There is a significant burden of surgically correctable cardiovascular disease in Africa. The goal of this research was to review the last 20 years of literature on this topic. A systematic search was performed using PubMed, Embase and African Index Medicus for the period 1996-2016. Publications came from 29 countries, all of different income brackets. Research output increased by 15-fold over the 20-year time period, with the majority of publications authored by local teams (71.4%) compared to visiting (4.9%) and mixed teams (23.7%). Although increasing, clinical reporting on cardiac surgery is still limited. Increased publication of results should be encouraged to better benchmark capacity and improve research capacity.SIGNIFICANCE: •The majority of the cardiovascular publications came from local research teams affiliated with public hospitals which suggests strong local engagement in research and cardiovascular care. •Research output significantly increased and the share of literature from major research contributors has relatively shrunk over the study period, which suggests emerging research capacities from previously underrepresented regions. •A demographic analysis of publications showed that studies were set in countries from all income brackets, with the majority of the studies originating from low-income countries. •There is a need to standardise reporting of surgical outcomes which is dependent on perioperative care and maintenance of high-quality health records. •Over half of the publications lacked evidence of outpatient follow-up or data on postoperative care, which highlights the need to focus on patient outcomes as a metric

Purpose: We evaluated the effectiveness of combining behavioral therapy, pharmacologic therapy and endoscopic hydrodistension for treating painful bladder syndrome / interstitial cystitis (PBS/IC). Materials and Methods: Twenty-five patients with PBS/IC were prospectively enrolled in a pilot multimodal behavioral, pharmacologic and endoscopic treatment protocol. Behavioral modification included diet recommendations, fluid restriction to 64 oz. /day, progressive timed voiding and Kegel exercises. Oral pharmacologic therapy consisted of daily doses of macrodantin 100 mg, hydroxyzine 10-20 mg and urised 4 tablets. Patients underwent endoscopic bladder hydrodistention under anesthesia at least 2 weeks after protocol enrollment. Behavioral and pharmacological treatments were continued after the hydrodistention. O'Leary-Sant questionnaire scores were recorded before starting the protocol, after pharmacologic/behavioral therapy, 2 months post-hydrodistension, and at scheduled follow-up. Results: Eighteen patients (72%) completed the pilot multimodal treatment protocol and were followed for a mean of 10.2 months. All patients were female with a median age of 36.3 years and had mean bladder capacity under anesthesia of 836 milliliters. Mean O'Leary-Sant symptom index scores for baseline symptoms, after behavioral/pharmacologic treatment, post-hydrodistension and during follow up were 12.5, 8.6, 7.0, and 6.7 (p < 0.05). Mean O'Leary-Sant problem index scores for baseline, after behavioral/pharmacologic treatment, post-hydrodistention and during follow up were 12.7, 8.9, 6.7, and 7.7 (p < 0.05). Conclusion: Our pilot multimodal protocol of behavioral modification, pharmacologic therapy and endoscopic hydrodistention demonstrated a significant progressive improvement in PBS/IC quality of life scores, compared to a pre-treatment baseline. These results should be validated in a larger, placebo controlled trial.

The present article is the adapted version of an electronic symposium organized by the Brazilian Society of Neuroscience and Behavior (SBNeC) which took place on June 14, 2000. The text is divided into three sections: I. The main issues, II. Chronodrugs, and III. Methods. The first section is dedicated to the perspectives of chronobiology for the next decade, with opinions about the trends of future research being emitted and discussed. The second section deals mostly with drugs acting or potentially acting on the organism's timing systems. In the third section there are considerations about relevant methodological issues concerning data analysis.