivity of all four tests was high (80%), but the specificity was low (20% to 40%), implying that a large number of false positive diagnoses can be made. The major contributors to the false positive results were sub-acromial sub-deltoid bursitis and a decreased acromio-humeral space. When considering pain alone for a positive result the correlation increased a little, however, taking both pain and muscle weakness into account, the correlation increased even more.Conclusion: The manual muscle tests were not as reliable as expected, but concurrent pathologies may be the main factor influencing the results of the tests. The combination of muscle strength and pain could be recommendedas criteria for a positive test. The empty can and full can tests could both be recommended in predicting a torn supraspinatus tendon, as they were equally sensitive
Global trends in incidence of lower limb amputation: a review of the literature
Authors: Godlwana L. , Nadasan T. , Puckree T. 
Published: June 2017

The aim of this paper was to compile a literature report on the global epidemiology of lower limb amputations. Specifically it aimed at capturing information on the incidence of traumatic and non-traumatic lowerlimb amputations throughout the world, to identify the etiology including diseases and lifestyle habits associated with lower limb amputees (LLA) in boththe developed and the developing countries, to identify the demographiccharacteristics, age, sex, race, geographical location of the people undergoing LLA including the levels of amputation as pointed out by the literature. Aliterature search was conducted. Different keyword combinations were used togather as much literature on the subject as possible. The authors systemicallyreviewed literature from some parts of Europe, Asia, North and South America and South Africa. The data was analyzed and presented under various themes. The existing literature shows that diabetes is the leading cause of LLA and trauma accounts for the minority of these cases. The incidence of LLA can be predicted by gender, age, maritalstatus, level of education and socio-economic status. Information on LLA in South Africa is almost absent.
The effect of isokinetic and proprioception training on strength, movement and gait parameters after acute supination injury of the ankle ligaments
Authors: Mucha C. 
Published: June 2017

The effects of a three-week isokinetic training compared to typical proprio -ceptive training on parameters of strength, movement and gait function after acute ankle ligament sprain were investigated. Thirty-nine patients were randomly allocated to two comparison groups. In group 1 (n=20)a proprioceptive training and in group 2 (n=19) an isokinetic strength training (Cybex 6000®) were administered. Thepatients of both groups underwent training five times a week for three weeks. Before and at the end of the treatmentcourse, in both groups isokinetic strength was tested, the range of motion in the ankle joint was recorded and gait wasanalyzed (multicomponent strength measurement platform, Henschel-System®). The maximum isokinetic torque(60°/s) [Nm] and the contact time (monopedal support time) of the injured leg during gait cycle were the basis for evaluation.The data obtained show that in group 2 a significantly greater increase of the maximum isokinetic torque wasattained in almost all range of motion of the ankle joint in the course of treatment. A t the same time, in group 2 theshortening of the contact time in the stance phase of the injured leg could be compensated. The active range of motionin the ankle joint was less at the end of treatment in group 2 than in group 1. The isokinetic training obviously did notonly lead to better strength regeneration, but also to a functionally more stable ankle joint with a rhythmically moreevenly balanced stance phase of the gait cycle. These results suggest that the used isokinetic training had positive effects on functional stability after acute ankle sprain.
Comrades marathon for short-term experiential learning as perceived by physiotherapy students: A short report
Authors: Useh U. , Human A. 
Published: June 2017

This study described the learning experiences of physiotherapy students during the 2009 comrades marathon. A quali-tative approach using focus group discussions was employed for this study.The population for this study was all the 43 B.Sc. physiotherapy final year students of the university of limpopo, who provided physio-therapy services at the 2009 comrades Marathon. forty (93%) students participated in this study. All the participants were black with majo-rity 23 (58%) of them from the limpopo province. Twenty one (52%) of the participants were females with ages ranging between 21 and 30 years. The field trip provided both sport specific and general learning experiences. participants had the opportunity to handle sports injuries and athletes, work and learn as a team and were quite independent. This trip also provided participants the opportunity experiencing workplace communication and interaction, the reality of the real workplace experience of heavy workload, experience of prejudice, time management and an unsafe environment.Despite organizational challenges of the trip, the event provided an opportunity for the participants to practice sport physiotherapy. Participants appreciated the opportunity to experience the dynamics of team and collaborative learning. To ensure effective use of this event for experiential learning, it is recommended that proper guidance and support be provided by the faculty.
Using caregivers’ perceptions of rehabilitation services for children with Cerebral Palsy at public sector hospitals to identify the components of an appropriate service
Authors: Saloojee G.M. , Rosenbaum P.L. , Stewart A.V. 
Published: June 2017

