SUNScholar - Browsing by Author "Lombard, C. J."

Browsing by Author "Lombard, C. J."

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Association of deworming with reduced eosinophilia : implications for HIV/AIDS and co-endemic diseases
(Academy of Science of South Africa, 2003-04) Fincham, J. E.; Markus, M. B.; Adams, V. J.; Lombard, C. J.; Bentwich, Z.; Mansvelt, E. P. G.; Dhansay, M. A.; Schoeman, S. E.
Eosinophil counts in venous blood were monitored during a randomized controlled deworming trial (n = 155 children) that lasted for a year, and in a whole-school deworming programme (range 174-256 children) of 2 years' duration. Mean eosinophil counts (x109/I) decreased from 0.70 in the randomized trial, and 0.61 in the whole-school study, to well within the normal paediatric range of 0.05-0.45 (P < 0.05). The prevalence of eosinophilia declined from 57% to 37% in the randomized trial (mean for 400, 800 and 1200 mg albendazole doses); and from 47% to 24% in the whole-school study (500 mg stat mebendazole). Benzimidazole anthelminthics were highly effective against Ascaris but less so against Trichuris. Activated eosinophils are effector and immunoregulatory leucocytes of the T-helper cell type 2 (Th2) immune response to parasitic helminths and atopic disorders. Under conditions of poverty where soil-transmitted helminths are hyperendemic, Th2 polarization of the immune profile is characteristic. Regular anthelminthic treatment should reduce contact with worm antigens, and this may contribute to re-balancing of the immune profile. Suppression of eosinophil recruitment and activation, together with related cellular and molecular immunological changes, might have positive implications for prevention and treatment of co-endemic diseases, including HIV/AIDS, cholera, tuberculosis and atopic disorders.
Comparison between umbilical artery and vein endogenous digoxin-like immuno-active factor levels in normal and pre-eclamptic patients
(Health & Medical Publishing Group, 1991) Schabort, I.; Odendaal, H. J.; Lombard, C. J.; Bredell, L.
Recent studies have pointed to the existence of an endogenous digoxin-like immuno-active factor (DLIF), which may be associated with hypertension and pre-eclampsia. The DLIF levels in the umbilical venous and umbilical arterial blood of neonates, as well as the maternal serum of primigravidas and multigravidas with and without pre-eclampsia, were determined by means of a commercially available radioimmunoassay kit, which is cross-reactive with DLIF, in 44 mothers and their babies in search for a possible placental, fetal or maternal origin of the DLIF. The mean placental and neonatal masses were significantly lower in the pre-eclampsia group than in the control group (P < 0,01). However, the DLIF levels in the maternal serum, umbilical cord venous and umbilical cord arterial serum were statistically significantly higher in the pre-eclampsia group than in the control pregnant group (P < 0,05). A very strong correlation was found between umbulical cord venous and arterial DLIF levels (r = 0,90; P = 0,001, Spearman rank-correlation coefficient). Although the mean DLIF level in cord arterial serum was lower than that of cord venous serum, statistical significance was not reached if the Bonferroni adjustment was applied to the P value.
The development of one- and two-cell mouse embryos in the absence of human serum
(Health & Medical Publishing Group, 1986) Kruger, T. F.; Stander, F. S. H.; Smith, K.; Lombard, C. J.
One- and two-cell embryos were obtained from F1 hybrid female mice stimulated with human menopausal gonadotrophin and randomly distributed into two groups - group 1 (no serum) and group 2 (10% patient's serum). Fifty of 53 (94.3%) one-cell embryos in group 1 had cleaved to the blastocyst stage and 44 of 49 (89.79%) in group 2 after 96 hours (no significant difference - chi-square test). In the two-cell embryos in group 1, 78 of 89 (87.6%) reached the blastocyst stage after 72 hours and 80 of 86 (93.02%) in group 2 (no significant difference - chi-square test). According to microscopic evaluation cleavage to the blastocyst stage without serum supplementation is possible. The value of serum is discussed.
Factors affecting pregnancy outcome in a gamete intrafallopian transfer (GIF) programme
(Health & Medical Publishing Group, 2003-07) De Bruijn, J. M.; Kruger, T. F.; Van der Merwe, J. P.; Stander, F. S. H.; Lombard, C. J.
