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Biomedical subjects

S Naidoo

Publications and source records attributed to S Naidoo.

At least 19 recordsLinked to original sources

Causes and distribution of facial fractures in a group of South African children and the value of computed tomography in their assessment.

The cases of 107 paediatric patients aged 0-12 years were retrospectively reviewed. The patients presented with facial trauma and both plain radiographs and computed tomography (CT) scans had been ordered. Sixty-five per cent of facial fractures were missed in radiography, but revealed on CT; fractures of the maxilla, the zygoma and the orbit were most frequently missed in radiography. Pedestrian motor vehicle accidents were the most frequent cause of facial fractures (37%), followed by passenger motor vehicle accidents (22%). In contrast with other studies reporting the mandible as the most frequent facial fracture site, the most common fracture sites in this study, in descending order of frequency, were the orbit, the frontal bone and the maxilla.

Accidental Falls↗

Tissue kallikrein and kinin receptor expression in an angiogenic co-culture neuroblastoma model.

The sprouting of new blood vessels from pre-existing vasculature (angiogenesis) is essential for tumour survival, influenced by tumour cell-endothelial cell interactions and is tightly regulated by biochemical cues including the kallikrein-kinin system (KKS). We examined the structural interaction between neuroblastomas and endothelial cells (HUVECs) in 2-D and 3-D (matrigel) in vitro, co-culture models by light microscopy, and performed in situ mono- and co-labelling of various KKS proteins. Neuroblastomas formed footplate-like multiple contacts on angiogenic HUVECs without disrupting differentiation of HUVECs into cord-like structures. Tissue kallikrein and the kinin B1R and B2R receptors were demonstrated on interacting neuroblastomas and HUVECs to varying degrees, as well as at actual heterogeneous contact zones in both 2-D and 3-D models. This KKS immuno-reactivity was generally confined to peri-nuclear regions on HUVECs but concentrated on cell extensions on neuroblastomas. The KKS, known to enhance DNA synthesis and process pro-angiogenic precursors of both tumour cells and the extra-cellular matrix, may, by its multi-functional activities at sites of tumour-blood vessel interactions, regulate aspects of both angiogenesis and tumourigenesis.

Brain Neoplasms↗

(A1) Identification of oral health care needs in children and adults, management of oral diseases.

The workshop considered five questions reviewing the identification of international oral health care needs of children and adults, and the management of oral diseases in resource-poor countries: (1) What is the role of the dental profession in the management of the HIV-infected individual? (2) Identifying health care needs-What are the epidemiology and disparities of HIV-associated oral lesions in children from different continents? (3) How effective is HIV treatment in controlling oral diseases? (4) Could we develop basic inexpensive oral and dental care protocols for economically deprived HIV-infected patients? and (5) What is the best method of arranging resources to meet the oral health care needs of people with HIV disease? The consensus of the workshop participants was that there is a need to re-target research efforts to non-established market economy countries and prioritize research in these regions to children with HIV disease. It will be important to assess commonalities and variations in oral health needs across geographical and cultural boundaries, and research efforts should be centralized in resource-poor countries to support multi-center longitudinal standardized studies. It is essential that oral health research be integrated into other health care research programs, to make these research priorities and public health initiatives feasible.

Adult↗

TB in health care workers in KwaZulu-Natal, South Africa.

SETTING: Eight public sector hospitals in Ethekwini municipality, KwaZulu-Natal, South Africa. OBJECTIVE: To describe the incidence of TB, clinical presentation and treatment outcomes among health care workers (HCWs) in public sector hospitals in Ethekwini Municipality, KwaZulu-Natal. METHODS: A descriptive study using a retrospective record review for the period January 1999 to June 2004 was conducted from July 2004 to February 2005. RESULTS: Five hundred and eighty three HCWs were diagnosed with TB. The mean incidence of TB among HCWs for the study period was 1133.0 per 100000 HCWs (standard deviation 282.8). The incidence of TB was highest in the age group 25-29 years and among paramedical staff (registered health professionals other than doctors and nurses). Clinical presentation of TB in HCWs included pulmonary TB 76.5% (n = 322) and MDR-TB 3% (n = 13). Cure was achieved in 22.2% (n = 118) of HCWs, and 40.7% (n = 212) of HCWs completed their treatment. CONCLUSION: The incidence of TB in HCWs in KwaZulu-Natal is alarmingly high, and the high incidence in the younger age groups and the poor treatment outcomes are cause for concern.

