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Biomedical subjects

B S Jeffery

Publications and source records attributed to B S Jeffery.

8 recordsLinked to original sources
PubMed2003

The effect of Pretoria Pasteurization on bacterial contamination of hand-expressed human breastmilk.

One of the challenges facing the development of programs to reduce mother to child transmission of HIV in developing countries remains the problem of infant feeding. One of the alternative feeding methods under investigation for infants of HIV-infected mothers is heat treatment of expressed breastmilk by Pretoria Pasteurization. The objective of this study was to determine the effect of Pretoria Pasteurization on commensal and pathogenic bacteria in hand-expressed human breastmilk, and to determine the duration of time for which milk can be kept safely without refrigeration after Pretoria Pasteurization. Samples of milk were hand expressed by lactating women in the postnatal ward. The samples were split into control and pasteurized specimens. The pasteurized specimens underwent Pretoria Pasteurization. All samples were stored at room temperature and were sampled for bacterial culture every 4 h, up to 12 h. Clinically significant levels of bacterial contamination occurred in 59 per cent of control and 7.8 per cent of pasteurized samples. Four pasteurized samples showed significant contamination. There is strong evidence that the contaminating organisms in these samples were introduced by handling after pasteurization. The 53 (91 per cent) pasteurized samples that had no contamination at 4 h remained sterile for the remainder of the standing period of 12 h. Forty-one per cent of control samples already had significant growth after standing at room temperature for 4 h. In conclusion, Pretoria Pasteurization kills pathogenic and commensal bacteria in hand-expressed breastmilk. Expressed breastmilk that has undergone Pretoria Pasteurization can be kept without refrigeration for up to 12 h with minimal probability of bacterial contamination provided that it is kept in the pasteurization container and is not handled.

Colony Count, Microbial↗
PubMed2001

Symphysis-fundal measurement as a predictor of low birthweight.

OBJECTIVE: To prospectively test the value of a symphysis-fundal measurement in labor of less than or equal to 29 cm as a predictor of birth mass below 2000 g. METHOD: Women admitted to Kalafong Hospital in labor with a singleton pregnancy were included in the study. Symphysis-fundal measurement according to the method of Westin was performed on two separate occasions and recorded together with other pertinent details. A receiver-operator curve was constructed to test various cut-off measurements. RESULTS: A total of 1216 women were included in the study. One hundred twenty-one fetuses had a birth mass less than 2000 g (10%). A measurement of less than or equal to 29 cm had a sensitivity of 69% and a specificity of 98% with a positive predictive value of 81% and a negative predictive value of 97%. On the receiver-operator curve a cutoff of 30 cm showed a better sensitivity with little loss of specificity. CONCLUSION: A symphysis-fundal measurement of less than or equal to 29 cm is a good predictor of birth mass less than 2000 g and can be used as an indication for referral to centres with neonatal facilities.

Adult↗
PubMed2001

Determination of the effectiveness of inactivation of human immunodeficiency virus by Pretoria pasteurization.

The risk of transmission of the human immunodeficiency virus (HIV) via breastfeeding is between 10 and 17 per cent. In resource-poor countries most HIV-infected women cannot afford to formula feed their infants and formula feeding is not desirable in areas of high infant mortality because of loss of the immunological benefits of breastmilk. A method has been devised by which HIV-infected women may express and pasteurize their breastmilk in a domestic setting using inexpensive apparatus and a simple technique. The method, Pretoria Pasteurization has been shown to be reliable under a wide range of conditions and maintains milk between 56 degrees and 62.5 degrees C for between 12 and 15 min. This study was devised to determine whether Pretoria Pasteurization effectively inactivates HIV in human milk. Samples of expressed breastmilk were obtained from a group of HIV-infected lactating women and a group of HIV-negative women. The samples of milk from the HIV-negative women were inoculated with high titres of cell-associated and cell-free HIV. Each sample was divided into a control portion and a study portion. The study portion underwent Pretoria Pasteurization. Control and pasteurized samples were inoculated into lymphocyte co-culture for a period of 35 days. All co-cultures were sampled weekly and analysed by serological and molecular methods for p24 antigen, cell-free HIV RNA and integrated DNA. Viral RNA was detected in the milk of 80 per cent amongst the known HIV-positive women. The mean serum viral load in the group of HIV positive women was 50728 copies/ml and the mean milk viral load was 422000 copies/ml. Evidence of viral replication was shown in 11 of the control specimens. There was no evidence of viral replication in any of the study specimens which had undergone Pretoria Pasteurization. It was concluded that Pretoria Pasteurization effectively inactivates HIV in human milk.