Objective. To identify the factors that most significantly affected pregnancy rates in a gamete intrafallopian transfer (GIFT) programme. Methods. A total of 863 GIFT cycles were analysed retrospectively. The variables found to be associated significantly with pregnancy were then used to obtain multivariate analysis using logistical regression. Results. Overall and ongoing pregnancy rates were significantly better in patients ≤ 38 years than in patients > 38 years (37.3% and 28.4% v. 23.7% and 11.0% respectively), and age was positively associated with success after GIFT (odds ratio (OR) 1.87, 95% confidence interval (CI): 1.22 - 2.85). Metaphase I (MI) oocytes were negatively associated with pregnancy (OR 1.54, 95% CI: 0.28 - 1.04). The highest pregnancy rates occurred when 3 metaphase II (MII) oocytes were transferred (39.8%, OR 7.51, 95% CI: 1.74 - 32.42). With regard to sperm morphology, overall pregnancy rates of 25.5% (≤ 4% normal forms) and 37.2% (> 4% normal forms) were obtained. Morphology of > 4% normal forms was positively associated with pregnancy (OR 1.58, 95% CI: 1.04 - 2.42). Conclusion. The results of this study suggest that the most important factors influencing pregnancy rates in a GIFT programme are the woman's age and those factors pertaining to the characteristics of the gametes. Considering the emotional and financial costs it is important to relate this information to all prospective participants in a GIFT programme.
Global shortages of BCG vaccine and tuberculous meningitis in children
(Elsevier, 2019) Du Preez, K.; Seddon, J. A.; Schaaf, H. S.; Hesseling, A. C.; Starke, J. R.; Osman, M.; Lombard, C. J.; Solomons, R.
ENGLISH ABSTRACT: No abstract available.
The incidence of melanoma in South Africa : an exploratory analysis of National Cancer Registry data from 2005 to 2013 with a specific focus on melanoma in black Africans
(Health & Medical Publishing Group, 2019-03-29) Tod, B. M.; Kellett, P. E.; Singh, E.; Visser, W. I.; Lombard, C. J.; Wright, C. Y.
Background. Melanoma is an aggressive skin cancer with poor survival when diagnosed late. There are important differences in clinical and histological features of melanoma and disease outcomes in people with darker skin types. Methods. A retrospective review of data captured by the National Cancer Registry (NCR) of South Africa (SA) was performed for 2005 - 2013. Data on patient numbers, demography, location and biological features were analysed for all records. Closer analysis of melanoma of the limbs reported in black Africans was done after manually collecting this information from original reports. Results. With 11 784 invasive melanomas reported to the NCR, the overall incidence of melanoma for SA was 2.7 per 100 000. Males (51%), individuals aged ≥60 years (48%) and the anatomical sites of lower limb (36%) and trunk (27%) were most commonly affected. Melanoma incidences in the white and black populations were 23.2 and 0.5 per 100 000, respectively. Most cases were diagnosed at private pathology laboratories (73%). Superficial spreading melanoma (47%) and nodular melanoma (20%) predominated. Among 878 black Africans diagnosed in the public sector with melanoma of the limbs, females (68%) and individuals aged ≥60 years (61%) were most commonly affected. Lower-limb lesions (91%) and acral lentiginous melanoma (65%) predominated, with 74% of cases affecting the foot and 62% of cases presenting with a Breslow depth >4 mm. Conclusions. This study provides up-to-date NCR incidence and demographic data on melanoma and highlights the neglected research gaps in relation to melanoma in black Africans to provide evidence needed to address health disparities in overlooked population groups.
Management of incomplete abortions at South African public hospitals
(Health & Medical Publishing Group, 1997) Fawcus, S.; McIntyre, J.; Jewkes, R. K.; Rees, H.; Katzenellenbogen, J. M.; Shabodien, R.; Lombard, C. J.; Truter, H.; Cronje, H.; Duminy, P.; Marivate, M.; Moodley, J.; Pattinson, B.
