Meyerslangballe6923

Our data showed consistency in the flow cytometry, CFU assay, PDT, soft agar assay, karyotyping and differentiation studies.

Using our protocols for extended xeno-free culture and cryopreservation of hWJ-MSCs, we could establish the shelf life of the cell-based product for up to 28 months.

Using our protocols for extended xeno-free culture and cryopreservation of hWJ-MSCs, we could establish the shelf life of the cell-based product for up to 28 months.

Flexible ureteroscopy (FURS) and laser lithotripsy for ureteric and renal calculi requires adequate irrigation for visualisation. This study aimed to evaluate how bolus administration of irrigant fluid impacts intrarenal pressure (IRP) during FURS. We also investigated how ureteral access sheaths (UAS) of varying sizes mitigate elevated IRP.

Using a porcine cadaveric model, IRP was evaluated using an arterial invasive pressure measurement system. Given a fluid column height (driving force) of 80 cm H2O, and varying bolus administration (1, 2, 3, 5, 10 ml), IRP was studied with and without a UAS. An IRP of < 40 mmHg was considered the cut off for "safe" FURS. The flow (drainage capacity) of UAS was also evaluated. At varying fluid column heights, three sizes of UAS were used, 10/12 French size (Fr), 11/13 Fr and 12/14 Fr, all 36 cm long.

Bolus administration with a UAS of < 5 ml with a starting fluid column height of 80 cm H

O was "safe" (< 40 mmHg). In contrast, where no UAS was used, bolus sizes as small as 2 ml produced "unsafe" peak pressures. The flow through a 10/12 Fr UAS was poor but improved greatly with larger UAS diameters.

This study suggests that 10/12 Fr UAS may be inadequate to maintain drainage from the kidney at acceptable pressures. Bolus fluid administration produces "unsafe" (> 40 mmHg) elevated IRP in the absence of a UAS. When a UAS is used, a fluid bolus of < 5 ml is likely "safe".

40 mmHg) elevated IRP in the absence of a UAS. When a UAS is used, a fluid bolus of less then 5 ml is likely "safe".

In South Africa, urological and other subspecialty training and exposure vary across each university at undergraduate and internship level. Many students and junior doctors complete their degrees and medical internship with little or no exposure and training to enable them to manage common urological conditions at primary healthcare level with the adequate competency, proficiency and confidence. We aimed to evaluate the exposure and urological training of junior doctors during internship and to determine whether it had any impact on their attitudes toward urology as a speciality in which to pursue a career.

We used a descriptive cross-sectional survey design. We emailed a questionnaire to 200 community service doctors who completed internship during 2016-2018, working across Western Cape hospitals. The questionnaire aimed to assess their clinical exposure to urology, confidence in basic urological knowledge and clinical skills, and their attitudes toward urology as a postgraduate career choice.

The respmitigate some of these challenges.

The study showed that urological exposure and training at internship level is below the standard it needs to be in order to produce proficient and competent doctors able to practise efficiently during community service. Selleckchem JAK inhibitor The study also highlighted that limited exposure has a negative impact on potential future urologists wanting to pursue a career in the field. Incorporation of necessary urology skills short courses into the internship programme might help mitigate some of these challenges.

This project reviews our experience with managing pancreatic trauma from 2012 to 2018.

All patients over the age of 15 years with a pancreatic injury during the period December 2012-December 2018 were retrieved from the Hybrid Electronic Medical Registry at Grey's Hospital and reviewed.

During the study period 161 patients sustained a pancreatic injury. The mechanism of trauma was penetrating in 86 patients (53%) and blunt in 75 (47%). The blunt mechanisms included MVA in 27, PVA in 15, falls in four and assaults in the remaining 29. There were 52 stab wounds and 34 gunshot wounds of the pancreas. A total of 26 patients (16%) were shocked on presentation with a systolic blood pressure of 90 mm Hg or less. The median injury severity score was 16. There were 90 patients with American Association for the Surgery of Trauma (AAST) grade I injury to the pancreas, 36 AAST grade II, 27 AAST grade III, 7 AAST grade IV and a single AAST grade V. Fifty-four patients (34%) were initially treated non-operatively of iated with significant morbidity and mortality.

Bowel preparation is essential for quality colonoscopy. Although most bowel preparation regimens recommend dietary restriction for 24 to 48 hours before the procedure, the evidence for this is poor. This study aimed to investigate whether dietary restriction during bowel preparation improves the quality of colonoscopy.

A prospective, randomised controlled pilot study in which the dietary restriction (DR) group (control) was instructed not to ingest high fibre foods for 48 hours prior to the use of a polyethylene glycol (PEG) bowel preparation. The non-dietary restriction (NDR) group were given no dietary instruction but received instructions for the use of the PEGbased preparation. On the day of colonoscopy, the quality of the bowel effluent was assessed, and additional preparation given as necessary. The primary endpoint was quality of bowel cleansing using the Harefield Cleansing Scale during colonoscopy. The secondary endpoints were the need for additional bowel preparation and the quantity of additiono be a reasonable methodology for a larger study.

