Browsing by Author "Akudugu, John"
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- ItemDiagnostic reference levels for paediatric computed tomography(AOSIS Publishing, 2015-11-30) Vawda, Zakariya; Pitcher, Richard; Akudugu, John; Groenewald, WillemObjectives: To establish local diagnostic reference levels (LDRLs) for emergency paediatric head computed tomography (CT) scans performed at a South African (SA) tertiary-level hospital and to compare these with published data. Materials and methods: A retrospective analysis was conducted of volume-based CT dose index (CTDIvol) and dose length product (DLP) data from uncontrasted paediatric head CT scans performed in the Trauma and Emergency Unit of a tertiary-level SA hospital from January to June 2013. A random sample of 30 patients in each of 3 age groups (0–2, >2–5 and >5–10 years) was used. LDRL values were compared with several national DRLs from Europe and Australia. Results: Mean CTDIvol and DLP values were: 30 mGy and 488 mGy.cm for the 0–2 years age group; 31 mGy and 508 mGy.cm for the >2–5 years group, and 32 mGy and 563 mGy.cm for the >5–10 years group, respectively. The mean DLP for 0–2 year-olds was the only parameter outside the range of corresponding published reference data. Stratification into narrower age groupings showed an increase in DLP values with age. Conclusion: An institutional review of the head CT scanning technique for emergency studies performed on children less than 2 years of age is recommended. The current study highlights the role of LDRLs in establishing institutional dosimetry baselines, in refining local imaging practice, and in enhancing patient safety. Standard age stratification for DRL and LDRL reporting is recommended.
- ItemA multi-parameter approach for predicting prostate cancer(Cogent OA, 2017) Serafin, Antonio; Chinhengo, Angela; Fernandez, Pedro; Akudugu, JohnUrokinase plasminogen activator (uPA) and its inhibitor (PAI-1) have shown to be of merit as biomarkers for a variety of cancers. The objective of this project was to assay for uPA and PAI-1 in prostate needle biopsy tissue from 217 patients using the FEMTELLE enzyme linked immunosorbent (ELISA) assay, and to examine the robustness of PAI-1 as a candidate marker in benign prostatic hyperplasia (BPH) and prostate cancer (PCa), as previously identified in a different cohort of 111 patients. These results validate the assertion that PAI-1 levels of >4.5 ng mg−1 protein in prostate biopsies are indicative of prostate malignancy in elderly men, but further show that tissue from BPH patients in the 70–80 year age interval express significantly high levels of this marker. To address this anomaly, a malignancy index, derived from the concentrations of prostate-specific antigen (PSA), uPA, and PAI-1, and patient age is proposed. This simple index discriminates prostate tissue from BPH and PCa patients with concordance indices of 0.59 and 0.69 when tissues are taken as biopsy or transurethral resection of the prostate (TURP), respectively. Corresponding indices for PSA as a predictor of prostate disease were 0.67 and 0.73. Further evaluation of the proposed malignancy index using specimens, such as venous blood, could prove valuable in the search for non-invasive predictive assays.