Browsing by Author "Van Zyl, J."
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- ItemA case control study of breast cancer risk and exposure to injectable progestogen contraceptives : methods and patterns of use among controls(Health and Medical Publishing Group (HMPG), 1997-03) Bailie, R.; Katzenellenbogen, J.; Hoffman, M.; Schierhout, G.; Truter, H.; Dent, D.; Gudgeon, A.; Van Zyl, J.; Rosenberg, L.; Shapiro, S.Objective. To describe the patterns of use of injectable progestogen contraceptives (IPCs) among coloured and black women in the Western Cape. These data are part of an ongoing study in the Western Cape, the main aim of which is to explore the relationship between IPCs and breast cancer. Design. A population-based case-control study of breast cancer risk in relation to the use of IPCs among coloured and black women. Setting. The Western Cape, including the Cape metropole and surrounding rural areas. Study subjects. All coloured and black women with newly diagnosed breast cancer, resident in the study area and below age 55 years, who present at either of the two tertiary care hospitals in the Western Cape are recruited. Controls are a sample of hospitalised patients representative of the populations from which the patients are drawn. Cases are frequency-matched according to cross-tabulation of age, ethnic group and residential area in a ratio of approximately 1:3. Measurements. Questionnaires are administered by trained nurse interviewers. Information is elicited on a wide range of variables, including sociodemographic variables, medical history, family history of breast disease, lifetime history of all methods of contraception and use of non-contraceptive female steroids, reproductive variables, cigarette smoking, alcohol consumption and other potentially confounding variables. Results. Between January and December 1994, 122 incident cases and 389 controls were enrolled. Ever-use of IPCs among the controls was 72% (N = 280) and use for 5 years or more was 30% (N = 117). Use of IPCs in the distant past was common, with 61% (N = 232) of all controls having initiated use 10 or more years previously. Current use was also high (19%). Other contraceptive methods were used far less commonly. Conclusion. Coloured and black women in South Africa have been using and continue to use IPCs far more commonly and for longer periods than women anywhere else in the world. It is therefore especially important to evaluate the risk of breast cancer and other health effects of IPCs. The rates of use identified in this study ensure that there will be adequate statistical power to evaluate long-term use, use in the distant past and current use of IPCs.
- ItemHigh-frequency oscillatory ventilation - rescue treatment for infants with severe respiratory failure(Health & Medical Publishing Group, 1998) Smith, J.; Pieper, C. H.; Kirsten, G. F.; Maree, D.; Van Zyl, J.; Pretorius, M. L.Objective. To assess the efficacy of high-frequency oscillatory ventilation (HFOV) as a rescue mode of therapy in newborn infants with severe respiratory failure poorly responsive or unresponsive to conventional ventilation and supportive management. Design. Prospective, descriptive clinical study. Setting. Tertiary care neonatal intensive care unit. Patients and methods. All infants with radiographic evidence of diffuse bilateral lung disease and failure to maintain adequate blood gas values while receiving conventional support were offered HFOV. Intervention. HFOV, utilising a high-pressure/volume strategy. Outcome variables. Improvement in arterial/alveolar oxygen tension ratio (a/APO2) of the infants subsequent to their transferral to HFOV; survival rate; and outcome of infants weighing more than 2 000 g who met criteria for extracorporeal membrane oxygenation (ECMO). Identifying the infants who met ECMO entry criteria allowed the success of HFOV to be compared with that of ECMO, the 'standard' treatment for infants considered unventilatable. Neonatal complications such as bronchopulmonary dysplasia, intraventricular haemorrhage and air leaks were documented. Results. Conventional support failed in 34 consecutive infants; they were transferred to HFOV at a mean postnatal age of 30 hours. Their respiratory diagnoses included respiratory distress syndrome (RDS) (N = 19), neonatal 'adult respiratory distress syndrome' (ARDS) (N = 3) and meconium aspiration syndrome (MAS) (N = 12). Owing to similarities in the underlying pathophysiology, RDS and ARDS were grouped together for the purposes of analysis. After starting HFOV the a/APO2 had significantly improved (P < 0.05) by 6 hours in the RDS group and by 12 hours in the infants with MAS. This improvement was sustained throughout the first 48 hours of HFOV. Twenty-six (76%) of the infants ultimately survived. Among those who met the criteria for ECMO (N = 13), the survival rate was 92%. Air leaks occurred on HFOV in 6 infants, 3 each in the MAS and RDS groups. Bronchopulmonary dysplasia was diagnosed in 6 (40%) of the 15 RDS infants and in 2 (18%) of the 11 infants with MAS. Eight infants died, 3 following nosocomial sepsis (Pseudomonas sp.), 3 due to extensive air leaks, 1 due to irreversible shock (unproven sepsis), and 1 due to ARDS. At a median age of 13.5 months the neurological development of 11 (5%) of 17 infants was normal; in 3 (18%) it was suspect and in 3 abnormal. Conclusions. The study demonstrates that a high-pressure/volume approach to HFOV is an effective mode of rescue ventilation for infants who present with severe respiratory failure caused by a variety of lung conditions during the neonatal period.
