scholarly journals Management Issues with Infection Control during Trauma Resuscitation in the Era of COVID-19: South African Experience.

2021 ◽  
pp. 72-76
Author(s):  
Timothy Craig Hardcastle ◽  
Daniel Den Hollander ◽  
Feroz Ganchi ◽  
Shanisa Naidoo ◽  
Thobekile Nomcebo Shangase
Keyword(s):  
Antibiotic Resistance ◽  
South African ◽  
Patient Outcomes ◽  
Medical Science ◽  
Short Report ◽  
Trauma Resuscitation ◽  
Resistance Development ◽  
African Experience ◽  
Trauma Service ◽  
Management Issues

Background: This invited short report aims to document the management of trauma and nontrauma ICU patients in one quaternary facility in South Africa during the first two waves of the SARS CoV2 (Covid-19) pandemic in Kwa Zulu-Natal. Content: The setting of the trauma service and the changes made to ensure staff and patient safety are detailed. A brief overview of the clinical experience of caring for both trauma and non-trauma cases is provided along with the management of those cases who were found to be Covid-19 positive. The concerning aspect of increased antibiotic resistance development and the potential roles of antiseptic sanitisers is briefly discussed. Conclusion: Trauma care is essential during the infectious pandemic and there is a risk of increased antibiotic resistance. Doing the basics “right” can prevent staff contamination or adverse patient outcomes. Bangladesh Journal of Medical Science Vol.20(5) 2021 p.72-76

scholarly journals The spectrum of injuries resulting from posterior abdominal stab wounds: a South African experience

2015 ◽  
Vol 97 (4) ◽  
pp. 269-273 ◽  
Author(s):  
VY Kong ◽  
GV Oosthuizen ◽  
DL Clarke
Keyword(s):  
South African ◽  
High Volume ◽  
Multiple Organ ◽  
Organ Injury ◽  
Colonic Injury ◽  
Stab Wounds ◽  
African Experience ◽  
Trauma Service ◽  
Abdominal Stab Wounds ◽  
Observation Period

IntroductionThe spectrum of injury associated with anterior abdominal stab wounds (SWs) is well established. The literature on the spectrum of organ injury associated with SWs to the posterior abdomen, however, is limited.MethodsWe reviewed our experience of 105 consecutive patients who had established indications for laparotomy managed over a 4-year period in a high volume trauma service in South Africa.ResultsOf the 105 patients, 97 (92%) were male and the overall mean age was 24 years. Fifty-seven patients (54%) had immediate indications for laparotomy. The remaining 48 patients (46%) initially underwent active clinical observation and the indications for laparotomy became apparent during the observation period. Of the 105 laparotomies performed, 94 (90%) were positive and 11 (10%) were negative. Of the 94 positive laparotomies, 92 were therapeutic and 2 were non-therapeutic. A total of 176 organ injuries were identified: 50 (53%) of the 94 patients sustained a single organ injury while the remaining 44 (47%) sustained multiple organ injuries. The most commonly injured organs were the colon (n=63), spleen (n=21) and kidney (n=19).ConclusionsThe pattern of intra-abdominal injuries secondary to SWs to the posterior abdomen is different to that seen with the anterior abdomen. Colonic injury is most commonly encountered, followed by injuries to the spleen and kidney. Clinicians must remain vigilant because of the potential for occult injuries.

The CEO’s route to the top: The South African experience

2019 ◽  
Vol 38 (2) ◽  
pp. 103-120
Author(s):  
Chris Van Melle Kamp ◽  
Karl Hofmeyr ◽  
Mandla Adonisi
Keyword(s):  
South Africa ◽  
South African ◽  
Chief Executive ◽  
Senior Management ◽  
Childhood And Adolescence ◽  
Next Generation ◽  
Chief Executives ◽  
Leadership Challenges ◽  
African Experience ◽  
Depth Interviews

In this study we draw on a series of in-depth interviews with chief executives of some of South Africa’s most prominent businesses, to investigate how their careers unfolded as they rose to the top of their organisations.Twenty-seven CEOs of South Africa’s top companies were interviewed. Eleven of these companies are listed among the top 50 South African companies.We trace the evolution of leadership, from its embryonic beginnings in childhood and adolescence, through the different stages of a developing career to the crucial transformation of an operational mindset into a strategic one.We examine the circumstances that led to these CEOs being appointed and describe the difficulties of transitioning from a senior management role into that of chief executive. We look at the competencies and experience necessary to be effective as the leader of an organisation, as well as the role played by motivation and self-belief. Finally, we identify the unique leadership challenges faced by chief executives in South Africa and pass on their advice to the country’s next generation of leaders.

When Political Transitions Work

2018 ◽  
Author(s):  
Fanie du Toit
Keyword(s):  
South African ◽  
Well Being ◽  
Transition To Democracy ◽  
Political Transitions ◽  
Political Reconciliation ◽  
Peace Processes ◽  
Theoretical Approaches ◽  
African Experience ◽  
The One

Reconciliation emphasizes relationships as a crucial ingredient of political transition; this book argues for the importance of such a relational focus in crafting sustainable political transitions. Section I focuses on South Africa’s transition to democracy—how Mandela and De Klerk persuaded skeptical constituencies to commit to political reconciliation, how this proposal gained momentum, and how well the transition resulted in the goal of an inclusive and fair society. In developing a coherent theory of reconciliation to address questions such as these, I explain political reconciliation from three angles and thereby build a concept of reconciliation that corresponds largely with the South African experience. In Section II, these questions lead the discussion beyond South Africa into some of the prominent theoretical approaches to reconciliation in recent times. I develop typologies for three different reconciliation theories: forgiveness, agonism, and social restoration. I conclude in Section III that relationships created through political reconciliation, between leaders as well as between ordinary citizens, are illuminated when understood as an expression of a comprehensive “interdependence” that precedes any formal peace processes between enemies. I argue that linking reconciliation with the acknowledgment of interdependence emphasizes that there is no real alternative to reconciliation if the motivation is the long-term well-being of one’s own community. Without ensuring the conditions in which an enemy can flourish, one’s own community is unlikely to prosper sustainably. This theoretical approach locates the deepest motivation for reconciliation in choosing mutual well-being above the one-sided fight for exclusive survival at the other’s cost.

