Browsing by Author "Labadarios, D."
Now showing 1 - 19 of 19
Results Per Page
Sort Options
- Item
- ItemEffect of 1% and 2% propofol on blood lipids during long-term sedation(Health & Medical Publishing Group, 2002) Coetzee, A.; Blaine, E. M.; Labadarios, D.; Schall, R.; Haus, M.Objectives. To compare the effects of 1% and 2% propofol on the maximum and average lipid levels, the relative frequency of hyperlipidaemia, the propofol dose required to achieve an equivalent degree of sedation, the pharmacodynamie effects at the required infusion rates, and the effect on respiratory function. Design. Open, randomised, parallel group, multicentre comparison study. Setting. Intensive care units (ICUs) at the Faculty of Medicine, University of Stellenbosch and at Vergelen Medicity, Somerset West. Subjects. Patients who were artificially ventilated for at least 72 hours in the ICUs and who required sedation or analgesia. Outcome measures. Continuous intravenous infusion of 1% or 2% propofol to provide an administration rate in the range of 1 - 4 mg/kg/h. The initial infusion rate was about 2 mg/kg/h, adjusted to achieve the appropriate level of sedation. Results and conclusions. Seventy-five patients were enrolled in the study, of which 72 were evaluable for safety analysis and 58 were evaluable for efficacy analysis. The total daily dose of propofol (ml/day) in the 2% propofol group was about 60% of that in the 1% propofol group, indicating that the lipid load in the 2% propofol group had only slightly more than half the lipid load in the 1% propofol group. Thirteen of 27 patients (48%) int 2% propofol group had abnormally high triglyceride levels compared with 19 of 31 patients (61%) in the 1% propofol group. Similarly, 1 of 22 patients (4%) in the 2% propofol group had lipaemia compared with 4 of 30 patients (13%) in the 1% propofol group. Abnormal cholesterollevels, alveolar-arterial oxygen tension gradient and daily percentage of time with desired sedation were comparable between the two groups. The observed incidence of raised plasma triglyceride concentrations, and of lipaemia, was lower in the 2% propofol group than in the 1% propofol group, although the differences were not statistically significant. The 2% formulation of propofol appears to be as effective and at least as safe as 1% propofol.
- ItemEstimating the burden of disease attributable to iron deficiency anaemia in South Africa in 2000(Health and Medical Publishing Group (HMPG), 2007-08) Nojilana, B.; Norman, R.; Dhansay, M. A.; Labadarios, D.; Van Stuijvenberg, M.E.; Bradshaw D.; South African Comparative Risk Assessment Collaborating GroupObjectives. To estimate the extent of iron deficiency anaemia (IDA) among children aged 0 - 4 years and pregnant women aged 15 - 49 years, and the burden of disease attributed to IDA in South Africa in 2000. Design. The comparative risk assessment (CRA) methodology of the World Health Organization (WHO) was followed using local prevalence and burden estimates. IDA prevalence came from re-analysis of the South African Vitamin A Consultative Group study in the case of the children, and from a pooled estimate from several studies in the case of the pregnant women (haemoglobin level < 11 g/dl and ferritin level < 12 μg/l). Monte Carlo simulation-modelling was used for the uncertainty analysis. Setting. South Africa. Subjects. Children under 5 years and pregnant women 15-49 years. Outcome measures. Direct sequelae of IDA, maternal and perinatal deaths and disability-adjusted life years (DALYs) from mild mental disability related to IDA. Results. It is estimated that 5.1% of children and 9-12% of pregnant women had IDA and that about 7.3% of perinatal deaths and 4.9% of maternal deaths were attributed to IDA in 2000. Overall, about 174 976 (95% uncertainty interval 150 344-203 961) healthy years of life lost (YLLs), or between 0.9% and 1.3% of all DALYs in South Africa in 2000, were attributable to IDA. Conclusions. This first study in South Africa to quantify the burden from IDA suggests that it is a less serious public health problem in South Africa than in many other developing countries. Nevertheless, this burden is preventable, and the study highlights the need to disseminate the food-based dietary guidelines formulated by the National Department of Health to people who need them and to monitor the impact of the food fortification programme.
