South African Medical Journal - January 2024 Vol 114 No 1

Introduction

Recurrent venous thrombosis – an unusual first presentation of autoimmune polyendocrinopathy syndrome type 3B

Recurrent  venous  thromboembolism  (VTE)  is  a  complex  clinical  problem,  and  there  is  a  lack  of  expert  consensus  regarding  the  management of this presentation. Autoimmune conditions have long been  associated  with  an  increased  risk  of  thrombosis  via  multiple  mechanisms   such   as   chronic   inflammation,   immune   complex   deposition and immunoparesis.

Artificial intelligence (AI) or augmented intelligence? How big data and AI are transforming healthcare: Challenges and opportunities

Healthcare  has  evolved  significantly  from  its  inception,  when  the  sanctity of the doctor-patient relationship was based on Hippocratic traditions.  William   Osler   described   medicine   as ‘a   science   of   uncertainty and an art of probability’. The human art of healing was embedded in a relationship of trust, with history-taking and the ritual of  human  touch  via  physical  examination  being  critical  methods  to  reach a diagnosis and prescribe treatment.

Pancreatic cancer mortality in South Africa: A case-control study

Globally, where pancreatic cancer is defined as all types of cancers originating   in   the   pancreas,   it   is   the   twelfth   most   common   malignancy  and  the  seventh  leading  cause  of  cancer  death  in  both  sexes.  Worldwide,  there  were  458  918  new  cases  of  pancreatic  cancer   and   432   242   deaths   in   2018.  In   South   Africa   (SA),   pancreatic cancer ranked seventh among all cancer deaths in 2020 in both sexes. Similarly, pancreatic cancer was the seventh leading cause  of  cancer  death  among  males  in  SA  in  2020,  whereas  it  was  the  sixth  in  females.  

The characteristics of dermatology inpatients seen at the quaternary Inkosi Albert Luthuli Central Hospital in Durban, South Africa, over a 5-year period – 2015 – 2020

Dermatology  is  an  outpatient-centred  specialty  frequently  dealing  with  non-acute  medical  conditions.  However,  dermatologists  admit   and   manage   patients   who   are   severely   ill   and/or   have   complicated  cutaneous  diseases. The  reasons  for  dermatology  inpatient admission can range from the severity of the disease and comorbid diseases to lack of transport and psychosocial support.

Factors influencing in-hospital mortality for salvage percutaneous transjugular intrahepatic portosystemic shunting in cirrhotic patients with recalcitrant variceal bleeding after failed endoscopic intervention

Acute  variceal  bleeding  (AVB)  is  the  most  serious  acute  life-threatening   complication   of   portal   hypertension,   especially   in   patients with hepatic decompensation. Rapid and sustained control of  bleeding  is  the  immediate  priority,  but  despite  conventional  treatment,   including   urgent   fluid   and   blood   resuscitation,   vasoactive    drugs,    prophylactic    antibiotics    and    endoscopic    intervention, treatment fails in up to 10% of patients, who continue to  bleed.  In  this  high-risk  group,  further  immediate  options  include  a  second  attempt  at  endoscopic  intervention  and  balloon  or  stent  tamponade  to  temporarily  control  variceal  bleeding.

Evaluation of the impact of PEPFAR transition on retention in care in South Africa’s Western Cape Province

Since 2003, the President’s Emergency Plan for AIDS Relief (PEPFAR) has  been  the  USA’s  most  ambitious  initiative  to  combat  the  global  burden  of  HIV/AIDS  and  tuberculosis.  PEPFAR  is  the  largest  contributor  to  global  HIV/AIDS  efforts.  From  2004  to  2016,  PEPFAR invested USD72.7 billion globally in HIV and TB, including contributions  to  the  Global  Fund.  PEPFAR  has  increased  the  number of people receiving HIV treatment globally, and decreased HIV-related mortality by 10.5% when compared with non-PEPFAR-supported countries.

Progress towards 90-90-90 and 95-95-95 strategy implementations and HIV positivity trends in the City of Johannesburg

Globally  by  2020,  ~38  million  people  were  living  with  HIV,  and  of  these, 6.1 million did not know that they were HIV positive. Globally, positive progress has been made towards elimination of HIV through implementation of the 90-90-90 strategy by 2020, which later evolved to the 95-95-95 strategy, meaning that 95% of people living with HIV (PLHIV)  should  know  their  HIV  status,  95%  of  people  who  know  their status will be on antiretroviral medication (ARVs) and 95% of all patients receiving antiretroviral therapy (ART) will be virally suppressed by  2025.