Charles Sanyika | Wits University (original) (raw)

Papers by Charles Sanyika

PubMed, Oct 1, 2001

Objective: To determine the efficacy and cost-effectiveness of bronchial artery embolisation (BAE... more Objective: To determine the efficacy and cost-effectiveness of bronchial artery embolisation (BAE) in the treatment of major and massive haemoptysis in HIV-positive and negative patients with pulmonary inflammatory disease. Methods: A retrospective review of patients admitted over a period of 24 months to Wentworth Hospital with major haemoptysis treated using BAE. Results: Eighty-seven patients were treated (77 males, 10 females). Bilateral disease was present in 50 patients (57%). Thirty-two patients were HIV-positive (37%). Embolisation was successfully performed in 77 patients (88.5%), and failed for technical reasons in 10 patients (11.5%). There was only one procedural complication. Fifty-seven patients had a successful outcome, with cessation of haemoptysis within 24 hours (66.5%). Haemoptysis continued in 30 patients (34%) (20 patients embolised and the 10 patients who had failed procedures). Fourteen of these patients (16%) required lobectomy or pneumonectomy as an emergency procedure. Five patients (5.7%) died from respiratory failure or pulmonary haemorrhage. Twenty-four HIV-positive patients were successfully embolised. Costing of BAE, including a 2-day ICU and 3-day ward stay, was R6,720; together with surgical resection the cost was R14,170. Conclusions: BAE is an effective treatment for major and/or massive haemoptysis in patients with pulmonary inflammatory disease who are not surgical candidates. Patients who are HIV-positive are able to tolerate the procedure well.

CardioVascular and Interventional Radiology, Nov 1, 1999

Purpose: To identify the role of pulmonary angiography in the diagnosis and treatment of severe h... more Purpose: To identify the role of pulmonary angiography in the diagnosis and treatment of severe hemoptysis due to cavitary pulmonary tuberculosis. Methods: Selective pulmonary angiography was performed on eight patients with severe hemoptysis uncontrolled by previous bronchial and systemic arterial embolization. Results: Three (38%) patients had Rasmussen aneurysms, which were successfully embolized with steel coils. Five patients demonstrated pulmonary arterial hypoperfusion in the diseased lung. Conclusions: We recommend pulmonary angiography in cavitary tuberculous patients with severe hemoptysis who do not respond to systemic arterial embolization. Rasmussen aneurysms are effectively treated by steel coil occlusion.

Clinical Radiology, Dec 1, 1999

PubMed, Jun 1, 1999

Objectives: A prospective randomised study of patients with irresectable oesophageal carcinoma tr... more Objectives: A prospective randomised study of patients with irresectable oesophageal carcinoma treated with self-expandable covered metal Wallstent and plastic Procter Livingstone tubes was performed. The purpose was to compare the efficacy, cost effectiveness, ease of implantation, long-term patency and complications of the two different stents. Methods: Data recorded included dysphagia score (0-4) the day before and after stent placement, location and length of stricture, procedural time and complications, and stent patency at 1 and 3 months' follow-up. A comparative costing of materials, theatre and anaesthetic time and hospital stay was undertaken. Results: Forty patients were studied over 12 months (20 in each group). Strictures were located most commonly in the middle third of the oesophagus (75%), followed by the upper third (12.5%) and lower third (12.5%). Mean stricture length was 6 cm (2-12 cm); 10 patients (25%) had strictures 8 cm or longer. Five patients had tracheo-oesophageal fistulas (3 Wallstent; 2 Procter Livingstone tube). There was effective fistula sealing in all 3 Wallstent patients, and non-sealing in 1 of the Procter Livingstone patients. The mean pre-operative dysphagia score in both groups was 3, and immediately postoperatively the score was 0 in the Wallstent group and 2 in the plastic tube group. Initial stent placement was satisfactory in all Wallstent patients, with 2 patients requiring 2 stents each for adequate tumour coverage, and in 15 patients (75%) having plastic stents. Immediate complications were chest pain in 2 patients with Wallstents and oesophageal perforation in 2 patients (10%) with plastic stents. Wallstent patency at 1 and 3 months was 90% and 88%, respectively, and plastic stent patency was 66% and 50%. Four patients (10%), 2 in each group, died during the study from massive tumour load or metastatic disease. Comparative costing of the Wallstent versus the plastic tube stent was R4 123 versus R2 146 or a factor of 1.9. Conclusion: Palliation with the Wallstent is effective, with excellent 1- and 3-month patency. The Wallstent is superior to the conventional plastic stent in terms of ease of implantation, better long-term patency and fewer complications. It is particularly useful for the treatment of patients with fistulas and long strictures. Accurate placement is critical in order to prevent stent migration and tumour overgrowth. However, it costs almost twice as much to implant the Wallstent as it does to implant the plastic tube.

