Maurice Mars - Academia.edu (original) (raw)

Papers by Maurice Mars

Post exercise lymphocytopenia is a well documented phenomenon. Studies have reported exercise ind... more Post exercise lymphocytopenia is a well documented phenomenon. Studies have reported exercise induced DNA damage in leucocytes and have postulated a possible link to apoptosis. Five subjects of differing fitness levels underwent a ramped treadmill test to exhaustion. Venous sampling was undertaken before, immediately post exercise, and 24 and 48 hours after exercise. Single cell gel electrophoresis showed evidence of single strand DNA breaks (as evidenced by an increase in tail moment measurements using the comet assay) in 100% oflymphocytes immediately after exercise, and in the 24 hour and 48 hour post exercise samples. Flowcytometric analysis oflymphocytes revealed a minimal amount of both apoptosis and necrosis at all time intervals. Lymphocyte apoptosis has again been demonstrated after exercise, however the percentage of apoptosis was a maximum of 4.8% at 24 hours. These findings may in part account for the exercise induced lymphocytopenia and reduced immunity demonstrated by ...

Journal of the International Society for Telemedicine and eHealth, 2017

Yearbook of Medical Informatics, 2012

SummaryTelehealth has an increasing role in future healthcare. This paper seeks to define and und... more SummaryTelehealth has an increasing role in future healthcare. This paper seeks to define and understand recent advances in provision of tele-healthcare through use of personal handheld computing devices, and suggests how such personalized solutions offer further opportunities for progress.We considered the current status of personal handheld computing devices for personalizing healthcare, through review of examples in the literature and web sources.We have identified the following four generic roles for personal handheld computing devices in personalized healthcare: educational, social networking and games, monitoring with notifications/reminders, and online/offline tele-consultations. We discuss examples of these in two settings: healthcare facilities and patient home.Advances in latest handheld computing devices have made tele-healthcare more personalized and increasingly possible even in the absence of the care provider.

Informatics in Medicine Unlocked, 2019

Introduction: Realisation of proven telemedicine scale-up benefits is a key consideration for Sou... more Introduction: Realisation of proven telemedicine scale-up benefits is a key consideration for South Africa, a developing country with a quadruple disease burden, inequitable access to healthcare, and ineffective and inefficient specialist referral pathways. Proven benefits of teledermatology include virtually enhancing access of rural communities to scarce urban specialist dermatologists, reducing time to triage of skin lesions, frequently an initial sign of underlying disease, and timely treatment initiation. Benefits realisation management (BRM) is a recognised means of managing how resources are invested into making effective and desirable changes, and enhancing project and programme success. The need for this study was identified in a recent review and critique of teledermatology and related scale-up frameworks. This study explores the use of BRM as a whole life-cycle approach applied to ehealth or teledermatology related scale-up framework development, and to sustain benefits of scaling ehealth or healthcare service delivery interventions. Material and methods: A structured search of academic literature was performed using Scopus, Science Direct, PubMed, IEEE Explore, Web of Science, and Google Scholar. The key terms Benefits Realisation Management or BRM were linked with: a) ehealth or telehealth or telemedicine or teledermatology related scale-up framework development, and b) sustainability of interventions such as scale-up. Subsequent Google searching explored grey literature evidence for BRM in ehealth. Results: The academic literature searches could not identify peer-reviewed literature to support the use or consideration of BRM as a whole life-cycle approach within ehealth or teledermatology related scale-up framework development. Discussion: However, the results showed that BRM has been used in related domains to promote sustainability of non-healthcare interventions. In contrast the grey literature provided evidence of limited use of BRM within healthcare and within ehealth. Conclusions: There is renewed support for the use of BRM as a whole life-cycle approach for management disciplines that focus on change, project, programme, and portfolio management. Although limited, the academic and grey literature provides support for consideration of BRM in ehealth, and for the use of BRM to ensure sustainability. Future research should explore the use of BRM as a whole life-cycle approach for ehealth implementation, and teledermatology scale-up framework development in particular, including its possible contribution to sustaining scaled-up teledermatology.

Journal of the South African Veterinary Association, 2006

Veterinary surgeons have a long tradition of consulting one another about problem cases and many ... more Veterinary surgeons have a long tradition of consulting one another about problem cases and many have unwittingly practised telemedicine when discussing cases by telephone or by sending laboratory reports by telefax. Specific veterinary telemedicine applications have been in use since the early 1980s, but little research has been undertaken in this field. The Pubmed and CAB International databases were searched for the following Boolean logic-linked keywords; veterinary AND telemedicine, veterinary AND telecare, animal AND telemedicine, animal AND telecare and veterinary AND e-mail and an additional search was made of the worldwide web, using Google Scholar. This returned 25 papers which were reviewed. Of these only 2 report research. Sixteen papers had no references and 1 author was associated with 13 papers. Several themes emerge in the papers reviewed. These include remarks about the use of telemedicine, the benefits that can and are derived from the use of telemedicine, areas of...

