South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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Neurological disease heralds the development of AIDS in 10-20% of HIV-seropositive individuals. In over half of these cases the presentation will be that of an intracranial mass lesion (IML). In developed countries toxoplasmosis is the most frequent cause of IML in a positive patient, followed by primary central nervous system lymphoma. Less common causes include tuberculomas, cryptococcomas, abscesses and gummas. As a result of these observations, the algorithm adopted in developed countries calls for initial empirical treatment for toxoplasmosis. Biopsy of the IML is only considered if there is no response to treatment after 10-14 days. Whether such an algorithm would be applicable to the local population is unknown. ⋯ This study demonstrated that the spectrum of IML seen locally was similar to that in developed countries. The management protocol used elsewhere was therefore adopted for local patients.
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To develop additional criteria to predict for successful extubation of very-low-birth-weight infants recovering from respiratory distress syndrome. ⋯ In addition to following very precise ventilatory criteria for extubation, we found that bedside measurement of total respiratory system compliance added to the likelihood of extubation success in infants recovering from respiratory distress syndrome. Prospective studies are needed to validate the findings of this study.
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Meta Analysis
A meta-analysis of the use of corticosteroids in pregnancies complicated by preterm premature rupture of membranes.
A systematic review of the literature has been undertaken with regard to the use of corticosteroids in women with preterm premature rupture of membranes (PPROM). the benefit of corticosteroids clearly outweighs their potential harmful effects. Antibiotics should probably be included in any management protocol for women with PPROM. There is no reason to suggest that use of corticosteroids in women with PPROM needs to be restricted in developing countries.