Adult↗

Dental specialist training in South Africa--demographic characteristics 1985-2004.

This short communication complements a recently published dental undergraduate analysis, and analyses the demographic profile of dental specialists trained from 1985-2004, as well as that of the registrars in training (in 2005). A total of 309 dental specialists were trained from 1985-2004, of these 86% were males and 74% White. Of the registrars, two-thirds are males and a quarter Black. The dental faculties and the Health Professions Council of South Africa (HPCSA) face a significant challenge to find innovative ways to address these disparities, as well as the urban/rural and private/public sector maldistribution of dental specialists, and to develop a more rational basis for training dental specialists for the country. Dealing with these disparities should improve access to dental specialist care for the poor and rural populations.

Education, Dental↗

Gender differences among oral health care workers in caring for HIV/AIDS patients in Osun State, Nigeria.

The study investigated the relationship between gender and knowledge, attitude and practice of infection control among oral health care workers in the management of patients with HIV/AIDS in Osun State of Nigeria. It was a cross-sectional survey using 85 oral Health care workers (OHCWs) enlisted in the public dental health clinics. A self-administered questionnaire was designed and used for data collection. A total of 85 questionnaires were distributed. The response rate was 93%; 42 (53%) were males and 37 (47%) females. The majority of the respondents were in the 25-40 year old age group and the mean age was 37.3 years. This study found significant differences in gender and ability to identify HIV/AIDS oral manifestations (p<0.001) and recognition of HIV/AIDS risk factors (p<0.001). There was statistically significant gender difference and infection control practices (p=0.02) among the OHCWs. Males were more compliant to the universal cross-infection control principle than the female respondents. A significant association (p< 0.001) was found between OHCW gender and their attitude to the management of HIV/AIDS patients with males showing a better attitude towards the care of HIV/AIDS patients. This study shows that there are significant gender difference in attitudes, behaviour and practices of OHCW with males faring better than the females. National AIDS Control Programme, Health Control bodies, Health educators and other organizations should make efforts to improve the attitude and practice of oral health care workers regarding the management of patients with HIV/AIDS.

Adult↗

Women in dentistry in South Africa: a survey of their experiences and opinions.

Women form an increasingly important part of the dentally trained workforce in South Africa. However, little is known about the professional issues and work-related problems affecting women dentists. A postal survey was undertaken of registered female dental practitioners in the country, with the aim to document their experiences. The survey (i) ascertained their current pattern of work, (ii) identified factors influencing their work patterns and (iii) identified factors that would help women remain in the profession or re-enter it more easily after an absence. A self-administered 50-item questionnaire containing open and closed-ended questions was used. Questions related to professional status, working patterns, practice ownership, postgraduate qualifications and career satisfaction. Nine hundred and sixty questionnaires were sent out and 280 were returned (29% response rate). Although a significant majority were currently practicing (96%), about 20% were employed or worked part-time and 7 reported that they were not in practice at the time of the survey for various reasons including maternity leave, ill-health, retirement or that they were now working outside the dental field. Major factors identified in this study were the women's dual responsibility at home and at work. Few women find themselves in specialist practice, although 68% indicated that they would liked to have specialised. Home responsibilities and inflexible working conditions were commonly reported difficulties experienced with further studies. In addition, the lack of part-time training and the geographical location of training facilities also played a role. Women dentists need more flexible working schedules and conditions of employment. Part-time training and part-time career options should be extended. Retraining and refresher courses for Women dentists who have had a break in their careers should be available to enable them to return sooner and more easily to practice. Tertiary training dental facilities throughout the country should take up this challenge and run courses that are tailored to the local need and domestic commitments of the women involved.

Adult↗

Patterns of tooth surface loss among winemakers.

