South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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Acute pancreatitis is an often-overlooked cause of acute abdominal pain in children and adolescents. Severe hypertriglyceridaemia is an important cause of recurrent acute pancreatitis. Monogenic causes of hypertriglyceridaemia, such as familial chylomicronaemia caused by lipoprotein lipase deficiency, are more frequently encountered in children and adolescents, but remain rare. ⋯ We report two cases of severe hypertriglyceridaemia and pancreatitis in adolescent females. Hypertriglyceridaemia improved markedly with restriction of dietary fat. An inhibitor to lipoprotein lipase was found to be the cause in one patient, while in the other limited genetic investigation excluded chylomicronaemia owing to deficiency of lipoprotein lipase, its activators and processing proteins.
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SARS-CoV-2 was first identified in Wuhan City, China, in 2019. Initially it was associated with the development of pulmonary disease, but research over the past 2 years has identified effects on multiple systems. Neuropsychiatric manifestations of COVID-19 have been reported in countries around the world, including new-onset psychosis in patients with no personal or family psychiatric history. ⋯ The patients had varied psychiatric presentations, from delirium and psychosis to mania, and all responded well to low doses of antipsychotics. One patient had newly diagnosed HIV in addition to COVID-19. Further research is needed to determine the prevalence of neuropsychiatric manifestations in acute SARS-CoV-2 infections in SA.
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Adolescents and youth living with HIV (AYLHIV) face an elevated non-communicable disease (NCD) risk resulting from HIV, psychosocial challenges, and the complications of antiretroviral therapy. ⋯ Our findings of a high prevalence of NCDs and risk factors in AYLHIV highlight the importance of NCD risk screening as part of HIV care for AYLHIV. Such integrated approaches are needed to achieve the dual purpose of improving outcomes through early diagnosis of pre-existing NCDs as well as the prevention of NCD multimorbidity in AYLHIV. This study further demonstrates the need for early intervention on the social, environmental and economic determinants of NCDs targeting adolescents and youth.
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Observational Study
Profile, presentation and outcomes of prosthetic valve endocarditis in a South African tertiary hospital: Insights from the Groote Schuur Hospital Infective Endocarditis Registry.
Prosthetic valve infective endocarditis (PVE) is associated with high morbidity and mortality. The prevalence of PVE in South African retrospective studies ranges between 13% and 17%. ⋯ PVE was uncommon, mainly affecting tissue prosthetic valves and prosthetic valves in the aortic position. Patients with PVE were sicker than those with NVE and had high in-hospital mortality.