- ItemThe influence of non-steroidal anti-inflammatory and antithyroid agents on myeloperoxidase-catalysed activities of human leucocytes(Health & Medical Publishing Group, 1979) Van, Zyl A.; Lubbe, S.; Potgieter, A.; Van Zyl, J.Viable leucocytes obtained fresh from normal human subjects were shown to be able to catalyse the in vitro iodination of bovine serum albumin (BSA) in a H20 2-generating system. The rate and degree of iodination were greatly improved by sonication of the cells. A balanced salt solution was a more favourable medium than phosphate buffer for the myeloperoxidase (MPO)-catalysed iodination of whole cells and sonicated cells. Reactions known to be catalysed by other peroxidases (e.g_ thyroid peroxidase (TPO) and lactoperoxidase), such as inorganic iodide exchange for organic iodine in di-iodotyrosine (01T) and the de-iodination of thyroxine (T4)' were also catalysed by the sonicated leucocyte suspension in the system used. The non-steroidal anti-inflammatory drugs indomethacin, flufenamic acid and naproxen were far less effective inhibitors of MPO-catalysed BSA iodination of sonicated leucocytes at concentrations expected in blood with therapeutic dose levels than was observed earlier with TPO-catalysed in vitro iodination of BSA. The antithyroid drug ethylmercapto-imidazole (MM!) inhibited in vitro MPO-catalysed "'I delabelling of '''1·01l at all concentrations between 10·' and 10·'M, whereas "'I-T4 delabelling was markedly stimulated at the same drug concentrations. On the other hand, '251 incorporation into '''I-OIT was not affected by increased concentrations of MMI up to 10·'M. At higher drug concentrations the drug caused inhibition of MPO-catalysed exchange of inorganic iodide for organic iodine in Oil.
- ItemThe Magpie Trial: A randomised trial comparing magnesium sulphate with placebo for pre-eclampsia. Outcome for children at 18 months(2007) Duley, L.; Farrell, B.; Armstrong, N.; Spark, P.; Roberts, B.; Smyth, R.; Tivnan, M.; Laws, A.; Corfield, N.; Salte, A.; Thorn, L.; Altman, D.; Yu, L. M.; Abalos, E.; Carroli, B.; Dellepiane, L.; Duarte, M.; Fernandez, H.; Giordano, D.; Clarke, M.; Gray, A.; Hey, E.; Neilson, J.; Simon, J.; Doyle, L.; Kelly, T.; Squires, J.; Collins, R.; Karaoglou, A.; Lilford, R.; Moodley, J.; Robson, S.; Roberts, I.; Rubin, P.; Thornton J.; Twaddle, S.; Villar, J.; Walker, I.; Watkins, C.; Bimbashi, A.; Demalia, E.; Gliozheni ,O.; Shpata, A.; Karolinski, A.; Lamas, M.; Pesaresi, M.; Wainer, V.; Barbato, W.; Paciocco, M.; Bertin, M.; Boiza, E.; Castaldi, J.; Partida, Y.; Arias, C.; Farri, M.; Kerz, G.; Aguirre, J.; De Sagastizabal, M.; Falcone, R.; Morales, E.; Carroli, G.; Krupitzky, S.; Lopez, S.; Palermo, M.; Montes, Varela D.; Delprato, H.; Camusso, H.; Curioni, M.; Ludmer, E.; Brandi, R.; Martin, R.; Mesas, W.; Taralli, R.; Lezaola, M.; Morosini, M.; Andina, E.; Bernal, L.; Estiu, M.; Ulens, E.; Ortiz De Speranza, B.; Peyrano, A.; Damiano, M.; Saumench, C.; Horn, J.; Pritchard, M.; Smith-Orr, V.; Wilson, M.; Lawrence, A.; Watson, D.; Crowther, C.; Paynter, J.; Ashrafunnessa,; Mannan, M.; Shahidullah, M.; Shamsuddin, L.; Barros, Santos