- ItemFailure to thrive and its relationship to serum vitamin A levels and diet(Health & Medical Publishing Group, 1995) Donald, P. R.; Shires, J.; Langenhoven, M. L.; Van Staden, E.; Labadarios, D.Serum vitamin A and retinol-binding protein (REP) levels were determined in a group of 34 children between 1 and 4 years of age with failure to thrive and in 34 age- and sex-matched controls. Both groups of children were also assessed in respect of anthropometry and diet. Vitamin A levels in patients (0-32,2 μg/100 ml; median 16,9 μg/100 ml) did not differ significantly from controls (6,4-47,2 μg/100 ml; median 16,1 μg/100 ml). Fourteen patients (42%) and 4 controls (12%) had vitamin A levels below 10 μg/100 ml. RBP levels in patients (0.45-3,50 mg/100 ml; median 2,17 mg/100 ml) also did not differ significantly from those in controls (1,21-3,66 mg/100 ml; median 2.06 mg/100 ml). No clinical features of vitamin A deficiency were detected. Weight and height for age, weight for height, mid-upper arm circumference and head circumference differed significantly between patients and controls (P < 0.0001 in each instance). Although within the recommendations for intake, patients had a significantly lower intake of the essential fatty acid C 18:2 (N=6) (linoleic acid) and vitamin A. In view of the current proposed relationship between vitamin A status and infectious diseases, the prevalence of biochemical vitamin A deficiency in children in the Cape Town community studied may contribute to the morbidity and mortality associated with infectious diseases in the area to a greater degree than has been suspected.
- ItemHousehold food security - What health professionals should know(Health & Medical Publishing Group, 1998) Steyn, N. P.; Robertson, H.-L.; Mekuria, M.; Labadarios, D.Objectives. To determine national food security (availability) from national food production and consumption data and to compare 'available' consumption data with actual consumption data obtained from dietary surveys in order to predict household food security. Design. Survey of the literature and calculations from South African food balance sheets. Methods. Data were obtained from reports and food balance sheets published by the Department of Agriculture's Directorate of Agricultural Economic Trends, the Development Bank of Southern Africa and the World Bank. Food available for individual consumption was calculated (production minus animal feed minus export and import) and compared with actual consumption data derived from dietary surveys published locally. Results. Findings indicate that the growth rates of staple foods and livestock over the last 23 years are lower than the population growth rate. The average available daily energy is 9 772 kJ and the protein content is 66.8 g as calculated from food balance sheets. However, dietary surveys indicate that urban and rural blacks have considerably lower energy intakes, indicating poor household food security. Mean daily energy intakes were found to be 7 345 kJ for urban, and 7 130 kJ for rural black South Africans. Conclusion. We recommend that research focus on causes of food insecurity in order to implement effective intervention programmes. It is essential that such research be multidisciplinary and include agriculturalists, health professionals and social scientists.
- ItemLack of a relationship between plasma pyridoxal phosphate levels and ischaemic heart disease(Health and Medical Publishing Group (HMPG), 1985-04) Rossouw, J. E.; Labadarios, D.; Jooste, P. L.; Shephard, G. S.The 'vitamin B6-homocysteine theory' has been proposed as an alternative to the widely accepted lipid hypothesis in the aetiology of ischaemic heart disease (IHD). In a cross-sectional study of 71 white men with evidence of IHD and 110 male controls (all aged 45-54 years) we have been unable to demonstrate any differences in plasma pyridoxal phosphate (PLP) levels between the groups. It is therefore unlikely that deficiency of vitamin B6 has a primary causal role in development of IHD. However, 31% of the overall study population had low plasma PLP levels, and the possibility that underlying vitamin B6 deficiency may facilitate the actions of the primary risk factors for IHD therefore cannot be excluded.
- ItemLow plasma pyridoxal-5'-phosphate levels in children with the nephrotic syndrome(Health & Medical Publishing Group, 1985) Van Buuren, A. J.; Shephard, G. S.; Labadarios, D.Of 35 children with the nephrotic syndrome in relapse, 88% were found to have low circulating plasma pyridoxal-5'-phosphate (PLP) levels. Remission of the syndrome was associated with spontaneous normalization of plasma PLP levels in 23 such children. A significant (P < 0.001) positive correlation (r = 0.81) was found between plasma albumin and PLP levels and a significant (P < 0.001) negative correlation (r = -0.66) between plasma PLP and serum cholesterol levels. The low plasma PLP levels may be due to enhanced urinary excretion of albumin-bound PLP in view of the severe proteinuria which characterizes the nephrotic syndrome.