Adult↗
PubMed2000

Pretoria pasteurisation: a potential method for the reduction of postnatal mother to child transmission of the human immunodeficiency virus.

HIV can be transmitted by breastfeeding. The virus is inactivated by heating. A simple and inexpensive method has been devised by which expressed breastmilk may be pasteurised in a domestic setting. The method uses the principle of heat transfer from 450 ml of water heated to boiling point in an aluminum pot to a smaller volume of milk in a glass jar placed into the water (Pretoria Pasteurisation). The aim of this study was to test the reliability of Pretoria Pasteurisation under a range of conditions. Pretoria Pasteurisation was performed using differing starting values for each of the following parameters: volume of milk (between 50 and 150 ml); initial temperature of milk (between 37 degrees C and the ambient temperature); and ambient temperature. Each of the parameters was varied within the range indicated while all other conditions were kept constant. A graph of milk and water temperature against time was constructed with 95% confidence intervals. The ideal temperature range was considered to be between 56 and 62.5 degrees C. Milk temperature remained between 56 and 62.5 degrees C for between 10 and 15 min depending on the combination of variables. The peak temperature and duration of time in the ideal temperature range was minimally sensitive to volume of milk, starting temperature of milk, and ambient temperature. Pretoria Pasteurisation is feasible and reliable under a range of conditions. The method requires refinement and further testing under different conditions.

Breast Feeding↗
PubMed2000

The impact of a pregnancy confirmation clinic on the commencement of antenatal care.

OBJECTIVE: To introduce a pregnancy confirmation clinic as part of antenatal care and to determine whether this would alter the gestational age at which patients commence antenatal care. SETTING: Three municipal antenatal clinics in Atteridgeville and Central Pretoria. METHOD: A pregnancy confirmation clinic was set up at three sites. At the clinic any woman wishing to confirm whether she was pregnant was offered a urine beta-HCG test. If this test was positive, on-site testing for syphilis, anaemia and rhesus status, dipstick testing of the urine, clinical examination and ultrasound examination were performed. Women with abnormal test results were commenced on appropriate treatment immediately and women requiring further medical care or investigation were referred appropriately. RESULTS: The study recruited 382 women, 145 of whom were defaulters from contraception. Half of the women (191) had a positive pregnancy test. The mean presenting gestational age was 12 weeks 4 days (standard deviation 5 weeks, range 5 weeks-25 weeks 2 days). Treatable conditions with the potential to influence pregnancy outcome were identified in 37 of the pregnant women (19.4%) Forty-three of the pregnant women intended to terminate the pregnancy. CONCLUSION: It is possible to shift the commencement of antenatal care to an earlier gestational age.

Adolescent↗
PubMed1989

Phaeohyphomycotic cutaneous disease caused by Pleurophoma in a cardiac transplant patient.

A 56-y-old female cardiac transplant patient treated with cyclosporine and prednisone noted the onset of three nontender red nodules on the legs and arms after gardening. Biopsy of all lesions revealed inflammatory cells and hyphal elements in the dermis. The dematiaceous fungus cultured from biopsy tissue was a pycnidial-forming organism of the genus Pleurophoma. The lesions responded to the topical application of miconazole.

Female↗