South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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Historical Article
Handmaidens and pioneers: Three female anaesthetists and their contribution to anaesthesia in South Africa.
The period during and after World War II saw enormous changes in the practice and status of anaesthesia, as well as in female participation. This article offers an account of three South African (SA) women who trained in anaesthetics before and during the War and participated in these changes. By the mid-1960s, they presided over the three independent anaesthetic departments at Johannesburg's three main teaching hospitals, teaching generations of junior doctors. ⋯ Hilde Ginsberg collaborated with Barlow in the 1950s, reducing intraoperative and perioperative mortality at Coronation Hospital, and fought for key interventions in anaesthetic practice and policy through the South African Society of Anaesthetists (SASA), becoming its most long-serving and honoured female member. Kathleen Barbara Vetten's exemplary career in academic medicine, including pioneering animal research (developing anaesthetic techniques for open-heart surgery in dogs and protocols for liver transplantation in primates) and a successful operation to separate craniopagus twins, shows both the achievement of and limits to female achievement at the end of this period. This article also offers a short account of factors that hindered black women from entering anaesthesia training, contributing to this history before the 1990s.
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Review
Rapid evolution of our understanding of the pathogenesis of COVID-19: Implications for therapy.
COVID-19 severity appears to lie in its propensity to cause a hyperinflammatory response, attributed to the cytokine release syndrome (CRS) or 'cytokine storm', although the exact role of the CRS remains to be fully elucidated. Hyperinflammation triggers a hypercoagulable state, also thought to play a key role in COVID-19 pathogenesis. Disease severity is linked to age, sex and comorbid conditions, which in turn may be linked to oxidative stress and pre-existing depletion of nicotinamide adenine dinucleotide (NAD+). ⋯ Since most information pertaining to COVID-19 has thus far been extrapolated from the 'global North', similar studies in African populations are warranted. Many studies are aimed at finding a therapeutic strategy based on scientific rationale. Some promising results have emerged, e.g. the use of corticosteroids in severe acute respiratory distress syndrome (ARDS).