BACKGROUND: This paper reviews our experience with management of renal injuries in children and adolescents with a focus on the outcome of non-operative management (NOM METHODS: Retrospective review of the clinical characteristics, injury grade (I-III, low grade and IV and V high grade), management and outcomes of children < 18 years old with renal trauma presenting to a major trauma centre in South Africa between December 2012 and October 2020 RESULTS: Sixty-one children with a renal injury were identified with a median age of 13 (range 0-18) years. Forty-five were boys; blunt and penetrating mechanisms of trauma were sustained by 55 (90%) and six (10%) children, respectively. The median American Association for the Surgery of Trauma (AAST) grade of renal injury was 3 (range 1-5): this included eight (13%) with grade I, six (10%) with grade II, 17 (28%) with grade III, 20 (46%) with grade IV and 10 (16%) with grade V injuries. Forty children (66%) were successfully managed non-operatively and 21 required a laparotomy; of these six (28%) required nephrectomy. The overall renal salvage rate was 55/61 (90%). Children who required laparotomy were significantly more likely to have sustained a penetrating mechanism of injury (24% vs 2%) and have greater length of hospital stay (median 9 vs 3 days) compared to children managed non-operatively (p < 0.05). Children who underwent a nephrectomy had a significantly greater length of hospital stay (median 9 vs 4 days, p = 0.03); however, their demographics, outcomes and complications were otherwise not different. Twenty-four (39%) children developed complications. Two children (3%) died; one managed non-operatively and one with a laparotomy CONCLUSION: Paediatric renal trauma can be successfully managed non-operatively in over two-thirds of cases in this middle-income country. High grade of renal injury does not absolutely predict need for surgery or nephrectomy and can be managed non-operatively

BACKGROUND: This study reviews the indications and outcome of emergency laparotomy for paediatric trauma in a South African trauma centre. METHODS: This was a retrospective study of all children less than 18 years of age who underwent an emergency laparotomy for trauma between December 2012 and October 2020 at Grey's Hospital in Pietermaritzburg. RESULTS: During the eight-year period under review, a total of136 children of which 107 were male underwent a laparotomy for trauma. The median age was 14 years. There were 80 (57.1%) blunt mechanisms, and the rest were penetrating mechanisms. A total of 46 (33%) patients required ICU admission. Thirty-four patients developed a complication. These included nine cases of pneumonia, one case of renal failure, two patients developed abdominal collections, three wound-related complications, three neurological complications and one miscellaneous complication. There were seven (5%) deaths. The penetrating cohort were older than the blunt cohort. Solid viscera were more likely to be injured in the blunt cohort and hollow viscera more likely in the penetrating cohort. A total of 16 (11%) patients underwent damage control surgery (DCS). Of this cohort, there were three female children. Six sustained blunt trauma and ten penetrating trauma. A total of six (37%) of these children died. CONCLUSION: Emergency laparotomy for trauma in children is not infrequent in Pietermaritzburg and there is a high incidence of penetrating trauma in this cohort. The response to increased degrees of physiological derangement is the application of DCS. Ongoing efforts to develop and strengthen a paediatric trauma service appear to be justified.

BACKGROUND: This study reviews our experience with paediatric trauma to help plan and strengthen ongoing strategies to deal with trauma in our regionMETHODS: All children and adolescents less than 18 years of age who were admitted to our centre following trauma between December 2012 and October 2020 were reviewedRESULTS: Over the 8-year period, 2 091 children were admitted with trauma to Grey's Hospital. There were 1 479 (71%) male patients, median age: 10 years. One thousand four hundred and fifty-eight (70%) patients were referral from rural regions. In 1 597 (76%) patients, the mechanism of injury was blunt trauma. A total of 387 (19%) patients underwent a surgical intervention, whilst 1 641 (78%) patients were managed non-operatively. In 63 patients, management records were missing. Multiple patients required multiple surgical procedures. A total of 144 patients had a laparotomy, 70 a soft tissue debridement procedure, 40 an orthopaedic procedure, 53 a neurosurgical procedure, which included 37 patients who underwent craniotomy, and 18 patients underwent a fasciotomy for compartment syndrome. There were 82 patients who required miscellaneous procedures. A total of 213 (10%) patients required ICU admission. There were 48 (2.3%) deathsCONCLUSION: The volume of child and adolescent trauma managed is significant and suggests that a dedicated paediatric trauma service in the region is warranted. It is hoped that future partnering with appropriate stakeholders will allow this service to continue to mature and provide leadership in all aspects of care of injured children in the region

RESUMO O objetivo deste comunicado é desenvolver um método quantitativo PCR em tempo real, baseado em guia molecular (MB) (MB-qPCR) para detecção de infecção por espécies de Brucella, e avaliar seu potencial de utilização clínica. Os primers e as sondas MB foram desenhados para amplificação específica e determinação de sequência conservada do código do gene para os primeiros 58-aa da proteína de membrana externa OMP-2a, que é compartilhada em cinco espécies de Brucella epidêmicas. A avaliação metodológica foi realizada por análise de sensibilidade, especificidade, coeficiente de variação intra e inter, e a linearidade do qPCR. O potencial diagnóstico foi avaliado comparando-se o método qPCR desenvolvido com ensaios de exames bacteriológicos convencionais, incluindo os testes de soroaglutinação convencionais (SATs) e os testes do Rosa Bengala (RBPTs). O método exibiu alta sensibilidade (tão baixo quanto 50 cópias) e grande faixa de linearidade (102-108 cópias). Nenhuma reação cruzada foi encontrada com bactéria clínica comum. A sensibilidade diagnóstica foi superior ao exame bacteriológico, e a especificidade diagnóstica foi superior ao SAT ou ao RBPT. Um método MB-qPCR altamente sensível e específico para DNA de Brucella foi estabelecido com sucesso, provando ser uma ferramenta útil no diagnóstico molecular de brucelose.