There are a few documented case studies on the adverse effect of wine on both dental hard and soft tissues. Professional wine tasting could present some degree of increased risk to dental erosion. Alcoholic beverages with a low pH may cause erosion, particularly if the attack is of long duration, and repeated over time. The purpose of this study was to compare the prevalence and severity of tooth surface loss between winemakers (exposed) and their spouses (non-exposed). Utilising a cross-sectional, comparative study design, a clinical examination was conducted to assess caries status; the presence and severity of tooth surface loss; staining (presence or absence); fluorosis and prosthetic status. The salivary flow rate, buffering capacity and pH were also measured. Thirty-six persons, twenty-one winemakers and fifteen of their spouses participated in the study. It was possible to show that there was a difference in terms of the prevalence and severity of tooth surface loss between the teeth of winemakers and those who are not winemakers. The occurrence of tooth surface loss amongst winemakers was highly likely due to frequent exposure of their teeth to wine. Frequent exposure of the teeth to wine, as occurs among wine tasters, is deleterious to enamel, and constitutes an occupational hazard. Erosion is an occupational risk for wine tasters.

Adult↗

Tumour metabolites regulate tissue kallikrein in human umbilical vein endothelial cells.

Angiogenesis, the sprouting of new blood vessels, is tightly mediated via a myriad of endogenous factors. A pro-angiogenic alteration facilitates the formation of neovascular tumour networks, thereby providing mechanisms for uncontrolled growth. The kallikrein-kinin system is postulated to be pro-angiogenic since its components have been detected in both endothelial cells and tumour tissue. No studies have, however, focussed on the role of tissue kallikrein (TK) in human angiogenic endothelial cell-tumour interactions. This study has optimised a challenge model whereby endothelial cells are presented with neuroblastoma metabolites, and vice versa. Image analysis of immunoreactive TK revealed a dose-dependant, significant reduction of TK localisation within endothelial cells, while gene expression remained unchanged, the latter determined by in situ RT-PCR. Neuroblastoma cells, when challenged with endothelial cell metabolites, displayed no change in TK synthesis or localisation. Alterations in TK synthesis and/or storage by angiogenic endothelial cells may be mediated by tumour-released signals and possibly indicate a shift from a proteolytic to a mitogenic function of TK. The challenge model provides a relatively simple experimental system to study angiogenic factors in tumour-endothelial cell interaction, and is the first to localise both TK and its mRNA within angiogenic endothelial and tumour cells.

Animals↗

Cellular distribution of the endothelin system in the human brain.

The vasoconstrictor endothelin-1 (ET-1) may also act as a neuropeptide. ET-1 is formed by the catalytic action of endothelin-converting enzyme-1 (ECE-1) on big ET-1 and its cellular actions are mediated via ET(A) and ET(B) receptors. Although localisation of these components in rodent brain has been extensively investigated, no single study has mapped their distribution in human brain. Here we describe the localisation of ET-1 mRNA, ET-1, ECE-1, ET(A) and ET(B) receptors within 24 human brain regions. In situ RT-PCR has previously detected ET-1 mRNA in 22 areas (excluding the post-central gyrus and pineal gland), and ET-1 immunoreactivity was visualised in cells of all regions. Using specific antibodies we have immunolocalised ECE-1 and ET(B) receptors in cells of 24 areas, and ET(A) receptors in nine regions (choroidal epithelial cells, neurones in the diencephalon, hippocampus, amygdaloid, dentate nucleus, Purkinje cells of the cerebellum, flocculo-nodular lobe and vermis). ET-1 mRNA, ET-1, ECE-1 and ET(B) receptors were observed in cortical pyramidal cells, neurones (brainstem, basal nuclei, thalamus, insula and claustrum, limbic region), cells in the anterior pituitary gland; nerve cell processes in the pars nervosa; pinealocytes and choroidal epithelial cells. Only ET-1 mRNA, ET-1, ECE-1, and ET(B) receptors were visualised in cerebral capillary endothelial cells. The presence of ET-1 mRNA, ECE-1 and ET-1 in 22 brain regions confirms ET expression and processing in human brain. The localisation of ET-1 and ET(B) receptors suggests receptor-mediated action akin to a neurotransmitter role for ET-1.

Adult↗

Immunolocalisation of endothelin-1 in human brain.