Objective. The objective of this report was to review and describe the management of incomplete abortion by public sector hospitals. Design. A descriptive study in which data were collected prospectively from routine hospital records on all women admitted with incomplete abortion to a stratified random sample of hospitals between 14 and 28 September 1994. Setting. Public sector hospitals in South Africa. Patients. Women with incomplete abortions. Main outcome measures. Length of hospital stay, details of medical management, details of surgical management, determinants of the above. Main results. Data were collected on 803 patients from the 56 participating hospitals. Of these, 767 (95.9%) were in hospital for 1 day or more, and 753 (95.3%) women underwent evacuation of the uterus. Sharp curettage was the method employed in 726 (96.9%) and general anaesthesia was used for 601 (88%) of the women requiring uterine evacuation. Antibiotics were prescribed for 396 (49.5%) and blood transfusions were administered to 125 (17%) women. Statistical analysis showed length of stay to be longer in small hospitals (under 500 beds) and when the medical condition was more severe. Antibiotic usage and blood transfusion were more common with increasing severity and a low haemoglobin level on admission. However, some inappropriate management was identified with regard to both. Main conclusions. It is suggested that uncomplicated incomplete abortion can be more effectively and safely managed using the manual vacuum aspiration technique with sedation/analgesia as an outpatient procedure. Attention should be directed at the introduction of this management routine at all types of hospital and to the ensuring of appropriate management of women with complicated abortion.
Masking through averages - intraprovincial heterogeneity in HIV prevalence within the Western Cape
(Health & Medical Publishing Group, 2006) Shaikh, N.; Abdullah, F.; Lombard, C. J.; Smit, L.; Bradshaw, D.; Makubalo, L.
Objective. To measure HIV prevalence at health-district level in the Western Cape (WC) and to compare these findings with those of the National HIV Antenatal Surveys (NHASs). This investigation aimed to estimate the degree of heterogeneity of HIV prevalence within the province in order to inform the design of appropriate and targeted HIV interventions. Method. Annual cross-sectional, unlinked district HIV antenatal surveys were implemented in all 25 health districts of the WC for the years 2001 - 2004, concurrently with the NHAS. A stratified proportional sample was drawn for each district, involving all 344 antenatal clinics in the province, and the anonymous screening method as described by the World Health Organization (WHO) was applied. Results. The NHAS revealed a significant increase in HIV prevalence in the WC from 8.6% (95% confidence interval (CI): 5.6 - 11.6) in 2001 to 15.4% (95% CI: 12.5 - 18.2) in 2004. The district-level HIV surveys showed wide variation in HIV prevalence across the health districts, which increased progressively during this period (a range of 0.6 - 22% for the year 2001 increased to 1 - 33% in 2004). Spatial analysis of HIV prevalence by health district for this period also revealed progressive spatial growth of the sub-epidemics, with the highest prevalence observed in districts located in the Cape metropole region. Conclusions. These concurrent surveys highlight the fact that examining a provincial estimate of HIV prevalence alone has the potential to mask epicentres within the province. This underscores the importance of expanding the surveillance systems to detect heterogeneity sub-provincially, in order to link with local-level planning and resource allocation.
'n Ondersoek na die jeugtoneel met betrekking tot die eietydse adolessent
(Stellenbosch : Stellenbosch University, 1974-12) Lombard, C. J.; Le Roux, F. J.; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Drama.
ENGLISH ABSTRACT: No abstract available
Osmolarity studies with different containers and volumes in a human in vitro fertilization programme
(Health and Medical Publishing Group (HMPG), 1985-10) Kruger, T. F.; Stander, F. S. H.; Menkveld, R.; Lombard, C. J.
[No abstract available]
Ovulasie-induksie vir in vitro-bevrugting in Tygerberg-hospitaal
(Health & Medical Publishing Group, 1987) Van der Merwe, J. P.; Kruger, T. F.; Lombard, C. J.; Muller, L. M. M.