Mineral homeostasis is often disrupted in intrauterine growth retardation (IUGR) infants. Most studies focus on calcium or phosphorus metabolism of IUGR infants via determining serum mineral concentrations instead of tissues. This study was conducted to investigate the effects of IUGR on the mineralization and physiological functions of tissue in a piglet model. Six normal birth weight (NBW) and six IUGR neonatal piglets were slaughtered at 35 days. Mineral concentrations in blood and selected tissues (liver, kidney, lungs, heart, and longissimus dorsi muscle (LDM)), hepatic lipid, mRNA expressions of magnesium (Mg) metabolism, and autophagy were analysed. Results showed that IUGR pigs showed significantly lower phosphorus (P) in LDM, and lower Mg in the liver and LDM, and higher Mg in lungs than NBW pigs. There were no significant differences in concentrations of selenium (Se), calcium (Ca), copper (Cu), aluminium (Al), and lithium (Li) in selected tissues. IUGR pigs had similar mRNA expression of TRPM7 and MagT1 to NBW pigs, but significantly lower expressions of HNF1B and Mrs2 in the liver than NBW pigs. Hepatic triglyceride was significantly increased, and MAP1LC3B expression was significantly decreased in IUGR pigs compared with those of NBW pigs. These result suggested that IUGR pigs had tissue mineralization disturbance, especially for Mg, and liver dysfunction (increased hepatic lipid and inhibited autophagy). Hepatic Mg deficiency might result from increased Mg efflux via reducing HNF1B expression.

This study was aimed at investigating the effects of weaning on jejunal redox status, morphology and expression of cell cycle regulators in piglets. A total of 120 new-born piglets from 12 litters were divided into two groups: the control (suckled normally) and weaning group (weaned at day 21). Six piglets from each group were slaughtered at day 22, day 25 and day 28. Results showed that weaning increased the serum hydrogen peroxide (H2O2) and malondialdehyde (MDA), decreased inhibitory hydroxyl radical (IHR) concentrations and superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities at day 25. Furthermore, the jejunal nitric oxide (NO) level was increased at days 22 and 28, while H2O2 concentrationwas increased at days 22, 25 and 28. Results of jejunum morphology showed weaning decreased villous height and width, and increased crypt depth at day 25. Relative mRNA and protein expression showed that Smad4 was decreased at day 25 and then increased at day 28. The expression of p21 and p27 were significantly increased by weaning at days 25 and 28, but cyclin D and cyclin E showed no significant differences compared with control group. In conclusion, weaning increased the serum and jejunal reactive oxygen species (ROS) production, inhibited jejunum development and cell cycle progression through down-regulation of Smad4 and up-regulation of p21 and p27 of piglets, which further explained weaning-induced stress syndrome.

The study investigated the effects of various levels of isoflavone aglycone-enriched fermented soybean meal (FSBM) on the redox status, serum hormones and milk quality of ewes from late pregnancy to early lactation. Twenty Chongming White ewes were chosen and divided into four treatment groups (n = 5): basal diet without FSBM (CON); basal diet with 2% (FSBM2); 4% (FSBM4); and 6% FSBM (FSBM6) replacing equal amounts of soybean meal (SBM). At parturition, maternal serum, the placenta and colostrum were collected. At day 21 of lactation, maternal serum and milk were collected. Results showed that, compared with CON, feeding ewes with FSBM6 reduced the concentrations of hydrogen peroxide (H2O2) and 8-hydroxy-2-deoxyguanosine (8-OHdG), and increased the activity of superoxide dismutase (SOD) and total antioxidant capacity (T-AOC) concentration in the placenta. At parturition and day 21 of lactation, the serum SOD activity and T-AOC concentration in FSBM4 and FSBM6 were higher than those in CON. Furthermore, the concentration of serum 8-iso prostaglandin (8-ISO-PGF2a) was markedly lower in FSBM6 than in CON. Serum prolactin (PRL), insulin-like growth factor 1 (IGF-1) and epidermal growth factor (EGF) concentrations were increased in FSBM4 and FSBM6 compared with CON. PRL concentration was increased in FSBM2. FSBM4 increased the levels of fat, protein, lactose, IgA, IgG and IgM in colostrum and milk. In conclusion, feeding ewes with FSBM from late pregnancy to early lactation seemed to increase maternal and placental anti-oxidative capacity, and improve serum hormones and milk quality. Considered overall, the level of 4% supplementation is recommended.