Rivista di neuroradiologia, Nov 1, 1998

We sought to identify early and possible reversible cerebral ischemia in patients with eclampsia.... more We sought to identify early and possible reversible cerebral ischemia in patients with eclampsia. Consecutive postpartum patients with a clinical diagnosis of eclampsia were examined by a neurologist to determine whether there was any neurological deficit or cognitive impairment. Patients were prospectively imaged within 48 hours of presentation and if the scans were abnormal 72 hours later. Fast spin echo T2 weighted axial and diffusion weighted axial scans were performed. The diffusion weighted scans were performed through the basal ganglia, occipital lobes and centrum semiovale. The scans were read by two neuroradiologists blinded to the patient data. Ten patients were studied. All patients had evidence of cognitive impairment. Four patients had transient hemiparesis. All patients recovered after vasodilator treatment. T2 weighted scans were abnormal in five patients with bilateral subcortical occipital hyperintense lesions. Diffusion weighted images demonstrated abnormalities in eight patients with focal hyperintense lesions in the basal ganglia, subcortical occipital poles and watershed regions of the centrum semiovale. Two patients had normal scans. Repeat imaging 72 hours later demonstrated complete resolution of the focal lesions in all eight patients. Diffusion imaging is more sensitive than T2 weighted scans in the detection of early ischemia in patients with eclampsia. Ischemia appears to be global and predominantly affects watershed regions, occipital poles and the basal ganglia. These changes appear to be completely reversible after treatment.

SA Journal of Radiology, May 31, 1998

Journal of Neurology, Neurosurgery, and Psychiatry, Apr 1, 1999

South African Gastroenterology Review, 2020

Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related mortality worldwide... more Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related mortality worldwide and management of this disease remains challenging in many cases. For patients with Barcelona Clinic Liver Cancer (BCLC) advanced stage (C) disease, systemic therapy with Sorafenib has been the standard of care with median overall survival (OS) rates of less than one year. Patients presenting with portal vein tumour thrombosis (PVT) are considered to have a particularly dismal survival. For select patients, various loco-regional therapies may improve outcomes and even aid in downstaging to surgical resection or liver transplant. We present a case report of an adult male patient with a unilobar HCC with lobar portal vein invasion who underwent transarterial radioembolization (TARE) as a downstaging procedure. The patient had complete radiological response and then underwent a liver transplant. Complete pathological response was confirmed in the liver explant. At time of writing, almost 4...

The Neuroradiology Journal, 1998

Central African Journal of Medicine, 2010

To determine the prevalence and risk factors for transmission of tuberculosis in children under f... more To determine the prevalence and risk factors for transmission of tuberculosis in children under five years of age who are household contact of sputum smear positive tuberculosis adults in Harare, Zimbabwe. Cross sectional study. City Health Infectious Diseases Hospital Outpatient Department. 174 children in contact with 102 index cases. TB infection status in children according to modified WHO classification of tuberculosis. Under five year old contacts of sputum smear positive TB adults were recruited over a three month period. A coded questionnaire was used to document the following: socio-demographic profile of caregivers, duration of stay with the index case and presenting complaints. Contacts were evaluated by clinical examination, Mantoux testing, HIV antibody testing and chest radiographs. Of the 174 children in contact with 102 index cases evaluated, 109 (62.6%) were Mantoux positive (> or = 10 mm), 42% had abnormal chest X-ray, with hilar lymphadenopathy being the commonest abnormality. Forty nine percent of the children evaluated had probable TB, 28% had suspected TB and 23% had no TB. High alcohol acid fast load (AAFB) in the index case was independently associated with probable and suspected TB (OR 2.27 95% CI (1.05 to 4.87). The documented high transmission rate among under five years contacts in the study justifies the need for strengthening contact tracing and appropriate therapeutic management of identified children.

Wits Journal of Clinical Medicine, 2019

South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 2001

To determine the efficacy and cost-effectiveness of bronchial artery embolisation (BAE) in the tr... more To determine the efficacy and cost-effectiveness of bronchial artery embolisation (BAE) in the treatment of major and massive haemoptysis in HIV-positive and negative patients with pulmonary inflammatory disease. A retrospective review of patients admitted over a period of 24 months to Wentworth Hospital with major haemoptysis treated using BAE. Eighty-seven patients were treated (77 males, 10 females). Bilateral disease was present in 50 patients (57%). Thirty-two patients were HIV-positive (37%). Embolisation was successfully performed in 77 patients (88.5%), and failed for technical reasons in 10 patients (11.5%). There was only one procedural complication. Fifty-seven patients had a successful outcome, with cessation of haemoptysis within 24 hours (66.5%). Haemoptysis continued in 30 patients (34%) (20 patients embolised and the 10 patients who had failed procedures). Fourteen of these patients (16%) required lobectomy or pneumonectomy as an emergency procedure. Five patients (5...