Yearbook of Medical Informatics, 2016

SummaryObjectives: Assess unforeseen consequences of Telehealth and suggest solutionsMethods: An ... more SummaryObjectives: Assess unforeseen consequences of Telehealth and suggest solutionsMethods: An outline was created collecting all possible ill effects classified into Clinical considerations, Administrative concerns including interpersonal relations, Technical issues, Legal / Ethical concerns and Miscellaneous. Each topic was assigned to a particular WG member to lead, gather opinion and review existing literature.Results and Conclusion: A wide array of problems have been described. Except for technical issues, literature on this topic is scant, so this article is based more on personal experience and data collected from surveys. Much can be done to prevent such problems, such as a need for standardization with related clinical studies for devices as well as processes used for telehealth is underlined, besides evaluation of outcomes of projects undertaken.

Environment and Water Resource Management / 837: Health Informatics / 838: Modelling and Simulation / 839: Power and Energy Systems, 2016

The use of Information and Communication Technologies (ICT) in health (e-health), has been propos... more The use of Information and Communication Technologies (ICT) in health (e-health), has been proposed as a useful tool to increase efficiency in provision of healthcare. However, application and integration of e-Health still has many challenges, often resulting in implementation failure. Interested healthcare institutions in countries such as Botswana must first ensure their preparedness for the anticipated challenges brought about by programmes related to ICT use. Such preparedness is termed e-Health Readiness. Any ICT use creates e-waste (or Waste Electrical and Electronic Equipment, WEEE), Therefore one criterion for judging a country's degree of e-Health Readiness should be how it handles its e-waste. Generation of large quantities of e-waste will be an inevitable result of increased ICT consumption by the healthcare sector. This study assesses the status of ewaste management in Botswana, as one of the indicators that could be used to determine the degree of e-health readiness of Botswana. The study design was based on a literature review, and initial use of an adapted e-waste assessment questionnaire developed by the Swiss company Empa (Appendix 1). This study shows Botswana still faces challenges with e-waste management. These challenges are similar to those faced by other developing countries: an absence of infrastructure for appropriate e-waste management, an absence of legislation dealing specifically with e-waste, an absence of a framework for end-of-life (EoL) product take-back or implementation of extended producer responsibility, limited public awareness about proper waste management and disposal practices, as well as limited technically skilled human resources to deal with issues such as e-waste recycling. This study has highlighted that Botswana needs an enhanced and enforced e-waste management strategy as a catalyst towards e-Health Readiness.

South African journal of surgery. Suid-Afrikaanse tydskrif vir chirurgie, 2001

The aim of this study was to establish the incidence of anastomotic aneurysm following aortobifem... more The aim of this study was to establish the incidence of anastomotic aneurysm following aortobifemoral bypass and to document management of this condition in our practice. This is a prospective study of anastomotic aneurysms developing in patients with aortobifemoral bypasses followed up for 49 months. Two tertiary referral hospitals served by the Durban Metropolitan Vascular Service. Four hundred and ninety-two patients underwent aortobifemoral bypass. Anastomotic aneurysms (N = 25) developed in 23 patients. Presence of anastomotic aneurysm was confirmed by Doppler ultrasound. All patients underwent aneurysm repair. Operations performed were: excision and interposition graft (15), re-suture (6), tube graft (1), crossover (1), graft-popliteal bypass (1) and ligation (1). There were no deaths and no recurrences. Wound infections occurred in 2 patients and occlusion of the opposite limb occurred in 1. Anastomotic aneurysms following aortobifemoral bypass are uncommon. They commonly occ...

South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, Jan 7, 1991

Snakebite remains a source of considerable morbidity in Natal. Despite the availability of specif... more Snakebite remains a source of considerable morbidity in Natal. Despite the availability of specific and polyvalent antivenins, the regional effects of envenomation and inappropriate first-aid result in significant, potentially avoidable, disability--particularly in children. Direct measurement of intracompartmental pressure has been used as an adjunct to clinical assessment of the child with a swollen limb following snakebite in order to diagnose compartment syndrome. Initial encouraging results in 9 patients suggest that, in this difficult clinical situation, such measurements may have an important role in patient assessment.

South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 1992

Journal of telemedicine and telecare, 2008

Over the past decade, our videoconferencing room has become a 'must-see' location for v... more Over the past decade, our videoconferencing room has become a 'must-see' location for visitors, delegates and VIPs from far and wide. Once, the then Chief Executive of Hong Kong's public hospital system, along with his entourage of pin-striped suits and Chanel ...

