Browsing by Author "Victor, T."

Now showing 1 - 4 of 4
  • Thumbnail Image
    Item
    The effect of intravenous amino acids on plasma amino acid concentration during total parenteral nutrition in infants with necrotizing enterocolitis
    (Health & Medical Publishing Group, 1981) Thom, J. C.; Victor, T.; Pichanick, A. M. E.
    Plasma aminograms of infants receiving total parenteral nutrition as part of the treatment for necrotizing enterocolitis were studied. Their ages varied from 2 to 60 days and their mean birth mass was 1621 g (range 760-2550 g). The intravenous administration of amino acids produced changes in plasma amino acid levels corresponding to the concentration of individual amino acid levels in the solution employed: higher levels of amino acids in the infusate produced increased plasma levels, whereas low plasma levels were obtained for amino acids not present or present in small amounts according to the solution used. The infants did not appear to suffer in any way, but the long-term effects still have to be evaluated. Pending further knowledge in this regard it is suggested that plasma amino acid levels should be maintained as near to normal values as possible. This could probably be achieved by the use of amino acid solutions specially formulated according to the amino acid profile of breast milk or the plasma amino acid profile of normal infants.
  • Thumbnail Image
    Item
    Evaluation of a rapid screening test for rifampicin resistance in re-treatment tuberculosis patients in the Eastern Cape
    (Health and Medical Publishing Group (HMPG), 2007-09) Albert, H.; Trollip, A. P.; Seaman, T.; Abrahams, C.; Mole, R. J.; Jordaan, A.; Victor, T.; Hoosain, E.
    Background and objectives. Patients with multidrug-resistant (MDR) tuberculosis (TB) are at high risk of treatment failure. It is anticipated that early identification of MDR-TB and appropriate treatment will improve patient outcome and disease control. We evaluated the rapid detection of rifampicin resistance in previously treated TB patients, directly from acid-fast bacilli (AFB)-positive sputum using a phage-based test, FASTPlaque-Response (Biotec Laboratories Ltd, Ipswich, UK). The ability of rifampicin resistance to predict MDR-TB was also determined. Design. A prospective study was done comparing performance of the rapid phage test with conventional culture and drug susceptibility testing (DST) in AFB-positive TB patients. Setting. Five primary health clinics and one TB referral centre in the Port Elizabeth Metropolitan area, Eastern Cape. Outcome measures. Sensitivity, specificity and overall accuracy of the phage test were determined compared with gold standard culture and DST. Discrepant results were resolved by molecular detection of mutations conferring rifampicin resistance. The proportion of rifampicin-resistant strains that were MDR was also determined. Results. Previously treated patients were at a high risk of MDR-TB (35.7%). Sensitivity, specificity and overall accuracy of FASTPlaque-Response for rifampicin resistance determination were 95.4% (95% confidence interval (CI): 91.0-99.8%), 97.2% (95% CI: 94.5-99.9%) and 96.5% (95% CI: 94.1-98.9%) respectively compared with conventional DST (unresolved), calculated for specimens that had both FASTPlaque-Response and conventional DST results available. FASTPlaque-Response results were available in 2 days instead of 28-85 days with conventional DST. However, only 70.6% of FASTPlaque-Response results were interpretable compared with 86.3% of conventional DST results. The majority (95.5%) of rifampicin-resistant strains were MDR-TB. Conclusions. Rapid detection of rifampicin resistance using FASTPlaque-Response could contribute to improved management of patients at risk of MDR-TB, such as previously treated patients. However, improvement in control of specimen-related contamination is needed to ensure that a higher proportion of FASTPlaque-Response results are interpretable. Where indicated, early modification of therapy could improve patient prognosis and reduce disease transmission.
  • Thumbnail Image
    Item
    Incidence of heat-labile enterotoxin-producing Escherichia coli detected by means of polymerase chain reaction amplification
    (Health & Medical Publishing Group, 1994) Winterbach, R.; Van Helden, P. D.; Janse Van Rensburg, J.; Victor, T.
    Diarrhoea can be caused by many different organisms, some of which are notoriously difficult to identify. One of these is enterotoxin-producing Escherichia coli. Recently a new diagnostic technique that uses polymerase chain reaction DNA amplification was developed for detection of the 'A' subunit of the labile enterotoxin-producing E. coli gene. This technique was used to evaluate the incidence of heat-labile (LT+) enterotoxin-producing E. coli in the causation of diarrhoea. The results from this study showed that LT+ E. coli is a cause of diarrhoea in the western Cape and that 5,3% of non-diagnosed diarrhoea patients in Tygerberg Hospital were infected with this pathogen. This represented less than 1% of the total number of cases of diarrhoea investigated in this hospital. The peak coincides with the wetter months in this locality and the infection rate is lower than that reported in most other countries. Given the low incidence of occurrence of this organism we do not recommend routine implementation of the diagnostic procedure. However, this test may be useful at times, e.g. to ascertain the source of a diarrhoea epidemic.
  • Thumbnail Image
    Item
    The use of the polymerase chain reaction test in the diagnosis of tuberculosis
    (Health & Medical Publishing Group, 1991) Van Helden, P. D.; Du Toit, R.; Jordaan, A.; Taljaard, B.; Pitout, J.; Victor, T.
    Current techniques for laboratory diagnosis of tuberculosis have some serious limitations. These include the high cost and time required for the current assays. The development of a rapid, sensitive, specific and low-cost assay is therefore of considerable importance. We report here the development and laboratory testing of a polymerase chain reaction DNA-based diagnostic test for the presence of Mycobacterium tuberculosis in sputum. The assay shows a high level of sensitivity and specificity and requires considerably less capital, consumables and time inputs than existing laboratory tests. We believe this technology is ready for large-scale evaluation and use, particularly in hospital-based laboratories.