Damon Bizos

Morphologic alterations in esophageal squamous cell carcinoma after preoperative high dose rate intraluminal brachytherapy.

Total esophagectomy specimens from 4 patients given preoperative high dose rate intraluminal brachytherapy (HDRILBT) of 20 Gray (Gy) in 2 fractions of 10 Gy each week were reviewed for radiation changes.

Guideline: appropriate use of tigecycline

INTRODUCTION Tigecycline, the first of a new class of antibiotics, the glycylcyclines, was licensed in South Africa for the parenteral treatment of adult patients with complicated intra-abdominal infections (cIAIs) and complicated skin and soft-tissue infections (cSSTIs). METHODS A multidisciplinary meeting representative of the Association of Surgeons of South Africa, the Critical Care Society of Southern Africa, the Federation of Infectious Diseases Societies of Southern Africa, the South African Thoracic Society and the Trauma Society of South Africa was held to draw up a national guideline for the appropriate use of tigecycline. Background information reviewed included randomised controlled trials, other relevant publications and local antibiotic susceptibility patterns. The initial document was drafted at the meeting. Subsequent drafts were circulated to members of the working group for modification. OUTPUT The guideline addresses several important aspects of the new agent, summarising key clinical data and highlighting important considerations with the use of the drug. The recommendations in this guideline are based on currently available scientific evidence together with the consensus opinion of the authors. CONCLUSION This statement was written out of concern regarding the widespread misuse of antibiotics. Its primary intention is to facilitate heterogeneous use of antibiotics as a component of antibiotic stewardship and to highlight the appropriate use of tigecycline in particular.

Comparison of the incidence of oesophageal cancer in two 6-year periods from selected hospitals in and around Gauteng Province, South Africa

Introduction. Global trends suggest that the incidence of squamous cell carcinoma (SCC) has decreased but that the incidence of adenocarcinoma (AC) has increased. In South Africa, outdated data exist, thereby prompting this investigation. Objectives. To determine the incidence of oesophageal cancer in two 6-year periods in and around Gauteng Province. Further distinction was made based on gender, race and histological types. Methods. A retrospective audit was conducted including histologically documented oesophageal cancer cases collected over a 12-year period from 2001 to 2012, which was divided into two 6-year periods. Incidence was calculated based on the 2013 Gauteng estimated population size. Statistical analysis was performed using the χ 2 test. Results. On the whole, there was a significant decrease in the incidence of SCC ( p =0.0001). Significant decreases were seen in the African male and female groups ( p =0.001 and p =0.0006, respectively). No significant difference was seen in the non-African male and female groups. A non-significant decrease was seen in the AC type with regards to gender and race. Conclusion. Reasons for the decline shown here are unknown as patient risk factors were not available. Furthermore, major healthcare centres were not included. These are points for future investigation. The incidence of oesophageal cancer has decreased since 2001, owing to the decrease in SCC in African males and females. Although the decreases in the AC type were not significantly different, they do not parallel global trends.

Guideline Summary: Appropriate use of tigecycline

Tigecycline, the first of a new class of broad-spectrum antibiotics (the glycylcyclines), has been licensed in South Africa for the parenteral treatment of adult patients with complicated intra-abdominal infections (cIAIs) and complicated skin and soft-tissue infections (cSSTIs). This article serves as a summary of the guideline on the appropriate use of tigecycline, published in mid-2010 as a collaborative effort by representatives of the Association of Surgeons of South Africa, the Critical Care Society of Southern Africa, the Federation of Infectious Diseases Societies of Southern Africa, the South African Thoracic Society and the Trauma Society of South Africa.