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Search Results: 1 - 10 of 297503 matches for " Riette J Brits "
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sRAGE in diabetic and non-diabetic critically ill patients: effects of intensive insulin therapy
Yaseen M Arabi, Mohammed Dehbi, Asgar H Rishu, Engin Baturcam, Salim H Kahoul, Riette J Brits, Brintha Naidu, Abderrezak Bouchama
Critical Care , 2011, DOI: 10.1186/cc10420
Abstract: A predesigned analysis was conducted of prospectively collected samples from 76 hyperglycemic critically ill patients (33 type-2 diabetes, 43 non-diabetes) aged ≥18 years with blood glucose of > 6.1 mmol/L enrolled in a randomized controlled trial comparing intensive insulin therapy with conventional insulin therapy. sRAGE and its ligand HMGB-1 together with IL-6, and soluble thrombomodulin (as markers of inflammation and endothelial cell injury, respectively) were evaluated in ICU, at Days 1, 3, 5 and 7. Plasma samples from 18 healthy subjects were used as controls.Both diabetic and non-diabetic hyperglycemic patients showed increased plasma sRAGE, HMGB-1 and soluble thrombomodulin levels at the time of admission to ICU. Plasma IL-6 concentration was only increased in non-diabetic patients. Plasma levels of sRAGE were higher in diabetic compared with non-diabetic patients. Intensive insulin therapy resulted in a significant decrease of sRAGE and thrombomodulin at Day 7, in diabetic but not in non-diabetic patients. Circulating sRAGE levels correlated positively with IL-6 and soluble thrombomodulin levels and inversely with HMGB-1. Multivariate regression analysis demonstrated that sRAGE remains independently correlated with HMGB-1 only in diabetic patients. Neither sRAGE nor any inflammatory markers are associated with mortality.These findings support the hypothesis that sRAGE release, time-course and response to intensive insulin therapy differ between hyperglycemic diabetic and non-diabetic critically ill patients. Whether this difference underlies the dissimilarity in clinical outcome of hyperglycemia in these two conditions warrants further studies.Hyperglycemia represents an important independent risk factor for morbidity and mortality in critically ill patients admitted to ICU [1,2]. Accordingly, the benefit of strict control of blood sugar with intensive insulin therapy (IIT) versus conventional insulin therapy (CIT) has been greatly debated with some studie
Etomidate and mortality in cirrhotic patients with septic shock
Antoine J Cherfan, Hani M Tamim, Abdulrahman AlJumah, Asgar H Rishu, Abdulmajeed Al-Abdulkareem, Bandar A Al Knawy, Ali Hajeer, Waleed Tamimi, Riette Brits, Yaseen M Arabi
BMC Pharmacology and Toxicology , 2011, DOI: 10.1186/1472-6904-11-22
Abstract: This is a nested-cohort study within a randomized double blind placebo controlled study evaluating the use of low dose hydrocortisone in cirrhotic septic patients. Cirrhotic septic patients ≥ 18 years were included in the study. Patients who received etomidate prior to intubation were compared to those who did not receive etomidate for all cause 28-day mortality as a primary outcome.Sixty two intubated patients out of the 75 patients randomized in the initial trial were eligible for this study. Twenty three of the 62 intubated patients received etomidate dose prior to intubation. Etomidate use was not associated with all cause 28-day mortality or hospital mortality but was associated with significantly higher ICU mortality (91% vs. 64% for etomidate and controls groups, respectively; p = 0.02). Etomidate patients who received subsequent doses of hydrocortisone required lower doses of vasopressors and had more vasopressor-free days but no improvement in mortality.In this group of septic cirrhotic patients with very high mortality, etomidate increased ICU mortality. Subsequent use of hydrocortisone appears to have no benefit beyond decreasing vasopressor requirements. The lowest mortality was observed in patients who did not receive etomidate but received hydrocortisone.Hypoxemia, hypotension, volume depletion are commonly present in septic shock patients and induction of anesthesia may cause cardiovascular collapse. This effect is thought to be least with etomidate making it the favored agent to use for rapid-sequence intubation (RSI) of patients who have or are at risk of hemodynamic collapse increasing its use in the critical care setting [1-4]. However, etomidate use is not without risks as it has been shown to suppress the adrenal function through the inhibition of 11 β-hydroxylase enzyme that converts 11 β-deoxycortisol into cortisol in the adrenal gland leading to a state of relative adrenal insufficiency that may persist for up to 72 hours [5-10]. What remains
An investigation into the dramatic increase in deaths from gastroenteritis during the summer of 2007/08 at National District Hospital, Bloemfontein, Free State
H Brits, J Joubert
South African Family Practice , 2009,