The quality of bowel preparation was comparable in patients with and without dietary restrictions prior to colonoscopy. Non-restrictive diets prior to bowel preparation should be considered to increase compliance. The sample size of this pilot study prohibited definite statistical conclusions but demonstrated this to be a reasonable methodology for a larger study.

Alarm features are commonly used to identify patients who require an endoscopy to rule out significant upper-gastrointestinal (GI) pathology. Validation of these features in a rural South African (SA) setting has implications for the provision of endoscopy services and was the aim of this study.

This was a retrospective chart review of 1 000 consecutive endoscopies performed at a rural SA regional/ referral hospital over three years. Demographic data, indication for endoscopy (upper GI bleed, dyspepsia, dysphagia, anaemia, weight loss, age) and major endoscopic findings (defined any tumour, ulcer, or stricture) were recorded. A multivariate logistic regression analysis was done to identify risk factors for major endoscopic findings.

The median age of the study sample was 51.0 (range14.0-88.0) years. Males (306/1 000) accounted for 30.6% of the study population. The prevalence of alarm features in the study sample was as follows upper GI bleed - 16.6%; dyspepsia - 58.4%; dysphagia - 10.3%; anaemia - 3.5%; weight loss - 0.3%. The following alarm features were statistically significant in detecting a major endoscopic finding age > 60 (OR 2.67, CI 1.82-3.96), male gender (OR 1.52, CI 1.03-2.24), dysphagia (OR 12.16, CI 4.33-34.19) and upper GI bleed (OR 2.77, CI 1.03-7.47),

< 0.05.

Dysphagia, age > 60, male gender, and upper GI bleed are identifiable risk factors for major endoscopic findings. Not all the alarm features for major endoscopic findings that are established elsewhere can be applied in our rural SA setting.

60, male gender, and upper GI bleed are identifiable risk factors for major endoscopic findings. Not all the alarm features for major endoscopic findings that are established elsewhere can be applied in our rural SA setting.

South Africa has a rich tradition in urinary tract stone research. This paper asks what research originating from South Africa has contributed to the understanding of the pathophysiology of nephrolithiasis. Many of these contributions are based on the premise that ethnicity variation accounts for dramatic differences in the prevalence of nephrolithiasis and that South Africa represents an ideal place for investigating this variation. It needs to be noted that many of the papers dealing with this question, as Rodgers has put it, "demonstrate an insensitivity to racial terminology and classifications." We have nevertheless attempted to review these papers to understand what valid science this literature holds and how it can inform further work in the relatively under-investigated field of nephrolithiasis aetiology and pathophysiology.

South Africa has a rich tradition in urinary tract stone research. This paper asks what research originating from South Africa has contributed to the understanding of the pathophysiology of nephrolithiasis. Many of these contributions are based on the premise that ethnicity variation accounts for dramatic differences in the prevalence of nephrolithiasis and that South Africa represents an ideal place for investigating this variation. It needs to be noted that many of the papers dealing with this question, as Rodgers has put it, "demonstrate an insensitivity to racial terminology and classifications." We have nevertheless attempted to review these papers to understand what valid science this literature holds and how it can inform further work in the relatively under-investigated field of nephrolithiasis aetiology and pathophysiology.

Idiopathic hyperoxaluria is a risk factor for developing calcium oxalate nephrolithiasis. Dietary oxalate's effect on urinary oxalate is not well studied. The aim of this study is to assess the effect of advice focused on reducing dietary oxalate in a cohort of idiopathic hyperoxaluric patients.

Patients referred to the Groote Schuur Hospital Stone Clinic from 2015 to 2017 were considered eligible, if they were an idiopathic hyperoxaluric stone former, excreting > 40 mg/d of urinary oxalate on a pre-intervention 24-hour stone study urinalysis. Patients were asked to adhere to a diet sheet which included general stone prevention advice (low salt diet, increased fluid intake and moderate protein intake) and specific low oxalate diet advice. A post-intervention 24-hour urinalysis was performed at six weeks.

Nineteen patients had hyperoxaluria (eight men and 11 women) with a mean age of 49 years (range 25-76 years). The mean BMI of the group was 28.4 kg/m

(17.4-50). All patients had mean number of 1.9 range prior stone episodes (range 1-6 stone episodes). Fourteen (14/19) patients completed the study. The mean pre-dietary advice urinary oxalate was 53.2 mg/24 hours (

= 14), SD while the post-intervention was 29.6 mg/24 hours SD (

= 0.0002). Only 3/14 patients who completed the assessment failed to normalise their urinary oxalate on the diet.

In the stone clinic setting, general advice of low salt diet, increased water intake, moderate protein intake and specific oxalate restriction can significantly reduce oxalate excretion in hyperoxaluric stone formers. Sustained reduction of oxalate excretion and longitudinal clinical benefit are worthy of study in larger cohorts.

In the stone clinic setting, general advice of low salt diet, increased water intake, moderate protein intake and specific oxalate restriction can significantly reduce oxalate excretion in hyperoxaluric stone formers. Sustained reduction of oxalate excretion and longitudinal clinical benefit are worthy of study in larger cohorts.