RecQ DNA helicases, including yeast Sgs1p and the human Werner and Bloom syndrome proteins, participate in telomere biology, but the underlying mechanisms are not fully understood. Here, we explore the protein sequences and genetic interactors of Sgs1p that function to slow the senescence of telomerase (tlc1) mutants. We find that the S-phase checkpoint function of Sgs1p is dispensable for preventing rapid senescence, but that Sgs1p sequences required for homologous recombination, including the helicase domain and topoisomerase III interaction domain, are essential. sgs1 and rad52 mutations are epistatic during senescence, indicating that Sgs1p participates in a RAD52-dependent recombinational pathway of telomere maintenance. Several mutations that are synthetically lethal with sgs1 mutation and which individually lead to genome instability, including mus81, srs2, rrm3, slx1 and top1, do not speed the senescence of tlc1 mutants, indicating that the rapid senescence of sgs1 tlc1 mutants is not caused by generic genome instability. However, mutations in SLX5 or SLX8, which encode proteins that function together in a complex that is required for viability in sgs1 mutants, do speed the senescence of tlc1 mutants. These observations further define roles for RecQ helicases and related proteins in telomere maintenance.

Background Hospital managers are best suited and located to enhance patient safety culture within their institutions. Aim This study sought to provide insight on the perceptions of 10 managerial staff regarding the patient safety culture at a tertiary academic hospital in South Africa. Method In-depth interviews were conducted with strategic and operational managers within high-risk units in order to determine their perceptions regarding patient safety culture. Findings Participants described diverse aspects of the hospital’s patient safety culture including an overview of patient safety, implementation of patient safety initiatives, challenges to patient safety, current management of patient safety issues, as well as ways to improve the patient safety culture of the hospital. Conclusion The findings highlighted a number of areas to improve on to advance patient safety within the South African context. These include improving basic services, strengthening the infrastructure, improving staff attitudes and implementation of patient safety initiatives. Further research and development of quality improvement plans are essential to enhance patient safety.

Skin and soft tissue infections (SSTIs) are one of the most common infectious diseases requiring antibiotics. However, complications of SSTIs may lead to the overprescribing of antibiotics and to subsequent antibiotic resistance. Consequently, monitoring the prescribing alignment with the current recommendations from the South African Standard Treatment Guidelines (STG) is necessary in order to improve future care. This study involved reviewing pertinent patients with SSTIs who were prescribed antimicrobials in the surgical ward of a leading South African tertiary public hospital from April to June 2021 using an adapted data collection tool. Sixty-seven patient files were reviewed. Among the patients with SSTIs, hypertension and chronic osteomyelitis were the most frequent co-morbidities at 22.4% and 13.4%, respectively. The most diagnosed SSTIs were surgical site infections (35.1%), wound site infections (23%), and major abscesses (16.2%). Blood cultures were performed on 40.3% of patients, with Staphylococcus aureus (32.7%) and Enterococcus spp. (21.2%) being the most cultured pathogens. Cefazolin was prescribed empirically for 46.3% of patients for their SSTIs. In addition, SSTIs were treated with gentamycin, ciprofloxacin, and rifampicin at 17.5%, 11.3%, and 8.8%, respectively, with treatment fully complying with STG recommendations in 55.2% of cases. Overall, the most common cause of SSTIs was Staphylococcus aureus, and empiric treatment is recommended as the initial management. Subsequently, culture sensitivities should be performed to enhance adherence to STGs and to improve future care.

Introduction: A scarcity of local published data on colorectal cancer (CRC) postoperative complications, including postoperative ileus (POI), exists. POI is a temporary gastrointestinal (GI) state of absent or reduced gastric motility shown to increase patient morbidity, prolong length-of-stay (LOS), and intensify the healthcare resource burden. The pathogenesis of POI involves a neurogenic and inflammatory phase plus a pharmacological component.Aim and Objectives: This study aimed to determine centre-specific preoperative risk factors associated with the development of ileus post elective therapeutic CRC resection. The objectives were to determine whether patient demographics; functional status; comorbidities; GI history; pharmacotherapy (including neoadjuvant chemotherapy); and lastly neoadjuvant radiation and chemoradiation were associated with the development of POI.Method: Patients who underwent CRC resection between January 2016 and May 2019 were retrospectively identified from an existing database. Urgent—or non-therapeutic surgeries; surgeries with the complication anastomotic leak or GI obstruction; patients under 18 at the time of surgery or surgeries preceded by preoperative parenteral nutrition were excluded. A comparison was done of the incidence of exposure in the study cohort to investigated variables as potential risk factors for the complication POI.Results: A total of 155 patient cases were included, and 56 (36%) of them developed POI. Univariate comparison of patients who developed POI with demographic characteristics of patients who did not suggested that women were at lower risk to develop POI compared to men (p = 0,013; RR 0,56; 95% CI 0,36–0,89). Functional status suggested that all previous smokers were at a higher risk to develop POI compared to lifetime non-smokers (p = 0,0069; RR 1,78; 95% CI 1,17–2,70). Multivariable comparison of ≤ 5 qualifying parameters showed no significance.Conclusion: The high local incidence of POI in this patient population shows that intervention is required to reduce the POI rate and improve postoperative outcomes. This study suggests that for men and all patients with a history of smoking both, CRC resection preoperative recommendations with the intention to prevent POI should include instructions initiating the activation of preventive strategies like the Enhanced Recovery After Surgery (ERAS) programme. More studies are needed to adequately determine local perioperative risk factors for POI.

Background. Patient safety research is scarce in developing countries. Estimates of patient harm due to the processes of healthcare in resource-poor settings are thought to be greater than those in developed countries. Ideally errors in healthcare should be seen as opportunities to improve the future quality of care. Objectives. To investigate the patient safety culture within high-risk units of a tertiary hospital in South Africa Methods. Quantitative, descriptive, cross-sectional methodology using a survey questionnaire which measured 10 safety dimensions and one outcome measure among clinical and nursing staff. Results. Two hundred participants completed the survey questionnaire. Areas of strength identified by the participants included organisational learning (91.09%), staff attitudes (88.83%) and perceptions on patient safety (76.65%). Dimensions which have the potential for improvement included awareness and training (74.04%), litigation (73.53%), feedback and communication about errors (70.77%), non-punitive response to error reporting (51.01%), size and tertiary level of hospital (53.76%) and Infrastructure and resources (58.07%). The only dimension identified as weak was teamwork and staffing (43.72%). In terms of the patient safety grade, respondents graded their own units highly but graded the hospital as a whole as having a poor patient safety grade. Conclusion. There are still significant gaps in the quality of care provided at this tertiary hospital. The current patient safety culture is perceived as punitive in nature with regards to reporting adverse events. It is recommended that targeted efforts to improve patient safety are urgently implemented, and followed-up with future research.