Abstract: Introduction and background: Despite national guidelines and agreed upon admission and referral criteria for children in National District Hospital (NDH), Bloemfontein, the number of children admitted with gastroenteritis (GE) has increased dramatically since December 2007. From the previous year’s Child Healthcare Problem Identification Programme (Child PIP) data the increase in GE admissions was evident in NDH. During the preceding year, 123 children were admitted for GE and during the audit period 267. The number of deaths in NDH also increased from an average of 2.25 a month over the past 3 years to 10 a month during January and February 2008. Aim: The aims of the study were: to determine the causes of death of children in NDH; to determine the relationship between nutritional status, HIV disease, laboratory results, demographic data, time of admission, duration of admission and other diseases or conditions and GE child deaths in NDH; to determine whether doctors adhered to prescribed GE treatment protocols; to determine whether nursing personnel carried out doctors’ orders as prescribed; and to identify other factors that contributed to GE deaths. Methodology: A cross-sectional study design was used. All child deaths, as well as all children admitted with GE to Ward 3 in NDH from May 2007 to April 2008 were included in the study. The first author collected the information on a cause of death form, a data form and an audit tool. As part of the quality-improvement project, 10 items were assessed to determine whether doctors adhered to treatment protocols, and 10 items were assessed to determine whether nurses adhered to nursing orders and basic nursing care. Any other factors that contributed to poor care were also noted. Results: 1. Cause of death: During this period, 49 children died, 33 (67%) due to GE, 6 (12%) due to tuberculosis (TB), 5 (10%) due to septicaemia, 4 (8%) due to pneumonia and 1 (2%) due to congenital abnormalities. Only 4.1% of the children who died were considered as normal weight for age according to their Road to Health Chart (RTHC). Regarding HIV status, 82.5% of the children who died tested HIV positive. In total, 19.4% of all GE admissions died during this one-year period. 2. GE deaths: Demographic data such as gender and age did not influence the outcome of GE. As expected, severe malnutrition, HIV-positive status and severe dehydration all contributed statistically significantly to high mortality in GE. Severe abnormalities occurred in the laboratory results of most of the children who died and indicated the severity of their disease(s). No specific organisms were cultured from stool specimens and the quality of drinking water in Bloemfontein was declared safe for human consumption. 3. Other factors that contributed to GE deaths: Medical and nursing care were of a high standard and treatment protocols were followed. Pre-admission factors such as transport, non-availability of 24-hour medical services, non-initiation
R. Brits,P.J. Conradie
South African Journal of Industrial Engineering , 2012,
Abstract: ENGLISH ABSTRACT: While improving customer service by allowing user definable mixed load orders of their plate glass product, PFG Building Glass was confronted with a problem of calculating the feasibility and optimum load layout for transporting the glass, without transgressing the regulatory requirements. In this article the development of an integrated solution is discussed, including the definition of a mathematical model that calculates the axle weights, the optimization model based on linear programming, as well as the user interface for their current information system. The solution enables the company to proceed with e-commerce service to clients, since the system can evaluate the transport feasibility and give real time feedback to clients. AFRIKAANSE OPSOMMING: Die uitbreiding van kli ntediens by PFG Building Glass om bestellings van gemengde glasplaatprodukte per vrag te aanvaar, het die onderneming voor ‘n uitdaging geplaas om te bereken of sulke bestellings binne die wetlike regulasie vervoer sal kan word. Hierdie artikel bespreek die ontwikkeling van ‘n ge ntegreede oplossing wat bestaan uit ‘n wiskundige model wat die gewig per as bereken, ‘n optimiseringsmodel wat die vraguitleg bepaal en op liniêre programmeringsbeginsels gebaseer is, sowel as die gebruikersintervlak met die onderneming se bestaande inligtingstelsel.Hierdie ontwikkeling stel die onderneming instaat om ‘n e-besigheidsdiens vir kliente daar te stel, aangesien terugvoer oor die uitvoerbaarheid van ‘n bestelling uit ‘n vervoeroogpunt intyds aan die kli nt gekommunikeer kan word.
Technique to study the impact of large herbivores on woody vegetation within piospheres
J. Brits,M.W. van Rooyen,N. van Rooyen
Koedoe : African Protected Area Conservation and Science , 2000, DOI: 10.4102/koedoe.v43i2.198
Abstract: A continuously sampled transect away from a watering point provides good results in situations where geology and soil type remain constant, but is unsuitable to apply where regular changes in soil type occur. A comparison was made between a continuously sampled transect and sampling taken at intervals along the transect. An analysis of variance indicated no significant differences in any of the variables obtained by means of the two sampling methods. The advantage of interval sampling is that, within each zone, areas with the same soil type can be selected in order to avoid environmental heterogeneity. A comparison between transects made in different directions from the watering point yielded no significant differences in any of the structural variables of the woody vegetation at the same distance from the watering point. Therefore, combining transects from different directions to attain a representative sample away from the watering point was an acceptable practice. It is recommended that the original data be smoothed and the logistic function used to model the impact of large herbivores on the structure of the woody vegetation around watering points.
