AmpathChat #58 Influenza

Influenza is an infectious respiratory disease caused by the influenza virus. It can range from a mild infection to a severe life-threatening disease.

AmpathChat #57 Hypercalcaemia a Diagnostic Approach

Hypercalcaemia is a relatively common clinical problem. Primary hyperparathyroidism and malignancy are the most common causes of hypercalcaemia

AmpathChat #56 Cystic Fibrosis

Cystic fibrosis (CF) is one of the most common life-limiting autosomal recessive conditions in South Africa. CF is increasingly being recognised in all of South Africa.

AmpathChat #55 - Tissue typing: HLA typing and screening

Ampath Immunology is proud to announce the introduction of HLA tissue typing and antibody screening using Luminex PCR-based multiplex technology.

AmpathChat #54 - Helicobacter pylori: an update

Helicobacter pylori is a highly prevalent curved gram-negative bacterium. Seropositivity rates in South-Africa range between 60% and 100%. It causes more than 90% of duodenal ulcers and up to 80% of gastric ulcers. Atrophic gastritis due to H. pylori can lead to gastric cancer.

AmpathChat #53 - Molecular testing in colorectal carcinoma

Colorectal carcinomas arise from colorectal epithelium, which has undergone a series of molecular changes, referred to as the adenoma-carcinoma progression sequence.4 With increasing genetic mutations, progression from normal epithelium to adenomas with dysplasia occurs. Eventually, adenomas that show high-grade dysplasia give rise to invasive colorectal carcinomas.

AmpathChat #52 - Breast Cancer

All individuals with a positive family history of breast or ovarian cancer are not equally at risk. The likelihood that BRCA testing will be informative should be assessed prior to testing.

AmpathChat #51 - Penicillin Allergy

Penicillin allergy is the most commonly reported antibiotic allergy. However, very few patients ever have their penicillin allergy confirmed. Furthermore, less than 20% of patients who report a positive history of a prior reaction to penicillin are found to be allergic to penicillin upon skin prick testing. Avoidance of penicillin based on self-reported allergic history alone often leads to the use of an alternate antibiotic with greater cost or side effect profile.

AmpathChat #50 - Bordetella pertussis

Pertussis, also known as whooping cough, is a highly infectious disease of the respiratory tract. Bordetella pertussis is classically regarded as the sole agent of pertussis. However, infection with other Bordetella species, such as B. parapertussis and B. holmesii, can cause a similar, though typically milder, clinical picture.

AmpathChat #49 - Cystatin C

The prevalence of chronic kidney disease (CKD) and end- stage renal disease is increasing worldwide. Initial diagnosis relies on estimation of the glomerular filtration rate (GFR), and examination of urinary sediment and protein-excretion to establish the presence of kidney damage.

AmpathChat #48 - Expanded chromosome screening of products of conception (POCs)

Ampath Genetics is excited to announce the introduction of products of conception (POCs) testing using next generation sequencing (NGS) technology. NGS allows analysis of all chromosomes (1-22, X and Y), resulting in significantly increased pick-up rates of chromosomal abnormalities when compared to conventional testing approaches.

AmpathChat #47 - CRP vs PCT

Clinicians are faced with a growing population of immuno- compromised patients who are at risk of systemic infections. The diagnosis of bacterial septicaemia is unfortunately not straightforward. Positive blood cultures remain the gold standard.

AmpathChat #46 - Screening and Diagnosis of Diabetes

Fasting glucose levels are affected by the duration of fasting and the effect of circadian rythmicity, the latter being the predominant factor. Both glucose and insulin levels are highest in the early morning,

AmpathChat #45 - Non-invasive prenatal testing (NIPT)

NIPT is a safe and accurate prenatal screen to calculate the risk that a foetus has of being affected with a chromosomal condition, for example, Down Syndrome. NIPT makes use of cell-free DNA released from the placenta into the maternal bloodstream (Figure 1)

AmpathChat #44 - Vitamin D Overview

After much consideration about the most appropriate cutoffs to define adequate vitamin D status, Ampath has decided to lower the currently reported cutoffs to those proposed by the Institute of Medicine, and recently endorsed by the National Osteoporosis Foundation of South Africa. According to these guidelines, a 25-hydroxyvitamin D level < 12 ng/ml is regarded as vitamin D deficient, with levels between 12 and 19 regarded as insufficient and levels of 20 ng/ml or above as sufficient.

AmpathChat #43 - Approach to the Neutropaenic Patient

The extent of evaluation and the nature of intervention depends on duration, severity and clinical findings. The normal absolute neutrophil count (ANC) in adults is 1.5 to 7 x 10/9 per l. The following grading evolved from clinical experience with patients on cancer chemotherapy

AmpathChat #42 - Frozen Section - An Invaluable Tool for Intra-operative Surgical Consultation

The frozen section technique has evolved and has improved immensely from 1818, when Dutch anatomist Pieter de Reimer utilised cold brine (salt water) to harden tissues, until 1895, when Thomas Cullen, MD, published the first written frozen section technique from Johns Hopkins [1].

AmpathChat #41 - Drugs of Abuse Screening

Drugs of abuse screening (DOAS) is well established in the workplace and in professional sports. It is increasingly being used in casualties and/or emergency departments for the medical management of patients with an altered mental state and in trauma patients.

AmpathChat #40 - The Utility of Urinary Lipoarabinomannan Antigen - LAM- in HIV Infected Patients with Suspected TB

The urine lipoarabinomannan test (U-lam) has been marketed as an adjunct diagnostic modality in HIV-infected patients with severe immunosuppression. The test detects a cell wall component of the Mycobacterium tuberculosis bacterium that is excreted in urine. The lateral flow test format of the test (DetermineTM TB-LAM Ag test) is rapid and can be performed directly on urine.

AmpathChat #39 - Anaemia of Chronic Disease Inflammation

Anaemia of chronic disease (ACD)/inflammation is the leading cause of anaemia in hospitalised patients and the second-most common cause of anaemia after iron deficiency. The main aetiologies are infection, autoimmune disorders and malignancies.