South African Journal of Radiology, 1998

South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 1999

A prospective randomised study of patients with irresectable oesophageal carcinoma treated with s... more A prospective randomised study of patients with irresectable oesophageal carcinoma treated with self-expandable covered metal Wallstent and plastic Procter Livingstone tubes was performed. The purpose was to compare the efficacy, cost effectiveness, ease of implantation, long-term patency and complications of the two different stents. Data recorded included dysphagia score (0-4) the day before and after stent placement, location and length of stricture, procedural time and complications, and stent patency at 1 and 3 months' follow-up. A comparative costing of materials, theatre and anaesthetic time and hospital stay was undertaken. Forty patients were studied over 12 months (20 in each group). Strictures were located most commonly in the middle third of the oesophagus (75%), followed by the upper third (12.5%) and lower third (12.5%). Mean stricture length was 6 cm (2-12 cm); 10 patients (25%) had strictures 8 cm or longer. Five patients had tracheo-oesophageal fistulas (3 Walls...

Objective. To determine the efficacy and cost-effectiveness of bronchial artery embolisation (BAE... more Objective. To determine the efficacy and cost-effectiveness of bronchial artery embolisation (BAE) in the treatment of major and massive haemop tysis in lllV-positive and negative patients with pulmonary inflammatory disease. Methods. A retrosp ective review of patien ts admitted over a period of 24 months to Wentworth Hospital with major haemop tysis treated using BAE. Results. Eighty-seven patients were treated (77 males, 10 females). Bilateral disease was present in 50 patients (57%). Thirty-two patients were lllV-positive (37%). Embolisation was successfully performed in 77 patients (88.5%), and failed for .technical reasons in 10 patients (11 .5%). There was only one procedural complication. Fifty-seven patients had a successful outcome, with cessation of haemoptysis within 24 hours (66.5%). Haemoptysis continued in 30 patients (34 %) (20 patients embolised and the 10 patients who had failed procedures). Fourteen of these patients (16%) required lobectomy or pneumonectomy as an...

South African Medical Journal, 2001

T he angiogram of a 34-year old male prospective living renal donor in Figure 1 demonstrates two ... more T he angiogram of a 34-year old male prospective living renal donor in Figure 1 demonstrates two right renal arteries. A delayed digital abdominal radiograph (Figure 2) demonstrated a complete right duplex renal collecting system.

South African Journal of Radiology

A three-year-old child presented with delayed developmental milestones and seizures. On examinati... more A three-year-old child presented with delayed developmental milestones and seizures. On examination the head circumference was below the l O" percentile. There was no cardiac failure or bruit.

World Journal of Gastrointestinal Endoscopy, 2013

AIM: To further reduce the risk of bleeding or bile leakage. METHODS: We performed endoscopic ult... more AIM: To further reduce the risk of bleeding or bile leakage. METHODS: We performed endoscopic ultrasound guided biliary drainage in 6 patients in whom endoscopic retrograde cholangiopancreatography (ERCP) had failed. Biliary access of a dilated segment 2 or 3 duct was achieved from the stomach using a 19G needle. After radiologically confirming access a guide wire was placed, a transhepatic tract created using a 6 Fr cystotome followed by balloon dilation of the stricture and antegrade metallic stent placement across the malignant obstruction. This was followed by placement of an endocoil in the transhepatic tract. RESULTS: Dilated segmental ducts were observed in all patients with the linear endoscopic ultrasound scope from the proximal stomach. Transgastric biliary access was obtained using a 19G needle in all patients. Bili-ary drainage was achieved in all patients. Placement of an endocoil was possible in 5/6 patients. All patients responded to biliary drainage and no complications occurred. CONCLUSION: We show that placing endocoils at the time of endoscopic ultrasound guided biliary stenting is feasible and may reduce the risk of bleeding or bile leakage.

Journal of the American College of Surgeons, 2003

Imaging of pancreatic cancer involves both diagnosis and staging of the tumor. Accurate diagnosis... more Imaging of pancreatic cancer involves both diagnosis and staging of the tumor. Accurate diagnosis allows the clinician to be frank with the patient and eliminates anxiety and uncertainty associated with a pancreatic le-sion of unknown etiology. Accurate staging should facil-itate clinical ...