L. Brits
Scientia Militaria : South African Journal of Military Studies , 2012, DOI: 10.5787/12-2-628
Abstract: The adoption of the Union Defence Act No 13 of 1912 led to the creation of the Union Defence Force. In this regard article 28 Sub-article 5 of the Act also made provision for the appointment of military chaplains: 'Citizens may be appointed to commissioned rank as Chaplains .. .'1)
Prioritising transport infrastructure projects: Towards a multi-criterion analysis
IC Schutte, A Brits
Southern African Business Review , 2012,
Abstract: This paper explores a number of aspects relevant to developing a systematic framework for the appraisal of transport infrastructure projects of the type ‘budget cycle projects with local economic impacts’, and applying it to the City of Tshwane. Such a framework is needed as, by implication, the budgeting process for any transport agency requires projects to be ranked in terms of their relative value. Cost/benefit analysis, when applied in a classic sense, is not suitable for this purpose, given its exclusive focus on economic efficiency, whilst attempts to broaden it to include other impacts (or objectives) are not generally accepted. Multi-criterion analysis, however, is capable of facilitating project ranking in a multi-objective decisionmaking environment, but needs to be customised first to accurately reflect local conditions. The paper concludes that an appraisal framework should combine these two types of analysis by adopting an overall multi-criterion approach with economic efficiency (optimal allocation of resources), equity (impact distribution aspects), sustainability (environmental considerations) and compatibility (alignment with community goals and objectives, and other strategic initiatives) as decision criteria. This will ensure a usable protocol for the appraisal of this type of transport infrastructure project in an essentially multi-criterion decision-making environment.
Investigating the status of supplementary tuition in the teaching and learning of mathematics
David Mogari,Hanlie Coetzee,Riette Maritz
Pythagoras , 2011, DOI: 10.4102/pythagoras.v0i0.44
Abstract: The study seeks to investigate the status of supplementary tuition in the teaching and learning of mathematics and mathematical literacy. The study followed a descriptive survey design involving the use of learner and teacher questionnaires. A convenient sample of mathematics and mathematical literacy teachers together with a stratified sample of their Grade 11 learners were drawn from a purposive sample of highperforming high schools in the East London district of the Eastern Cape, South Africa. The results show that supplementary tuition is popular, especially among girls, and it is in three forms (i.e. private tuition, vacation school and problem-solving classes): Problemsolving classes dominated by working on past/model examination papers is the most preferred; in some instances supplementary tuition is offered for a fee; it is not only confined to poor performing learners; and participation in supplementary tuition is influenced by a variety of factors.
Human biomonitoring on heavy metals in Ath: methodological aspects
Javiera Rebolledo, Sebastien Fierens, Ann Versporten, Ethel Brits, Pierre De Plaen, An Van Nieuwenhuyse
Archives of Public Health , 2011, DOI: 10.1186/0778-7367-69-10
Abstract: This paper describes the study design and methodology used to carry out this human biomonitoring.A random sampling was done in the general population, in two areas of Ath: an area centered around the industries and a peripheral area. The target population was children (2.5-11 years) and adults (40-60 years) without occupational exposure. The three-stage sampling procedure consisted of a mixture of both mail and telephone recruitment. Firstly, 3259 eligible people, identified from a population register, were mailed an introductory letter. In a second stage, eligible individuals were contacted by phone to propose them to participate in the study. They were randomly contacted until the required sample size was obtained. In the third stage, a second mail was sent to those who agreed to participate with a questionnaire to be filled out. Finally, biological samples (blood and urine) from 278 persons were collected. The final participation rate of this study was 24%.This sampling procedure, especially designed for the purpose of this biomonitoring study in Ath, allowed us to recruit a sample representative of the population of children and adults of Ath, reaching the expected sample size in a short period of time.The Belgian municipality of Ath is characterised by the presence, in the center of the town, of two industries of non-ferrous metals. The industries are known for their production of lead, cadmium, chromium, cobalt, nickel and zinc. Therefore, Ath may have long been polluted by the emissions of those industries. Furthermore, an environmental study had found relatively high levels of lead, cadmium, chromium, cobalt and nickel in the surface soil in the vicinity of these industries [1]. Health concerns rose among neighbors of this area due to the possible exposure to heavy metals and exposure-related health effects, especially for children living close to such sources. Therefore, the authorities of the Walloon Region and the municipality of Ath decided to undertake
Marginally trapped tubes and dynamical horizons
Ivan Booth,Lionel Brits,Jose A. Gonzalez,Chris Van Den Broeck
Physics , 2005, DOI: 10.1088/0264-9381/23/2/009
Abstract: We investigate the generic behaviour of marginally trapped tubes (roughly time-evolved apparent horizons) using simple, spherically symmetric examples of dust and scalar field collapse/accretion onto pre-existing black holes. We find that given appropriate physical conditions the evolution of the marginally trapped tube may be either null, timelike, or spacelike and further that the marginally trapped two-sphere cross-sections may either expand or contract in area. Spacelike expansions occur when the matter falling into a black hole satisfies $\rho - P \leq 1/A$, where $A$ is the area of the horizon while $\rho$ and $P$ are respectively the density and pressure of the matter. Timelike evolutions occur when $(\rho - P)$ is greater than this cut-off and so would be expected to be more common for large black holes. Physically they correspond to horizon "jumps" as extreme conditions force the formation of new horizons outside of the old.
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