Objective: The clinical profile and surgical outcomes of patients with constrictive pericarditis were compared in HIV-positive and-negative individuals. Methods: This study was a retrospective analysis of patients diagnosed with constrictive pericarditis at Inkosi Albert Luthuli Central Hospital, Durban, over a 10-year period (2004-2014). Results: Of 83 patients with constrictive pericarditis, 32 (38.1%) were HIV positive. Except for pericardial calcification, which was more common in HIV-negative subjects (n = 15, 29.4% vs n = 2, 6.3%; p = 0.011), the clinical profile was similar in the two groups. Fourteen patients died preoperatively (16.9%) and three died peri-operatively (5.8%). On multivariable analysis, age (OR 1.17; 95% CI: 1.03-1.34; p = 0.02), serum albumin level (OR 0.63; 95% CI: 0.43-0.92; p = 0.016), gamma glutamyl transferase level (OR 0.97; 95% CI: 0.94-0.1.0; p = 0.034) and pulmonary artery pressure (OR 1.49; 95% CI: 1.07-2.08; p = 0.018) emerged as independent predictors of pre-operative mortality rate. Peri-operative complications occurred more frequently in HIV-positive patients [9 (45%) vs 6 (17.6%); p = 0.030]. Conclusions: Without surgery, tuberculous constrictive pericarditis was associated with a high mortality rate. Although peri-operative complications occurred more frequently, surgery was not associated with increased mortality rates in HIV-positive subjects.
10 mg. three times a day. In September the smear showed 77% of cornified cells, indicating a high oestrogen effect. In November the pain had gone, the patient was walking, and the bone lesions were calcifying. This case exemplifies the dictum that the correct dose is the one that works. Case 2.-Aged 46. Carcinoma of the breast with secondary deposits in the spine and pelvis. Periods were becoming slightly irregular, and in October vaginal smear showed 27% of cornifled cells. X-ray therapy was given to the spine and whole pelvis to include the bone deposits as well as the ovaries. In November menstruation had ceased, and vaginal smear showed 15% corni
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