Transactions of the Royal Society of Tropical Medicine and Hygiene, 1999

In the absence of a direct laboratory test of envenomation, there is a need for an alternative me... more In the absence of a direct laboratory test of envenomation, there is a need for an alternative mechanism for the early recognition of envenomation following snake-bite in children. A severe clinical diathesis may result either from envenomation or from the release of an inappropriate tourniquet applied as 'first-aid' often several hours before presentation to hospital. Abnormalities of clotting are associated with both events. A normal thromboelastogram (TEG) provides early recognition of patients in whom the clinical course is likely to be benign (sensitivity = 94%). An abnormal TEG identifies patients of whom 50% will develop a severe clinical diathesis. A TEG is a more accurate predictor of disease severity than International Normalized Ratio alone. The TEG does not supplant clinical observation in the management of snake-bite in children but allows stratification into high-and low-risk categories.

Pediatric Surgery International, 2006

Hypertension is a frequent problem in children with renal tumour, yet there are few reports from ... more Hypertension is a frequent problem in children with renal tumour, yet there are few reports from centres in the third world. A retrospective study of blood pressure in a cohort of 46 patients with renal tumours seen over a 3-year period was carried out. Fifty percent of patients presenting with Wilms' tumour were hypertensive. Serum concentrations of active renin correlated poorly with blood pressure. There was no correlation between serum concentrations of active renin and tumour mass or histology. Specific antihypertensive therapy was offered to 11 patients who had either neurological or cardiac complications of hypertension. All other patients with Wilms' tumour had their blood pressure controlled by neoadjuvant chemotherapy. Patients with mesoblastic nephroma were managed by primary surgery. Patients with asymptomatic hypertension may be monitored as hypertension will resolve with neoadjuvant chemotherapy. Those with compelling symptomatology will require additional hypertensive medication.

Medicine and Science in Sports and Exercise, 2001

Purpose: The time course of physiological exercise responses after acute ascent to moderate altit... more Purpose: The time course of physiological exercise responses after acute ascent to moderate altitude was investigated. Methods: Fifteen young male subjects (16.5 Ϯ 0.8 yr) completed one familiarization and then two further sea level sessions to determine sea level values (SL). Subjects were then tested 6 h (ALT1), 18 h (ALT2), and 47 h (ALT3) after arrival at 1700 m. Subjects completed a 5-min submaximal cycle test, shuttle run test, and 45-s repeated push-up test. Hemoglobin (Hb) and hematocrit (Hct) were measured. Results: Cycle test heart rate (HR) was higher at ALT1 than SL (182 Ϯ 15 vs 177 Ϯ 16 b⅐min-1 , P Ͻ 0.01) but had returned to 177 Ϯ 13 and 176 Ϯ 12 b⅐min-1 at ALT2 and ALT3, respectively. At ALT1, only five subjects completed the full 5 min. Postexercise plasma lactate was not different. Shuttle test HR was higher at ALT1 than SL (191 Ϯ 8 vs 185 Ϯ 14 b⅐min-1 , P ϭ 0.01) but had returned to 185 Ϯ 10 and 183 Ϯ 16 b⅐min-1 at ALT2 and ALT3. Shuttle run time (SRT) was 37% shorter at ALT1 than SL (251 Ϯ 134 vs 401 Ϯ 115 s, P Ͻ 0.001) and remained impaired at ALT2 and ALT3 (330 Ϯ 124 and 344 Ϯ 115 s, both P Ͻ 0.001 vs SL). There was a significant relationship between magnitude of increased HR and reduction in SRT between SL and ALT1 (r ϭ 0.52, P Ͻ 0.05). Push-up HR, Hb, and Hct were not affected by altitude. Conclusions: These findings indicate that detrimental effects of acute ascent to 1700 m on exercise performance are greater after 6 h than after 18 or 47 h. Performance was not entirely restored to SL values even after 47 h, despite restoration of easily measured physiological parameters. The results suggest travel to moderate altitude should occur as early as is practical before competition.

Medicine & Science in Sports & Exercise, 2002

Medicine & Science in Sports & Exercise, 2003

Medical Education, 1999

The study aimed to assess the knowledge increment in paediatric surgery of interns (pre-registrat... more The study aimed to assess the knowledge increment in paediatric surgery of interns (pre-registration) after a 1-month period of training and of registrars after a 6-month rotation. A comparison of the knowledge base of interns from different universities was included. A standard questionnaire was completed by all interns and registrars on the first day of their appointment and again at the end of rotation. Knowledge increment was assessed for each student and each question. King Edward VIII Hospital, Durban, South Africa. Interns (equivalent to pre-registration house officers) and registrars (registered practitioners) undergoing general surgical training. Both registrars and interns improved their test scores after their training period. However, satisfactory exit scores were achieved by interns in only 72% of questions. This study forms the basis for assessing future educational strategies and has identified areas of teaching weakness which can be remedied. The reduction in exposure of interns to clinical paediatric surgery must be balanced by more efficient use of teaching time.

The Journal of Hand Surgery: Journal of the British Society for Surgery of the Hand, 1988