A five-year clinical audit of concussive injuries in South African collegiate male rugby players—a South African experience

2021 ◽  
Author(s):  
Lovemore Kunorozva ◽  
Riaan van Tonder ◽  
Lindsay Starling ◽  
James C. Brown ◽  
Pierre L. Viviers ◽  
...  
Keyword(s):  
South African ◽  
Clinical Audit ◽  
African Experience ◽  
Rugby Players ◽  
Concussive Injuries

scholarly journals Risk factors for antibiotic resistance development in healthcare settings in China: A systematic review

2021 ◽  
pp. 1-30
Author(s):  
Qi Chen ◽  
Duguang Li ◽  
Claudia Beiersmann ◽  
Florian Neuhann ◽  
Babak Moazen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Antibiotic Resistance ◽  
Resistance Development ◽  
Healthcare Settings

scholarly journals Vibrio cholerae Triggers SOS and Mutagenesis in Response to a Wide Range of Antibiotics: a Route towards Multiresistance

2011 ◽  
Vol 55 (5) ◽  
pp. 2438-2441 ◽  
Author(s):  
Zeynep Baharoglu ◽  
Didier Mazel
Keyword(s):  
Escherichia Coli ◽  
Antibiotic Resistance ◽  
Vibrio Cholerae ◽  
Fluorescent Protein ◽  
Resistance Development ◽  
Content Type ◽  
E Coli ◽  
Wide Range ◽  
Green Fluorescent ◽  
Regulated Promoters

ABSTRACTAntibiotic resistance development has been linked to the bacterial SOS stress response. InEscherichia coli, fluoroquinolones are known to induce SOS, whereas other antibiotics, such as aminoglycosides, tetracycline, and chloramphenicol, do not. Here we address whether various antibiotics induce SOS inVibrio cholerae. Reporter green fluorescent protein (GFP) fusions were used to measure the response of SOS-regulated promoters to subinhibitory concentrations of antibiotics. We show that unlike the situation withE. coli, all these antibiotics induce SOS inV. cholerae.

scholarly journals ALK inhibitors, resistance development, clinical trials

2018 ◽  
Vol 25 ◽  
pp. 59 ◽  
Author(s):  
J.M. Rothenstein ◽  
N. Chooback
Keyword(s):  
Clinical Trials ◽  
Patient Outcomes ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Current Treatment ◽  
Resistance Development ◽  
Ongoing Research ◽  
Alk Positive ◽  
Emergence Of Resistance ◽  
Key Questions

The treatment of advanced non-small-cell lung cancer (nsclc) has undergone a paradigm shift since the early 2000s. The identification of molecular subtypes of the disease, based on oncogenic drivers, has led to the development of personalized medicine and the ability to deliver molecularly targeted therapies to patients. In the 10 years that have elapsed since the discovery of the ALK gene in a patient with nsclc, several active drugs have moved rapidly from bench to bedside, and multiple others are currently in clinical trials. Those developments have led to important improvements in patient outcomes, while simultaneously raising key questions about the optimal treatment for ALK-positive nsclc. The inevitable emergence of resistance to alk-directed therapy is central to ongoing research and daily clinical practice for affected patients. In the present review, we highlight the current treatment landscape, the available and emerging clinical trials, and the evolving clinical decision-making in ALK-positive nsclc, with a focus on Canadian practice.

scholarly journals Selective non-operative management of abdominal stab wounds is a safe and cost effective strategy: A South African experience

2017 ◽  
Vol 99 (6) ◽  
pp. 490-496 ◽  
Author(s):  
KSS Dayananda ◽  
VY Kong ◽  
JL Bruce ◽  
GV Oosthuizen ◽  
GL Laing ◽  
...  
Keyword(s):  
Point Of Care ◽  
Cost Effective ◽  
Operative Management ◽  
Surgical Interventions ◽  
Stab Wounds ◽  
African Experience ◽  
Negative Laparotomy ◽  
Trauma Service ◽  
Abdominal Stab Wounds ◽  
Non Operative Management

INTRODUCTION Selective non-operative management (SNOM) of abdominal stab wounds is well established in South Africa. SNOM reduces the morbidity associated with negative laparotomies while being safe. Despite steady advances in technology (including laparoscopy, computed tomography [CT] and point-of-care sonography), our approach has remained clinically driven. Assessments of financial implications are limited in the literature. The aim of this study was to review isolated penetrating abdominal trauma and analyse associated incurred expenses. METHODS Patients data across the Pietermaritzburg Metropolitan Trauma Service (PMTS) are captured prospectively into the regional electronic trauma registry. A bottom-up microcosting technique produced estimated average costs for our defined clinical protocols. RESULTS Between January 2012 and April 2015, 501 patients were treated for an isolated abdominal stab wound. Over one third (38%) were managed successfully with SNOM, 5% underwent a negative laparotomy and over half (57%) required a therapeutic laparotomy. Over five years, the PMTS can expect to spend a minimum of ZAR 20,479,800 (GBP 1,246,840) for isolated penetrating abdominal stab wounds alone. CONCLUSIONS Provided a stringent policy is followed, in carefully selected patients, SNOM is effective in detecting those who require further intervention. It minimises the risks associated with unnecessary surgical interventions. SNOM will continue to be clinically driven and promulgated in our environment.

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