The protocol for in vitro fertilisation (IVF) at Tygerberg Hospital is presented and the results are analysed. Indications for ovulation induction for IVF included the following: (a) irreversible tubal damage; (b) infertility due to immunological factors; (c) male factor - infertility; and (d) endometriosis. A combination of human menopausal gonadotrophin (HMG) and clomiphene citrate (Clomid; Mer-National) and human chorionic gonadotrophin was used. Clomid is given in dosages of 100 mg for 5 days depending on the cycle length. Three doses of HMG (150 IU) are given on alternate days, starting on the second day of clomiphene treatment. If the leading follicle has not reached a mean diameter of 14 mm the day after the last HMG dose, another dose is given. This dosage is continued until the leading follicle reaches a diameter of 14 mm. A total of 109 cycles in 100 patients was analysed. Ova were considered to be mature as soon as the dominant follicle had reached a sonographic average diameter of 18 mm, another two follicles of 16 mm average diameter being present. Serum luteinising hormone levels were determined 4-hourly from the stage when the leading follicles exceeded an average diameter of 14 mm. In this study the pregnancy rate was 21.3% per laparoscopy and 24,4% per embryo transfer. The oestradiol levels on the 5th day of treatment have a predictive value of the length of stimulation.
Risk factors for the development of osteoporosis in a South African population. A prospective study
(Health & Medical Publishing Group, 1994) Blaauw, Renee; Albertse, E. C.; Beneke, T.; Lombard, C. J.; Laubscher, R.; Hough, F. S.
Despite the vast number of risk factors that apparently predispose to the development of osteoporosis (OP), they have not been accurately identified and given relative priority. In order to analyse possible risk factors prospectively in a local patient population with overt OP (histomorphometrically confirmed and characterised) and compare it with an appropriately matched non-OP control group (with normal bone mass on dual-energy X-ray absorptiometry), a detailed general history, risk factor analysis, dietary history and anthropometric data were obtained from 56 OP and 125 non-OP subjects. In females a positive family history of OP (P = 0,002), a fair complexion (P = 0,009), lower body mass (P = 0,02) and height (P = 0,03), no breast-feeding of babies (P = 0,006), a history of smoking (P = 0,001) and fat distribution around the waist (P = 0,009) were idenfified as risk factors. In males lack of exercise (P = 0,008), a history of smoking (P = 0,01), lower body mass (P = 0,04) and height (P = 0,04), a preference for salty food (P = 0,02) and fat distribution around the waist (P = 0,002) appeared to predispose. Dietary calcium, phosphorus, protein and caffeine intakes were similar in OP and control subjects, but alcohol consumption was clearly higher in both OP males (P = 0,001) and females (P = 0,01).
Self-induced vomiting : risk for oesophageal cancer?
(Health & Medical Publishing Group, 2006-03) Matsha, T.; Stepien, A.; Blanco-Blanco, E.; Brink, L. T.; Lombard, C. J.; Van Rensburg, S.; Erasmus, R. T.
Background. Chronic inflammation of the oesophagus is considered a precursor condition for the development of oesophageal cancer. Identification of the causes of chronic oesophageal irritation is therefore relevant in developing preventive measures. Self-induced vomiting is a cultural practice among the black population of South Africa, particularly those living in the Transkei, a region reported to have one of the highest incidences of oesophageal cancer worldwide. Methods. We retrospectively examined the association between the practice of self-induced vomiting and the development of cytological features of inflammation in 478 self-selected subjects living in Transkei who underwent early screening for oesophageal cancer. Screening involved brush biopsy, cytological investigation and a questionnaire interview. Results. The prevalence of self-induced vomiting was 80.5% and 79.1% in males and females, respectively, and this was stable across all ages. Furthermore, self-induced vomiting was found to be significantly and independently associated with oesophageal chronic inflammation (odds ratio 1.83, 95% confidence interval: 1.13 - 2.96, p = 0.013). Conclusion. While the association between the cultural practice of self-induced vomiting and oesophageal cancer has previously been hypothesised, this is the first study to report on an association between this practice and oesophageal chronic inflammation. Further studies that take into account the method used, frequency and duration of vomiting, age of commencement and fasting state of subjects practising self-induced vomiting coupled with accurate indicators of inflammation are needed to elucidate the role of self-induced vomiting in oesophageal pathogenesis.
Standards for the assessment of visual evoked potentials in an ethnically heterogeneous adult population
(Health and Medical Publishing Group -- HMPG, 1985-02) De Graaf, A. S.; Lombard, C. J.; Hart, G. L.
