Patients with secondary spontaneous pneumothorax (SSP) complicated by persistent air leak (PAL) and who are poor surgical candidates have limited treatment options. This case series explored autologous blood patch pleurodesis as a possible cost-effective management option. A total of 46 episodes of SSP with PAL were included. The procedure was successful in 33 (71.7%). Of these, 17 (51.5%) resolved within 1 day. The mean duration of intercostal drainage prior to the blood patch was 22 days in the successful group. Pneumothoraces with incomplete lung re-expansion at the time of procedure were successful in 20 of 30 (66.7%). Only human immunodeficiency virus infection was associated with failure (<i>p</i> = 0.03). Adverse events included transient fever (<i>n</i> = 3) that resolved spontaneously, and empyema (<i>n</i> = 3) which were successfully managed with antibiotics and pigtail drainage. We conclude that a large proportion of patients with SSP complicated by PAL who are unfit for surgery may be liberated from intercostal drainage by an autologous blood patch pleurodesis, with minimal adverse effects.

The apparent low incidence of colon cancer in the Black population of South Africa has been ascribed to a non-Western diet. The present authors report the identification of two common 5-bp deletions at codons 1309 and 1061 of the adenomatous polyposis coli (APC) gene in a Xhosa and Zulu patient, respectively. The in vitro transcription/translation test (PTT) and a non-radioactive heteroduplex method, which facilitates resolution of enzymatically amplified DNA by agarose gel electrophoresis, were used for mutation detection. This study represents the first report of APC mutations in indigenous Black individuals clinically diagnosed with familial adenomatous polyposis coli (FAP). The two deletion mutations are responsible for FAP in 35% of affected South Africans, a frequency similar to that described in several other non-African populations. The apparently low incidence of colon cancer in the African population may be ascribed either to the rare occurrence of the 'second hit' needed for polyp formation or to a lower incidence of mutations in the APC gene.

Background: Pleural fibrosis and restriction are well-known complications of tuberculous pleurisy, which is often accompanied by respiratory distress and limitation of daily life activities. Objectives: Current evidence suggests that pleural drainage offers little benefit over and above antituberculous treatment in improving pulmonary function. Our study aims to define the role of additional pleural drainage in the management of tuberculous pleural effusions. Methods: We enrolled 21 patients with tuberculous effusions and performed therapeutic drainage in 10 randomly selected cases. Pulmonary function testing, exercise capacity, chest radiography, and ultrasonography were performed at baseline, 7 to 10 days, and at 3 months. Results: Complete therapeutic drainage was achieved in 4 of 10 patients randomized to undergo drainage. Immediate benefit in total lung capacity (TLC) was achieved in the 10 patients assigned to intervention. Intervention group showed significant changes compared to the non-intervention group in several functional parameters at 3 months: change in forced vital capacity (

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