South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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Observational Study
Maternal and neonatal outcomes of COVID-19 in a high-risk pregnant cohort with and without HIV.
The impact of SARS-CoV-2 infection in pregnant women living with HIV (PLHIV) has not been described previously. ⋯ In this cohort of high-risk pregnant women, the impact of COVID-19 was severe, significantly increasing maternal mortality risk compared with baseline rates. Virally suppressed HIV infection was not associated with worse COVID-19 outcomes in pregnancy.
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Efavirenz (EFV), a non-nucleoside reverse transcriptase inhibitor, has been a component of first-line antiretroviral therapy (ART) in the South African HIV/AIDS programme since 2004. It is extensively used in ART programmes in other low- and middle-income countries. The natural history of the previously recognised EFV drug-induced liver injury (DILI) is not known. ⋯ EFV DILI is a severe drug complication of ART with appreciable mortality and significant inpatient morbidity, requiring prolonged hospitalisation and follow-up.
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People with spinal cord injury (SCI) experience preventable secondary health conditions (SHCs) that worsen the disability, reduce the quality of life and affect health and wellbeing. There is limited information on the prevalence of SHCs and the associated factors to inform planning and practice in South Africa (SA). ⋯ Secondary health conditions were prevalent among patients with SCI. People with SCI experience multimorbidity that requires multiple management strategies. These findings point to the need for prevention strategies to minimise the occurrence of SHCs.
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A scenario is presented in which a wife's request for religious reasons, and in accordance with her husband's wishes, that her husband not be given a potentially life-saving blood transfusion was ignored by the doctors. Her husband subsequently died. The question then arose whether her husband's estate, or she as his legal proxy, could bring an action for pain and suffering and sentimental damages against the doctors on behalf of her husband. ⋯ The spouse may only claim damages for pain and suffering and sentimental damages if he or she can show that the defendants' conduct regarding the deceased directly affected the spouse concerned. Where emotional shock was caused negligently, a spouse may only recover patrimonial damages and damages for pain and suffering. Where such shock was caused by intentional conduct, additional sentimental damages may also be claimed.