Oxidative and haemostatic effects of copper, manganese and mercury, alone and in combination at physiologically relevant levels: An ex vivo study.

Water contamination with metals due to anthropogenic activity is increasing and subsequent exposure increases the risk of associated toxicity. Exposure is not limited to a single metal but usually involves mixtures of different metals at different concentrations. Little is known about the contribution of this type of exposure, in humans, to the development of non-communicable diseases such as cardiovascular disease, and an increased risk to thrombosis. The World Health Organization has established limits for metal levels in drinking water and this includes levels for copper (Cu), manganese (Mn) and mercury (Hg). In this study, at 100X these limits, the ability of the metals' oxidative effects as catalysts of the Fenton reaction and/or ability to bind glutathione (GSH) were determined. The haemostatic effects of these metals, alone and in combination, at the World Health Organization limit were then evaluated. The ultrastructural and viscoelastic alterations of exposed ex vivo whole blood were also evaluated using scanning electron microscopy and thromboelastography® (TEG), respectively. Cu, alone and in combination with Mn and/or Hg, induced hydroxyl radical formation and reduced GSH levels. Ex vivo exposure caused deformation of erythrocytes and accelerated platelet activation especially for Cu, alone and in combination, with Mn. Reduction in the lysis potential of the clot was also observed for all combinations, especially Cu in combination with Hg as well as Mn alone. Although the TEG findings were not statistically significant, the trends indicate that the exposure to these metals, alone and in combination, adversely affects thrombus formation in ex vivo blood, thereby potentially increasing the risk in exposed individuals for thrombosis.

The dominant methicillin-resistant Staphylococcus aureus clone from hospitals in Cape Town has an unusual genotype: ST612.

There is currently limited information available on the molecular epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) in South Africa. A molecular characterization of 100 MRSA from five hospitals in Cape Town was carried out in this study. The strains were separated into six clusters by pulsed-field gel electrophoresis, indicating transmission of MRSA between local hospitals. None of the strains carried the Panton-Valentine Leukocidin gene. SCCmec typing, multilocus sequence typing and spa typing were used to further characterize the MRSA. Three clones corresponded to frequently described pandemic clones: ST239-MRSA-III, ST36-MRSA-II and ST5-MRSA-I. ST239-MRSA-III and ST36-MRSA-II were minor clones and collectively accounted for 16% of the isolates. ST5-MRSA-I was the second-most prevalent clone and accounted for 37% of the isolates. The dominant local clone was the infrequently described ST612-MRSA-IV (44% of isolates), which has only been described in South Africa and Australia.

Salt gland adenitis associated with bacteria in Blue Penguins (Eudyptula minor) from Hauraki Gulf (auckland, New Zealand)

Three blue penguins (Eudyptula minor) were rescued between July 2006 and January 2007 off the east coast of Auckland, New Zealand. They were taken to a rehabilitation center, where they subsequently died in May 2007 and were submitted for necropsy. There was unilateral enlargement of the salt glands with disseminated small, pale, and firm foci in all birds. Histologic examination of the affected glands demonstrated the presence of multifocal granulomas and areas of severe squamous metaplasia of the collecting ducts. The remaining gland had areas of hyperplasia, dysplasia, and necrosis with a severe granulomatous inflammatory reaction. Intralesional gram-negative bacteria were detected, but, unfortunately, bacterial culture was unrewarding. No further cases were observed in penguins in the subsequent year, and the primary cause of the salt gland adenitis remains uncertain.

[Nursing study on the occurrence of unplanned home births in Tygerberg Hospital]. / 'N verpleegkundige ondersoek na die voorkoms van onbeplande tuisgeboortes by die Tygerberghospitaal.

A retrospective, descriptive study was conducted from March to May 1992 to investigate the incidence, factors associated with, and neonatal and maternal complications of babies born before arrival (BBA) at the Tygerberg Hospital and its peripheral clinics. This was done by means of a personal interview with 30 of the mothers within 6 hours after the birth of their babies, representing 44% of the study population during the period the study was undertaken. The incidence of BBA over the period was 5.3%. The typical patient who presented with BBA, was found to have little education, no or small income, gravida 2 and between the ages of 20 and 25 years. As much as 47% of patients did not have transport available. Only 53% of patients received specific guidance as to when to come to the hospital or clinic. The majority of these "informed" respondents, did not fully understand the information given to them. Maternal complications included vaginal and perineal lacerations, retained placenta and abruptio placentae. 47% of babies developed complications. Neonatal death, breech presentation, prematurity and umbilical cord around the neck, featured prominently. The lack of transport and inadequate or ineffective prenatal guidance and information as well as relative illiteracy were identified as the most important causative factors. The solution to the problem lies at least partially in better prenatal guidance, which includes specific reference to the symptoms of the onset of labour and the timely arranging of transport.

Embolisation of arteriovenous malformation of the spinal cord. A case report.

An arteriovenous malformation of the spinal cord in a 41-year-old man treated by intra-arterial embolisation is reported. The progressive spastic weakness and severe burning pain responded well to treatment. The carefully calculated use of Ivalon particles is essential and is described. Evoked potentials were used to monitor the status of the spinal cord during the procedure. It is essential that a team of clinicians and radiologists be established at major centres to handle such cases.

Bacterial aneurysm of the intracavernous carotid artery secondary to suppurative otitis media. A case report.

A case of an intracavernous carotid aneurysm, with ophthalmoplegia, secondary to cavernous sinus thrombophlebitis is reported. The necessity of angiography when this condition persists despite adequate antibiotic therapy is stressed.

Cardiac failure in a case of aneurysm of the vein of Galen associated with diffuse meningeal angiectasia.

A case of aneurysm of the vein of Galen associated with diffuse meningeal angiectasia is described and compared with a similar reported case. The current literature dealing with arteriovenous malformation of the vein of Galen in young children is reviewed. The need for proper clinical and angiographic examination of all newborn infants with congestive cardiac failure due to extracardiac causes is stressed. Attention is drawn to the association of meningeal angiectasia with arteriovenous malformation of the vein of Galen.

Temporal lobe epilepsy due to an intracerebral Schwannoma: case report.

An intracerebral Schwannoma giving rise to temporal lobe epilepsy is described. The possible origin of such tumours in the central nervous system in general, and in the temporal lobe in particular, is discussed.