C.; Freire, S.; Melo, E.; Cobo, E.; Jaramillo, E.; Cardozo, C.; Fandino, N.; Gaitan, H.; Montano, L.; Lozano, J.; Rojas, M.; Breto, Garcia A.; Fuentes, Ramirez A.; Garcia, Miras R.; Sampera, S.; Farnot, U.; Gomez, E.; Rojas, G.; Valdes, R.; Abd El-Kreem, H.; Al-Hussaini, T.; Hammad, E.; Danso, K.; Kwapong, E.; Ofosu-Barko, E.; Padmini, Jasper M.; Peedicayil, A.; Regi, A.; Sharma, R.; Chauhan, A.; Raut, V.; Udani, R.; Batra, S.; Muthal-Rathore, A.; Ramji, S.; Zutshi, V.; Balakrishnan, S.; Eapen, E.; Koshy, G.; Ambardar, N.; Vadakkepat, P.; Vaidya, D.; Lema, V.; Rijken, Y.; Tadesse, E.; Dada, O.; Sofekun, A.; Ohiaeri, C.; Runsewe-Abiodun, T.; Adewole, I.; Adeyemo, A.; Brown, B.; Oladokun, R.; Adewale, O.; Inimgba, N.; John, C.; Ogu, R.; Ekele, B.; Isah, A.; Onankpa, B.; Jamelle, R.; Junejo, D.; Ruby, Faiz N.; Gul, F.; Sherin, A.; Bangash, K.; Mahmud, G.; Masud, K.; Tasneem, N.; Gassama, S.; Soyei, A.; Agarwal, P.; Rajadurai, V.; Pirani, N.; Delport, S.; Macdonald, P.; Mokhondo, R.; Pattinson, R.; Zondo, M.; Adhikari, M.; Mnguni, N.; Moodley, J.; Carstens, M.; Kirsten, G.; Steyn, W.; Van Zyl, J.; Helwig, A.; Jacobson, S. L.; Panosche, R.; Hammond, E.; Masanganise, L.Objective: To assess the long-term effects of in utero exposure to magnesium sulphate for children whose mothers had pre-eclampsia. Design: Assessment at 18 months of age for children whose mothers were recruited to the Magpie Trial (recruitment 1998-2001 ISRCTN 86938761), which compared magnesium sulphate with placebo. Setting: Follow-up of children born at 125 centres in 19 countries across five continents. Population: A total of 6922 children were born to women randomised before delivery at follow-up centres. Of these, 2271 were not included for logistic reasons and 168 were excluded (101 at a centre where <20% were contacted, 40 whose death or disability was due to a problem at conception or embryogenesis and 27 whose parent/s opted out). Therefore, 4483 children were included in follow-up, of whom 3283 (73%) were contacted. Methods: Assessment by questionnaire, with interview and neurodevelopmental testing of selected children. Main outcome measures: Death or neurosensory disability at age of 18 months. Results: Of those allocated magnesium sulphate, 245/1635 (15.0%) were dead or had neurosensory disability at 18 months compared with 233/1648 (14.1%) allocated placebo (relative risk [RR] 1.06, 95% CI 0.90-1.25), and of survivors, 19/1409 (1.3%) had neurosensory disability at 18 months compared with 27/1442 (1.9%) (RR 0.72, 95% CI 0.40-1.29). There were no substantial differences in causes of death or in the risk of individual impairments or disabilities. Conclusions: The lower risk of eclampsia following prophylaxis with magnesium sulphate was not associated with a clear difference in the risk of death or disability for children at 18 months. © RCOG 2006 BJOG An International Journal of Obstetrics and Gynaecology.