Despite a growing body of evidence favouring a family-centred approach to rehabilitation services for children with cerebral palsy (cp), the essential components for a quality service for children with disabilities and their families living in poorly-resourced South African (SA) settings remains unknown. The study aimed to identify key components of an appropriate rehabilitation service which would meet the needs of children with CP and their caregivers at SA public sector hospitals. This cross-sectional descriptive study used the modified Measure of processes of care (Mpoc-20) questionnaire together with two open-endedquestions with a convenience sample of caregivers attending therapy at CP Clinics in gauteng and limpopo hospitals. A total of 263 caregivers attending cerebral palsy clinics at 31 public sector hospitals in gauteng and limpopo were interviewed. Kind and caring attitudes, exercises or “training” for the child, and practical assistance (handling ideas and suggestions, assistive devices, food supplements, nappies, advice) were components of care most valued. The most frustration was caused by long queues waiting for files or at the pharmacy and being treated disrespectfully whilst providing caregivers with information and explanations regarding treatment choice were services that could be improved. Key components for an appropriate therapy service include caring and respectful attitudes, hands-on therapy, handling suggestions and practical assistance. Logistical and administrative procedures together with disrespectul and unhelpful attitudes negatively impact rehabilitation service delivery.
Banho de chuveiro como estratégia não farmacológica no alívio da dor de parturientes
Authors: Davim Rejane Marie Barbosa , Torres Gilson De Vasconcelos , Dantas Janmilli Da Costa , Melo Eva Saldanha de , Paiva Cecília Pessoa , Vieira Daniele , Costa Isabelle Katherinne Fernandes 
Published: June 2017

O objetivo do estudo foi avaliar a efetividade do banho de chuveiro para o alívio da dor de parturientes na fase ativa do trabalho de parto. Estudo delineado como ensaio clínico do tipo intervenção terapêutica “antes e após”, realizado na Unidade de Parto Humanizado da Maternidade Escola Januário Cicco da Universidade Federal do Rio Grande do Norte, em Natal/RN, com 100 parturientes na aplicação dessa estratégia no período de setembro de 2005 a fevereiro de 2006. Para avaliar a intensidade da dor das parturientes utilizou-se a escala analógica visual. A maioria das parturientes do estudo estava na faixa etária entre 20 a 30 anos (60%), ensino fundamental incompleto (85%), renda familiar até 2 salários mínimos (74%) e 78% tinham um acompanhante, e destes, 44% era o próprio companheiro. A ocitocina foi administrada em 81% dos casos e apenas 15% dessas mulheres não receberam qualquer medicação. Verificou-se alívio significativo da dor na aplicação do banho de chuveiro, sendo efetivo no alívio da dor das parturientes do estudo.
Unidade de Atenção ao Idoso: atividades, mudanças no cotidiano e sugestões
Authors: Caetano Ana Cláudia Moura , Tavares Darlene Mara dos Santos 
Published: June 2017

Com o aumento da expectativa de vida surgem novas demandas sociais e de saúde para o atendimento à população idosa. A enfermagem deve somar esforços com a equipe multiprofissional visando contribuir com a manutenção da independência e autonomia do idoso, nos espaços sociais de promoção da saúde. Neste estudo objetivou-se descrever as características sócio-demográficas dos idosos freqüentadores da Unidade de Atenção ao Idoso (UAI), localizada no município de Uberaba-MG, bem como as atividades realizadas pelos idosos no local, identificando as mudanças ocorridas em seu cotidiano após freqüentar a UAI e sugestões de atividades. Os dados foram coletados, no período de julho e agosto do ano de 2007, junto a 39 idosos e, após, submetidos à distribuição de freqüência e análise temática segundo Bardin. A maioria dos entrevistados era do sexo feminino (87,1%); com 4 a 8 anos de estudo (66,7%), aposentados (84,7%) e renda mensal individual de 1 salário mínimo (59%). As atividades realizadas são: hidroginástica (28%); dança (15,8%), ginástica (14%) e alongamento (13,1%). A análise temática evidenciou as categorias: Mudanças no posicionamento social (32,1%); Melhoria nas condições de saúde (27%) e Atividades na UAI (40,9%). A participação dos idosos nas atividades da UAI acarretou mudanças positivas na vida dos usuários, propiciando melhorias na sua qualidade de vida.
Estrutura conceitual da tensão do cuidador familiar de idosos dependentes
Authors: Fernandes Maria Das Graças Melo , Garcia Telma Ribeiro 
Published: June 2017

O aumento de idosos com incapacidade funcional levou ao surgimento do fenômeno de tensão do cuidador familiar. Em nosso contexto, esse tema é abordado ainda de modo incipiente na pesquisa e prática assistencial gerontológica. Tendo em vista esses aspectos, este estudo, desenvolvido em 2003, com base no método proposto por Schwartz-Barcott e Kim para o Modelo Híbrido de Análise Conceitual, objetivou elaborar um esboço teórico para o conceito Tensão do cuidador familiar de idosos dependentes de modo a subsidiar o cuidado em saúde dessa clientela. Para a primeira fase, de análise teórica, utilizou-se um corpus de 84 trabalhos pertinentes à temática, publicados em português, inglês e espanhol, entre 1990 e 2001; os resultados subsidiaram a elaboração do instrumento de coleta de dados. A segunda fase, de estudo de campo, envolveu trinta cuidadoras, sendo os dados obtidos mediante entrevista individual, e analisados quantitativamente. O cotejamento entre os achados teóricos e empíricos permitiu a elaboração de uma estrutura conceitual para o referido conceito, que contempla fatores antecedentes, atributos críticos e conseqüências do fenômeno. O fenômeno investigado apresenta-se como multidimensional, recomendando-se a inclusão do idoso, cuidador e família como sujeitos inter-relacionados no processo de cuidado profissional.