Differences between bone mineral density, lean and fat mass of HIV-positive and HIV-negative black women

Objectives: To investigate the differences between bone mineral density (BMD), lean and fat mass of human immunodeficiency virus (HIV-) positive and HIV-negative black women and to investigate factors associated with low BMD. Methods: Case-control study of black women (n= 565) aged 29­65 years from Potchefstroom, North West province, South Africa, based on secondary analysis of data. Total BMD, left femur neck of the hip (LFN BMD), spine BMD, total fat, fat-free tissue mass and percentage body fat (%BF) were measured by dual-energy X-ray absorptiometry. Results: HIV-negative women had significantly higher median BMD, %BF, appendicular skeletal mass (ASM), ASM index, body mass index (BMI) and waist circumference than HIV-positive women. When the groups were matched for age and BMI, only spine BMD was marginally lower in HIV-positive women. In the total group, age, smoking and HIV status were associated with lower BMD, while calcium intake was positively associated with BMD. Similar variables were associated with BMD in HIV-negative women, while age and educational status were associated with BMD in HIV-positive women. Conclusion: Low BMD was more common among HIV-positive than HIV-negative women. Older HIV-positive women with low educational status are particularly at risk

The Impact of a Change in Referral Pathway on a Paediatric Short-Stay Ward in Cape Town; South Africa

Background. The opening of the new Khayelitsha District Hospital in April 2012 coincided with a change in referral pathway to Tygerberg Hospital (TBH) for children requiring specialist care. Objective. To determine the disease burden impact of the referral pathway change on paediatric short-stay ward admissions at TBH. Methods. A retrospective cohort study; analysing routine health information as captured in ward admissions registers over two similar seasonal periods: 1 April - 30 September 2011 (prior to referral change) and 1 April - 30 September 2012 (post referral change). Results. Paediatric short-stay ward admissions remained similar; but a statistically significant increase in the number of admissions from Khayelitsha sub-district (SD) (p0.001) was seen. The median age was 13 months over the two time periods.Children from Khayelitsha (median age 9.49 months for 2011 and 5.2 months for 2012) were; however; significantly younger than those from other SDs (median age 26.31 months in 2011 and 26.44 months in 2012) (p

Childhood Cancer Survival and Future Challenges

The history of childhood cancer treatment is one of the major success stories of the second part of the 20th century; where cure rate improved from no survival in 1950 to more than 70in the present day. This cure rate is due to the development of dedicated paediatric oncology units; prospective clinical trials; and improved supportive care. The challenges for the 21st century include finding therapies that will cure the other 30of children and reduce the complications of treatment. At the same time only about 20of the world's children has access to this specialized care and a major focus area is how to ensure improved access to these treatment modalities for the other 80of the world's children