- ItemThe Magpie Trial: A randomised trial comparing magnesium sulphate with placebo for pre-eclampsia. Outcome for women at 2 years(2007) Duley, L.; Farrell, B.; Armstrong, N.; Spark, P.; Roberts, B.; Smyth, R.; Tivnan, M.; Laws, A.; Corfield, N.; Salter, A.; Thorn, L.; Altman, D.; Yu, L.-M.; Abalos, E.; Carroli, B.; Dellepiane, L.; Duarte, M.; Fernandez, H.; Giordano, D.; Clarke, M.; Gray, A.; Hey, E.; Neilson, J.; Simon, J.; Collins, R.; Karaoglou, A.; Lilford, R.; Moodley, J.; Robson, S.; Roberts, I.; Rubin, P.; Thornton, J.; Twaddle, S.; Villar, J.; Walker, I.; Watkins, C.; Doyle, L.; Bimbashi, A.; Demalia, E.; Gliozheni, O.; Shpata, A.; Karolinski, A.; Lamas, M.; Pesaresi, M.; Wainer, V.; Barbato, W.; Paciocco, M.; Bertin, M.; Boiza, E.; Castaldi, J.; Partida, Y.; Arias, C.; Farri, M.; Kerz, G.; Aguirre, J.; De Sagastizabal, M.; Falcone, R.; Morales, E.; Carroli, G.; Krupitzky, S.; Lopez, S.; Palermo, M.; Montes, Varela D.; Delprato, H.; Camusso, H.; Curioni, M.; Ludmer, E.; Brandi, R.; Martin, R.; Mesas, W.; Taralli, R.; Lezaola, M.; Morosini, M.; Andina, E.; Bernal, L.; Estiu, M.; Ulens, E.; Ortiz De Speranza, B.; Peyrano, A.; Damiano, M.; Saumench, C.; Horn, J.; Pritchard, M.; Smith-Orr, V.; Wilson, M.; Lawrence, A.; Watson, D.; Crowther, C.; Paynter, J.; Ashrafunnessa,; Mannan, M.; Shahidullah, M.; Shamsuddin, L.; Barros Santos, C.; Freire, S.; Melo, E.; Cobo, E.; Jaramillo, E.; Cardozo, C.; Fandino, N.; Gaitan, H.; Montano, L.; Lozano, J.; Rojas, M.; Breto Garcia, A.; Fuentes, Ramirez A.; Garcia, Miras R.; Sampera, S.; Farnot, U.; Gomez, E.; Rojas, G.; Valdes, R.; Abd El-Kreem, H.; Al-Hussaini, T.; Hammad, E.; Danso, K.; Kwapong, E.; Ofosu-Barko, E.; Padmini Jasper, M.; Peedicayil, A.; Regi, A.; Sharma, R.; Chauhan, A.; Raut, V.; Udani, R.; Batra, S.; Muthal-Rathore, A.; Ramji, S.; Zutshi, V.; Balakrishnan, S.; Eapen, E.; Koshy, G.; Ambardar, N.; Vadakkepat, P.; Vaidya, D.; Lema, V.; Rijken, Y.; Tadesse, E.; Dada, O.; Sofekun, A.; Ohiaeri, C.; Runsewe-Abiodun, T.; Adewole, I.; Adeyemo, A.; Brown, B.; Oladokun, R.; Adewale, O.; Inimgba, N.; John, C.; Ogu, R.; Ekele, B.; Isah, A.; Onankpa, B.; Jamelle, R.; Junejo, D.; Ruby, Faiz N.; Gul, F.; Sherin, A.; Bangash, K.; Mahmud, G.; Masud, K.; Tasneem, N.; Gassama, S.; Soyei, A.; Agarwal, P.; Rajadurai, V.; Pirani, N.; Delport, S.; Macdonald, P.; Mokhondo, R.; Pattinson, R.; Zondo, M.; Adhikari, M.; Mnguni, N.; Moodley, J.; Carstens, M.; Kirsten, G.; Steyn, W.; Van Zyl, J.; Helwig, A.; Jacobson, S.-L.; Panosche, R.; Hammond, E.; Masanganise, L.Objective: The aim of this study was to assess long-term effects for women following the use of magnesium sulphate for pre-eclampsia. Design: Assessment at 2-3 years after delivery for women recruited to the Magpie Trial (recruitment in 1998-2001, ISRCTN 86938761), which compared magnesium sulphate with placebo for pre-eclampsia. Setting: Follow up after discharge from hospital at 125 centres in 19 countries across five continents. Population: A total of 7927 women were randomised at the follow-up centres. Of these women, 2544 were not included for logistic reasons and 601 excluded (109 at a centre where <20% of women were contacted, 466 discharged without a surviving child and 26 opted out). Therefore, 4782 women were selected for follow-up, of whom 3375 (71%) were traced. Methods: Questionnaire assessment was administered largely by post or in a dedicated clinic. Interview assessment of selected women was performed. Main outcome measures: Death or serious morbidity potentially related to pre-eclampsia at follow up, other morbidity and use of health service resources. Results: Median time from delivery to follow up was 26 months (interquartile range 19-36). Fifty-eight of 1650 (3.5%) women allocated magnesium sulphate died or had serious morbidity potentially related to pre-eclampsia compared with 72 of 1725 (4.2%) women allocated placebo (relative risk 0.84, 95% CI 0.60-1.18). Conclusions: The reduction in the risk of eclampsia following prophylaxis with magnesium sulphate was not associated with an excess of death or disability for the women after 2 years. © RCOG 2006 BJOG An International Journal of Obstetrics and Gynaecology.