Browsing by Author "Ross, Ian L"

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    Anti-retroviral therapy increases the prevalence of dyslipidemia in South African HIV-infected patients
    (Public Library of Science, 2016) Dave, Joel A; Levitt, Naomi S; Ross, Ian L; Lacerda, Miguel; Maartens, Gary; Blom, Dirk
    Purpose Data on the prevalence of dyslipidaemia and associated risk factors in HIV-infected patients from sub-Saharan Africa is sparse. We performed a cross-sectional analysis in a cohort of HIV-infected South African adults. METHODS: We studied HIV-infected patients who were either antiretroviral therapy (ART)-naive or receiving non-nucleoside reverse transcriptase inhibitor (NNRTI)-based or protease inhibitor (PI)-based ART. Evaluation included fasting lipograms, oral glucose tolerance tests and clinical anthropometry. Dyslipidemia was defined using the NCEP ATPIII guidelines. RESULTS: The median age of the participants was 34 years (range 19-68 years) and 78% were women. The prevalence of dyslipidemia in 406 ART-naive and 551 participants on ART was 90.0% and 85%, respectively. Low HDL-cholesterol (HDLC) was the most common abnormality [290/406 (71%) ART-naïve and 237/551 (43%) ART- participants]. Participants on ART had higher triglycerides (TG), total cholesterol (TC), LDL-cholesterol (LDLC) and HDLC than the ART-naïve group. Severe dyslipidaemia, (LDLC> 4.9 mmol/L or TG >5.0 mmol/L) was present in <5% of participants. In multivariate analyses there were complex associations between age, gender, type and duration of ART and body composition and LDLC, HDLC and TG, which differed between ART-naïve and ART-participants. CONCLUSION: Participants on ART had higher TG, TC, LDLC and HDLC than those who were ART-naïve but severe lipid abnormalities requiring evaluation and treatment were uncommon.
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    Hyperthyroidism - an unusual feature of thyroid carcinoma
    (MedPharm Publications, 2006) Ekpebegh, Chukwuma O; Ross, Ian L; Levitt, Naomi S
    A 53-year-old woman presented with thyrotoxicosis, which is an unusual manifestation of thyroid carcinoma. Hyperthyroidism associated with malignancy usually occurs with well-differentiated follicular thyroid carcinoma. We show that extensive disease burden contributed to the development of hyperthyroidism, the occurrence of the Jod-Basedow phenomenon and the subsequent death of the patient. This diagnosis and treatment can be challenging.
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    Investigation of microRNA expression in thyroid carcinoma among South Africa patients
    (2017) Mokhesi, Neo; Naidoo, Richard; Govender, Dhiren; Ross, Ian L; Dandara, Collet
    Objective: Thyroid cancer affects approximately 298 million people worldwide and the major challenge is reliably distinguishing patients who present with poor prognosis from those who do not. There are genetic markers that have been shown to be associated with poor clinical outcome in thyroid cancer, which include mutations in the BRAF and RAS genes. In addition to genetic variation, recent studies have reported on the effects of micro-ribonucleic acids' (miRNAs) differential expression observed in tumour and normal tissue as another possible marker of thyroid cancer prognosis. Therefore, miRNA expression signatures in thyroid cancer could be used as biomarkers for prognosis and diagnosis. This study compared the expression of miRNAs in papillary thyroid cancer and follicular thyroid cancer. Methods: As part of a preliminary study, 66 differentiated thyroid cancer samples were obtained from patients attending Groote Schuur Hospital and used in the study. MiRNA miScript polymerase chain reaction (PCR) Array (Qiagen) was used to determine the differential miRNA expression profiles between follicular thyroid carcinoma (FTC) and papillary thyroid carcinoma (PTC). Real time PCR was employed to confirm the expression levels of miRNA- 21 and miRNA-122. Results: 17 miRNAs were upregulated in PTC and 14 in FTC. There were significant differences in the miRNA expression between FTC and PTC. For example, miRNA-21 was the most upregulated miRNA in PTC and miRNA-122 in FTC. We found no correlation of the expression of these miRNAs to clinicopathological features. We observed an association of BRAF mutation positivity to advanced tumour stage and advanced age of presentation however, no correlation was seen to miRNA-21 or miRNA-122 expression. Conclusion: Although we did not observe correlations between miRNAs and any of the clinicopathological features, microRNA expression profile signatures were able to differentiate between PTC and FTC and could potentially be further validated as diagnostic markers.
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    Overt hypoadrenalism is uncommon in patients with stage 3 and 4 bronchogenic carcinoma
    (Health & Medical Publishing Group, 2003) Ross, Ian L; Marais, Suzaan; Raubenheimer, Peter; Abratt, Raymond; Isaacs, Sedick; Soule, Steven
    Introduction. Lung cancer is the leading cause of cancer mortality in most countries. The adrenal glands are common sites of metastatic lung cancer as approximately 40% of subjects with stage 4 bronchogenic carcinoma have adrenal metastases. The prevalence of biochemical hypoadrenalism is, however, remarkably poorly documented. Objectives. Our study aimed to determine the prevalence of primary hypoadrenalism, as defined by a subnormal cortisol response to the 250 µg adrenocorticotrophic hormone (ACTH) stimulation test, in patients with stage 3 and 4 lung cancer. Methods. Thirty patients with stage 3 and 4 bronchogenic carcinoma were prospectively recruited from the bronchus clinic. Demographic data and electrolytes were recorded and each patient had a 250 µg ACTH stimulation test to determine the prevalence of overt adrenal insufficiency, defined as a +30 minute cortisol of less than 550 nmol/l. Results. The median age and quartile deviation was 62 (10) years and the median basal cortisol was 429.5 (321) nmol/l. The median peak cortisol was 828.5 (342) nmol/l (range 536 - 1 675 nmol/l). Twenty-eight patients (93.3%) had an appropriate rise of cortisol to greater than 550 nmol/l following 250 µg ACTH stimulation. Two patients (6.7%) had mild primary adrenal failure with a peak cortisol between 500 and 550 nmol/l associated with a raised plasma ACTH concentration (131.4 and 10.5 pmol/l, normal 2.2 - 10 pmol/l). Twenty-eight patients (92.9%) were normonatraemic, while the two hyponatraemic patients had biochemical evidence of the syndrome of inappropriate antidiuretic hormone secretion. Conclusion. In conclusion, despite evidence that the adrenal glands of patients with disseminated bronchogenic carcinoma are frequently affected by metastatic disease, biochemical evidence of clinically significant hypoadrenalism is relatively uncommon and is not accurately predicted by electrolyte abnormalities.