Explore the vast range of titles available.

South Africa is a high tuberculosis (TB) burdened country. People who are newly diagnosed with TB must link to a TB treatment facility and be registered in the electronic TB notification system for ongoing care. Delayed linkage to care increases the risk of disease progression, mortality, and ongoing TB transmission. We describe lessons from a systematic tracing process aimed to support linkage to care for people diagnosed with TB. The study used the Western Cape Provincial Health Data Centre (PHDC) to identify persons newly diagnosed with TB (January-December 2020) who were not recorded as linked to care after routine linking efforts, in one peri-urban health sub-district in Cape Town, South Africa. A systematic tracing process was followed, including visits to primary health care (PHC) facilities, and home visits for those with no evidence of linkage at PHC level. Descriptive statistics were used to analyse quantitative data. Lessons learned during the process were documented. Within the PHDC, 406 persons diagnosed with TB had no evidence of being linked to TB care. Verification at PHC facilities found that 153/406 (38%) had linked to care. We traced 219 persons; of which107 (49%) could not be found. Overall, the PHDC showed 76% linkage among those traced and found and 72% among those not found. Lessons learned include the need for improved; (i) record keeping enabling the allocation of resources to patients who are truly lost to follow up, (ii) communication to improve patient understanding of timely treatment initiation and (iii) interpersonal relationships to encourage trust. The systematic tracing process was useful to understand the complexities around delayed linkage to care. To reduce ILTFU, we recommend, improving accuracy and timely recording of TB data, updating patient contact details regularly and strengthening interpersonal relations and communication between patients and healthcare workers.

Isolated hypoglossal nerve injury is an infrequent occurrence in clinical and forensic traumatology practice. Its etiology includes trauma, malignancy, vascular events, autoimmune diseases, and complications of surgical procedures. Clinical manifestations resulting from nerve damage may present early or be delayed. We present the case of a 44-year- old woman who sustained a fracture of the third cervical vertebra following a traffic accident. An anterior approach was employed for instrumentation using an anterior plate spanning two cervical segments. The patient developed dysphagia and swallowing difficulties and subsequently underwent evaluation for disability status. Physical examination revealed significant atrophy and asymmetry of the right half of the tongue body, slight rightward deviation of the tongue apex at rest, and fasciculations. Electromyography performed 22 months after the injury demonstrated chronic axonal injury of the right hypoglossal nerve. Causality assessment favored the traffic accident as the initiating event, with postoperative edema and retraction likely contributing to progression. The condition was classified as permanent, and a 25% functional loss was assigned for tongue paralysis according to national disability criteria. This report highlights the diagnostic, prognostic, and legal complexities of delayed hypoglossal nerve palsy following cervical trauma and underscores the importance of a multidisciplinary approach in determining the etiology and prognosis of isolated hypoglossal nerve paralysis, as well as in establishing medical causality.

This article has been retracted. Please see the Retraction Notice for more detail:

Interest in the use of cell-free nucleic acids (CFNAs) as clinical non-invasive biomarker panels for prediction and prevention of multiple diseases has greatly increased over the last decade. Indeed, circulating CFNAs are attributable to many physiological and pathological processes such as imbalanced stress conditions, physical activities, extensive apoptosis of different origin, systemic hypoxic-ischemic events and tumour progression, amongst others. This article highlights the involvement of circulating CFNAs in local and systemic processes dealing with the question, whether specific patterns of CFNAs in blood, their detection, quantity and quality (such as their methylation status) might be instrumental to predict a disease development/progression and could be further utilised for accompanying diagnostics, targeted prevention, creation of individualised therapy algorithms, therapy monitoring and prognosis. Presented considerations conform with principles of 3P medicine and serve for improving individual outcomes and cost efficacy of medical services provided to the population.

[This corrects the article DOI: 10.1371/journal.pone.0333202.].