The potent vasoconstrictor endothelin-1 (ET-1) may function as a neuropeptide and be a contributing factor in some neurological disorders, e.g. Alzheimer's dementia. The presence of ET-1 has been studied more extensively in the rat and porcine nervous systems than in the human brain. Also, the recent description of the extensive ET-1 mRNA localisation in human neural tissue supports expression in regions of human brain not previously investigated. Using specific anti-ET-1 polyclonal antiserum, we immunolocalised ET-1 in 24 regions of human brain autopsy tissues, and correlated this with ET-1 mRNA distribution. ET-1 immunoreactivity was observed within some cells of all the 24 areas examined. Neuronal staining for ET-1 was demonstrated within the diencephalon, brainstem, basal nuclei, cerebral cortex, cerebellar hemisphere, amygdala and hippocampus. In addition, ET-1 immunolabelling was visualised in the pituitary gland as well as in the choroid plexus. The primary sensory cortex and pineal gland also contained immunoreactive ET-1, although ET-1 mRNA had never been detected in these regions previously. The localisation of ET-1 and its subsequent correlation with ET-1 mRNA in most of the regions investigated suggest a more extensive distribution of the ET system in the human brain than was previously identified.

Adult↗

Oro-facial manifestations in paediatric HIV: a comparative study of institutionalized and hospital outpatients.

The aim of the study was to compare dental caries status and the number and type of oral mucosal lesions in HIV positive children from a hospital outpatient department and an institutionalized setting. Oral examinations were performed using presumptive diagnostic criteria. The Fisher's Exact and the Mann-Whitney tests were used for statistical comparison of the two study groups. A total of 169 children were examined of whom 42% were institutionalized and 58% hospital outpatients. One institutionalized child presented with Noma. Twenty-one percent of the institutionalized population presented with molluscum contagiosum, while none of the hospital outpatients presented with this condition. Significantly more intraoral mucosal lesions were observed in the hospital compared with the institutionalized group. The most frequently encountered oral lesion was candidiasis. Pseudomembranous candidiasis was the most common type. Twice as many intraoral ulcers were recorded in the institutionalized group. Thirty-nine percent of the hospitalized patients had multiple lesions compared with 28% in the institutionalized group. Almost three quarters of both populations were caries-free. The mean DMFT was considerably higher in the hospital population. For both the permanent and primary teeth, the decayed component (D/d) made up the major part of the DMFT/dmft, followed by the missing (M/m) component. No fillings were recorded in either the primary or permanent teeth for both groups. Oral lesions are common in HIV populations and were seen in both the hospital and institutionalized groups, at high prevalence levels (63 and 45%). HIV infected children should be considered high risk for caries because of the use of chronic medications, and to receive appropriate care in terms of both treatment and services.

Candidiasis, Oral↗

Oral health knowledge, attitudes and behaviour among nursing staff in Lesotho.

The decreasing prevalence of oral diseases in industrialised countries is attributed to a paradigm shift of oral health services from being mainly curative to preventative care. In under-resourced countries, the use of non-oral health care workers in the promotion of oral health, can contribute substantially to improving oral health and the adoption of a multidisciplinary team approach in oral health is highly recommended. Owing to the inadequate number of oral health personnel in Lesotho, the use of health care workers other than oral health care workers has been investigated. Nurses are one of the most suitable cadres of health care workers to take on this role. The aim of this study was to determine oral health knowledge, attitudes and behaviour among nurses in Lesotho. A descriptive cross-sectional study, using a random sampling method was used. A self-administered questionnaire with open and closed-ended questions was used to collect the data. The response rate was 87%. Knowledge of aetiology and prevention of dental caries, periodontal disease and the oral manifestations of HIV-infection was found to be adequate, while knowledge of oral cancer was found to be satisfactory. Nurses in Lesotho reported positive attitudes towards the provision of oral health education and oral hygiene practices. Most nurses themselves were found to be symptom-orientated in their utilisation of the oral health services. It is recommended that oral health be given greater attention in the nursing curriculum, with more clinical hands-on training in oral examination and diagnosis of oral diseases.

AIDS-Related Opportunistic Infections↗

Giant intracavernous internal carotid artery aneurysm with fatal epistaxis.

The case history and autopsy findings of a 32-year-old male, who suffered a mild closed-head injury and then had repeated epistaxis beginning 5 months later, is presented. The condition culminated in an episode of fatal epistaxis 1 year after the injury. At one time during the course of his work-up, the etiology of his repeated epistaxis was thought to be a vascular nasopharyngeal neoplasm. The diagnosis of an intracavernous internal carotid artery aneurysm was made only at autopsy. The principles of management of traumatic intracavernous internal carotid artery aneurysm presenting with epistaxis are discussed.

Accidents, Traffic↗