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Health Sciences
Associate Professor Brian Rayner
Cardiovascular outcomes in renal atherosclerotic lesion
(CORAL Study): A prospective, multi-center, unblinded,
two-arm, randomized trial; Genetics of salt sensitive
hypertension (PhD dissertation); PTH and low renin
hypertension; The genetics of ACE inhibitor related
angioedema in black and coloured South Africa
Dr Nicola Wearne
Retrospective analysis of all HIV positive renal biopsies
between 2004 and 2008 at GSH hospital; Prospective
observational study of all HIV positive patients who
undergo a renal biopsy at GSH hospital to establish best
medical management, mortality and spectrum of disease;
HIV related renal disease: Histological Classification;
Randomised controlled study: Treatment of HIV +ve
patients with confirmed HIVAN on renal biopsy with
Corticosteroids; Epidemiology of renal dysfunction and
chronic kidney disease in HIV positive HAART naïve
patients
Contact Details
Postal Address: E13 Groote Schuur Hospital, Observatory,
7925
Telephone: +27 21 404 3318
Fax: +27 21 404 5215
E-mail: mmcadi@pgwc.gov.za
Department Of Medicine
Division Of Neurology
Head of Division: Associate Professor A. Bryer
Divisional Profile
A general clinical neurology service is operated at
Groote Schuur Hospital. This provides a full range of
clinical activities, including in-patients, consultative,
and emergency services. Additionally, there is a clinical
neurophysiology laboratory, a dedicated actue stroke unit,
and specialised clinics for stroke, myasthenia gravis, HIV
neurology, neuro-genetic disorder and epilepsy.
Areas of research include:
Stroke:
A large cohort of stroke patients were followed up
for 6 months post incident stroke to determine survival,
disability and functional outcomes following their discharge
from an acute stroke unit to community-based health care
and rehabilitation. Factors predictive of poor outcome were
identified. Data from this study are being used to develop
a community based model of stroke care. An in-service
training program for health care workers involved in stroke
care in under-resourced settings is being developed. The
new South African National Guideline for the management
of acute ischaemic stroke and TIA has been published
with substantial input from the GSH/UCT stroke Unit. A
longitudinal study of HIV associated stroke to evaluate the
underlying biological mechanisms (specifically endothelial
dysfunction and ultrasonographic vascular phenotypes) has
been undertaken.
Myasthenia gravis:
Clinical and Laboratory-based research
projects are focussed on improving therapeutic strategies
and increasing understanding of disease pathogenesis.
a. Methotrexate vs. azathioprine randomized trial
completed. Presented at NASA and ANA 2010.
Submitted to Neuromuscular Dis. 2011
b. A Multi-center, Randomized Study comparing
Thymectomy to No Thymectomy in Myasthenia Gravis-
International study NIH funded. On advisory committee.
c. The psychiatric manifestions in thymomatous MG (Dr
Freeman, Psychiatry) Complement regulation in MG
subjects with DAF promoter SNP and the effect of
therapies. This work done by the Neurology Research
Group in partnership with Human Bilogy laboratory.
PI J Heckmann with Dr’s Amaal Abrahams and Sharon
Prince. MSc student Ms J Auret.
d. TGFb polymorphisms and their association with
extraocular muscle MG damage- in collaboration with
Dr C Dandara, Human Genetics.
HIV/AIDS:
Clinical and Laboratory-based research projects
studying the risk factors for developing neuropathy in HIV-
infected subjects.
a. Research collaboration with Endocrine (UCT) and
Neurology (Emory University) – longitudinal prevalence
study of HIV neuropathy and risk factors at the
Crossroads CHC.
Dr Johan van der Watt, received the CIDRI Post
Graduate Scholarship award to study inflammation in
HIV- associated toxic neuropathy
b. Dr Chad Centner is studying Pyridoxine & NAT – 2
genotypes as risk factors for HIV- associated neuropathy.
c. Dr John- Randel Vermaak is studying the incidence of
HIV- neuropathy since the cART regimen has changed
from d4T to Tenofovir.
d. Collaboration with Dr’s Todd Hulgan (Vanderbilt
University) and Dr P Sinxadi, Pharmacology, UCT
to investigate mitochondrial DNA haplotype and
susceptibility to HIV- associated toxic neuropathy by
examining mitochondrial haplogroups and association
with HIV- associated neuropathy in African subjects on
d-drugs.
e. Dr Friedrich Thienemann is performing a retrospective
analysis of demyelinating CNS disease in HIV- infected
subjects.