- ItemMalnutrition in the developing world: The triple burden(2005) Labadarios, D.[No abstract available]
- ItemNutrition related knowledge and practices of hypertensive adults attending hypertensive clinics at day hospitals in the Cape Metropole(AOSIS Publishing, 2004-05) Becker, H.; Bester, M.; Reyneke, N.; Labadarios, D.; Monyeki, K. D.; Steyn, N. P.The aim of this study was to determine nutrition knowledge and dietary practices of hypertensive adults attending hypertensive clinics at Day Hospitals in the Cape Metropole. Ten Day Hospitals were randomly selected from a total of 31 Day Hospitals and the first participants attending the hypertension clinics per day were recruited. A total of 85 participants were evaluated. The weight, height, waist and hip circumference of each participant was measured, as well as their blood pressure. Knowledge of dietary intake was obtained by completing a questionnaire, during an interview with the patient. Knowledge regarding salt usage indicated that a large percentage (34.1 %) of participants believed that flavour enhancers like Aromat or Fondor could safely be used instead of table salt. Furthermore, 23.5% reported that tinned and smoked meat or fish have a low sodium (salt) content. Fruit and vegetables were perceived as having a positive effect on hypertension by 74.1 % of participants. However, only 15% of the group knew that the recommendation for their usage was five or more servings per day. Only 12.9% of participants in this study had a normal weight (body mass index (BMI) < 25), 25.9% were overweight (BMI 25 - 29.9) and 61.2% were obese (BMI ^30); 84.7% recognized the association between obesity and hypertension. A large waist circumference (> 88 cm in women; 102 cm in men) was found in 61.2% of participants, however, only 18.2% of black men had such a measurement. Uncontrolled blood pressure readings (> 140/90 mm Hg) were found in 61.2% of these patients at the hypertension clinics.
- ItemNutritional composition of South African eggs(Health & Medical Publishing Group, 1994) Herselman, M. G.; Blaauw, Renee; Labadarios, D.; Langenhoven, M. L.; Kruger, M.We congratulate Van Niekerk and Van Heerden on their excellent study on the nutritional composition of South African eggs,' in which they show that the cholesterol content of South African eggs is 23,5% lower than the values listed in the NRlND Food Composition Tables. The anicle raises a number of imponant issues that should be addressed.
- ItemNutritional status of renal transplant patients(Health & Medical Publishing Group, 2002) Du Plessis, A. S.; Randall, H.; Escreet, E.; Holl, M.; Conradie, M.; Moosa, M. R.; Labadarios, D.; Herselman, M. G.Objective. To assess the effect of renal transplantation on the nutritional status of patients. Design. Prospective descriptive study. Setting. Renal Transplant Clinic at Tygerberg Hospital, Western Cape. Subjects. Fifty-eight renal transplant patients from Tygerberg Hospital were enrolled in the study. The sample was divided into two groups of 29 patients each: group 1, less than 28 months post-transplant; and group 2, more than 28 months post-transplant. Outcome measures. Nutritional status assessment comprised biochemical evaluation, a dietary history, anthropometric measurements and a clinical examination. Results. Serum vitamin B6 levels were below normal in 56% of patients from group 1 and 59% from group 2. Vitamin B6 intake, however, was insufficient in only 14% of patients from group 1 and 10% from group 2. Serum vitamin C levels were below normal in 7% of patients from group 1 and 24% from group 2, while vitamin C intake was insufficient in 21% and 14% of patients from groups 1 and 2 respectively. Serum magnesium levels were below normal in 55% of patients from group 1, and in 28% from group 2. Serum albumin and cholesterol levels increased significantly during the post-transplant period in the total sample (P = 0.0001). There was also a significant increase in body mass index (P = 0.0001) during the post-transplant period. Conclusions. Several nutritional abnormalities were observed, which primarily reflect the side-effects of immunosuppressive therapy. The causes, consequences and treatment of the vitamin B6 and vitamin C deficiencies in renal transplant recipients need further investigation.
- ItemPlasma vitamin A, E, C and B6 levels in myocardial infarction(Health & Medical Publishing Group, 1987-5) Labadarios, D.; Brink, P. A.; Weich, H. F. H.; Visser, L.; Louw, M. E. J.; Shephard, G. S.; Van Stuijvenberg, M. E.ENGLISH ABSTRACT: Vitamin A, E, C and B6 status was studied in 30 patients with myocardial infarction and in 19 age- and sex-matched patients after elective surgery or trauma. Plasma levels of the four vitamins studied were low, remained low or decreased transiently in both groups of patients during the acute catabolic response phase, and began to return to normal after the third day from the start of the catabolic response. These changes in plasma levels are therefore neither of any special pathophysiological importance in nor specific to myocardial infarction.
- ItemPlasma vitamin E values in the newborn(Health & Medical Publishing Group, 1984) Labadarios, D.; Shephard, G. S.; Green, J.Plasma vitamin E values of newborn infants in a coloured population of Cape Town have been determined. The mean plasma α-tocopherol value was 3,2 ± 0,8 mg/l. A significant correlation between the plasma α-tocopherol level and plasma total lipid content (r = 0.45; P<0,001) and plasma cholesterol level (r = 0,65; P<0,001) has been found. However, maternal and neonatal plasma vitamin E levels were unrelated.