Visual evoked potentials (VEPs) were recorded by chequerboard pattern-reversal stimulation in 276 normal adult subjects aged 15-73 years. The sample comprised comparable white, coloured and black groups of both sexes. Significantly shorter latencies of the major positive component were found in both male and female black subjects compared with those in whites. No significant differences were found between the amplitudes in the different population groups, but females in each population group showed significantly higher amplitudes of the major positive component than males. There was a close relationship between latency and amplitude for both right and left eyes. Except in coloured females, a nonlinear relationship of the major positive component with age was demonstrated, the shortest latency being at about 35 years of age. It is suggested that the following criteria be used in the evaluation of VEP recordings: latency as well as the difference between latencies and amplitudes of the two sides of the major positive component (P1) as compared with standardized values for ethnic, sex and age groups.
Supplemented low-protein diets : are they superior in chronic renal failure?
(Health & Medical Publishing Group, 1995) Herselman, M. G.; Albertse, E. C.; Lombard, C. J.; Swanepoel, C. R.; Hough, F. S.
Twenty-two patients with chronic renal failure were randomly assigned to a conventional low-protein diet containing 0,6g protein/kg/day or a very-low-protein diet containing 0,6g protein/kg/day supplemented with essential amino acids; they were followed up for 9 months. There were no significant changes in body mass index, arm muscle area, percentage body fat, serum albumin and transferrin levels in any of the groups; neither was there any difference between the groups in respect of these parameters. Renal function, as measured by the reciprocal of serum creatinine over time, stabilised in both groups during intervention, with no significant difference between the groups. There was however no correlation between changes in renal function and changes in blood pressure, or dietary intake of protein, phosphorus, cholesterol, polyunsaturated and saturated fatty acids. There were also no significant changes and no significant differences between the groups in serum levels of parathyroid hormone and alkaline phosphatase, urine cyclic adenosine monophosphate, tubular reabsorption of phosphate, and the theoretical renal threshold for phosphate. The results of this study suggest that the supplemented very-low-protein diet was not superior to the conventional low-protein diet in terms of its effect on protein-energy status, renal function and biochemical parameters of renal osteodystrophy.
Surgical treatment of endometriosis before gamete intrafallopian transfer (GIFT)
(Health & Medical Publishing Group, 2007) Van der Merwe, J. P.; Kruger, T. F.; Lombard, C. J.
Objective. To determine whether active pelvic endometriosis impairs the efficacy of GIFT (gamete intrafallopian transfer) and whether prior surgical treatment of endometriosis improves the efficacy of GIFT. Design. Matched controlled retrospective study. Setting. University-based assisted reproduction programme. Patients. Patients who had GIFT between 1990 and 1997 were included in the study. Female patients were laparoscopically diagnosed as having endometriosis. Patients who did not have surgical treatment for endometriosis before GIFT were staged for endometriosis during the GIFT laparoscopy. Two patients, with no signs of endometriosis, were matched for every endometriosis case, and served as controls. Patients were matched for age, number of eggs transferred and percentage of normal sperm morphology. Intervention. Patients in 80 cycles had surgical treatment for endometriosis and 128 patients had GIFT procedures as treatment for endometriosis-related infertility. Main outcome measures. Ongoing pregnancies and deliveries. Statistical analysis. A Mantel-Haenszel approach was used to estimate relative risk of pregnancy outcome in the endometriosis groups versus controls. Results. There was a 22.9% pregnancy rate (11/48) among patients with active endometriosis who had GIFT procedures, versus a 37.0% pregnancy rate (37/100) for the controls, giving a relative risk of 0.62 (95% confidence interval (CI): 0.35 - 1.10, p = 0.082). There was a 36.3% pregnancy rate (29/80) among patients who had surgical treatment for endometriosis before GIFT, versus a 33.3% pregnancy rate (53/159) for the controls, giving a relative risk of 1.07 (95% CI: 0.75 - 1.54, p = 0.647). Conclusion. There is an indication that GIFT pregnancy rates are impared in patients suffering from active endometriosis, while prior surgery may alleviate the impairment.

Browsing by Author "Lombard, C. J."

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