- ItemA rapid method of monitoring the acute phase response in a rat model(Health & Medical Publishing Group, 1997) Moodie, I. M.; Labadarios, D.The acute phase response (APR) is accompanied by major changes in micronutrient status. It is important to be able to quantitate the degree of APR, which can then be related to the accompanying alterations in micronutrient levels. A rapid and convenient means of achieving this, viz. the use of an animal model in which APR can be induced, would facilitate such an investigation. The aim of the present study was to establish, by means of a rat model, a rapid procedure to identify APR which is less time-consuming and less expensive than the more traditional enzyme-linked immunosorbent assay and radioimmunoassay. Blood was drawn immediately prior to, and at 24, 48, 72 and 96-hour intervals post-inducement of the acute phase. The serum was deproteinised and treated with a dye, Auramine O, which specifically binds the acute phase protein α1-acid glycoprotein (AAG), the latter remaining in solution after deproteinisation. The product formed is a fluorescent addition compound. With fluorescence spectrophotometry, levels of AAG were determined and the extent of APR monitored. A progressive and reproducible increase in AAG was observed, the highest fluorescence intensity recorded after 48 hours; this indicated a mean value (N = 5) of 9.4 mg/ml from zero at baseline. With a spiking approach, a mean AAG recovery of 96% was obtained. The validated methodology, less expensive and less time-consuming than existing procedures, which rapidly detects AAG in rat serum, provides a simple technique for monitoring the APR process in these animals.
- ItemSouth African Nutrition Congress 1992(Health & Medical Publishing Group, 1992) Labadarios, D.; Venter, C. S.Report on the South African Nutrition Congress 1992.
- ItemThiamine deficiency-induced gestational polyneuropathy and encephalopathy : a case report(Health & Medical Publishing Group, 1985) Nel, J. T.; Van Heyningen, C. F.; Van Eeden, S. F.; Labadarios, D.; Louw, N. S.A 22-year-old multigravida presented with polyneuropathy and encephalopathy at 18 weeks' pregnancy. After excluding other applicable conditions, the diagnosis of a hyperemesis-induced thiamine deficiency was made. With the necessary vitamin supplementation the patient gradually recovered over a period of 4 months and was delivered of a normal infant at term. Gestational polyneuropathy and encephalopathy due to thiamine deficiency has very rarely been reported. The literature is reviewed with discussion of the differential diagnosis, the treatment and the prognosis.
- ItemVitamin A : time for action(Health & Medical Publishing Group, 1994) Labadarios, D.In the last decade, it has become apparent that vitamin A, apart from its function in vision, is also essential for child health and survival.
- ItemWanvoeding in drie hospitaalbevolkings(HMPG, 1981-08) Labadarios, D.; Rossouw, J. E.A disturbingly high incidence of malnutrition has been found in patients with chronic liver disease, in patients with renal failure on chronic haemodialysis, and in the elderly. The aetiology of malnutrition would appear to be variable, and nutrient requirements may furthermore be disease-specific. The recognition and amelioration of malnutrition in chronic disease states should form an integral part of the overall patient management.
- ItemWho is the nutrition workforce in the Western Cape?(2011) Goeiman, H. D.; Labadarios, D.; Steyn, N. P.; Titus, S.Objectives: The aim of the present study was to determine the current nutrition staffing profile of the Integrated Nutrition Programme (INP) in Department of Health in the Western Cape, and establish whether it is adequate to meet the objectives of the INP. Method: Self-administered questionnaires compiled in English were used as the main data collection instrument for nutrition staff in districts and at hospitals (n = 647). Eight individual questionnaires, one per staff category, were developed and utilised in the study. Results: Foodservice workers were the largest group of nutrition personnel (n = 509; 79%), followed by dietitians (n = 64; 10%), managers (n = 31; 5%), auxiliary workers (n = 28; 4%), and administrative workers (n = 15; 2%). Sixty-two per cent of the nutrition workforce was located in urban areas and 38% in rural districts. Hospital and district dietitians experienced common problems, as well as specific differences. Regarding problems, both categories referred to limited resources, inadequate number of available posts, and lack of acknowledgement and support from administrative and supply chain management. District dietitians were also hampered by lack of space for consultations, poor referrals from doctors, insufficient posts for nutrition advisers, and difficulty in communicating with Xhosa-speaking patients. Hospital dietitians were hampered by insufficient interaction with district dietitians and lack of dietitians for specialised units. They also mentioned that poor salaries were affecting morale. Conclusion: Recommendations such as additional posts for dietitians, improved conditions of service and salaries, increased advocacy for nutrition, and a number of human resources recommendations were made, and should be considered if the INP objectives are to be met.