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Article ; Online: ChatGPT's Relevance for Bioethics: A Novel Challenge to the Intrinsically Relational, Critical, and Reason-Giving Aspect of Healthcare.

Alvarado, Ramón / Morar, Nicolae

The American journal of bioethics : AJOB

2023 Volume 23, Issue 10, Page(s) 71–73

MeSH term(s)	Humans ; Bioethics ; Health Facilities ; Delivery of Health Care
Language	English
Publishing date	2023-10-09
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	2060433-6
ISSN	1536-0075 ; 1526-5161
ISSN (online)	1536-0075
ISSN	1526-5161
DOI	10.1080/15265161.2023.2250305
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Article ; Online: Sarcoidosis in Johannesburg, South Africa: A retrospective study.

Morar, R / Feldman, C

African journal of thoracic and critical care medicine

2022 Volume 28, Issue 4

Abstract: Background: Sarcoidosis is a multisystem granulomatous condition of uncertain aetiology that most frequently affects the lungs. Because of clinical and radiological similarities with tuberculosis (TB), particularly in high-prevalence regions, ... ...

Abstract	Background: Sarcoidosis is a multisystem granulomatous condition of uncertain aetiology that most frequently affects the lungs. Because of clinical and radiological similarities with tuberculosis (TB), particularly in high-prevalence regions, sarcoidosis is frequently misdiagnosed as TB. Objectives: To review the clinical features of sarcoidosis patients in a South African (SA) population, adding clinical information to the relatively few studies that have been conducted in SA patients with sarcoidosis. Methods: This was a retrospective study of 102 sarcoidosis patients conducted between 2002 and 2006 at the Charlotte Maxeke Johannesburg Academic Hospital. Results: Of 102 sarcoidosis patients, there were 69 (67.6%) females and 33 (32.4%) males. The majority (85.3%) were non-smokers. The mean age of the group was 44.6 years. One-third of patients had chronic comorbid diseases. Almost 17% had been treated initially for TB, prior to being diagnosed as having sarcoidosis. Two patients developed active TB while receiving corticosteroid treatment for sarcoidosis. The salient clinical manifestations were dry cough (the most common presenting symptom in 82.4%), dyspnoea in 53.9%, cutaneous lesions other than erythema nodosum in 33.3%, and on lung examination crackles were noted in 37.3% of patients. Raised angiotensin-converting enzyme (ACE) levels were found in 56.8% of patients. The majority (48%) of patients had stage II chest radiographic changes. Cutaneous (28.4%), mediastinal lymph node (25.5%) and transbronchial lung (25.5%) biopsies were the most frequent sites confirming granulomatous inflammation. Overall, 21.2% of patients had obstructive airway disease. Systemic corticosteroids were indicated in 87.3% of patients and the relapse rate was 60.7%. Conclusion: Sarcoidosis is often initially misdiagnosed as TB in SA. The most common biopsy sites for histological confirmation were the skin and mediastinal lymph nodes, and transbronchial lung biopsies were also frequently taken. Stage II chest radiographic changes were most common. Overall, systemic corticosteroids were administered in 87.3% of cases and the relapse rate was 60.7%.
Language	English
Publishing date	2022-12-19
Publishing country	South Africa
Document type	Journal Article
ZDB-ID	2945902-3
ISSN	2617-0205 ; 2617-0191
ISSN (online)	2617-0205
ISSN	2617-0191
DOI	10.7196/AJTCCM.2022.v28i4.205
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Article ; Online: Clinical features and outcomes of patients with myasthenia gravis admitted to an intensive care unit: A 20-year retrospective study.

Morar, R / Seedat, F / Richards, G A

The Southern African journal of critical care : the official journal of the Critical Care Society

2023 Volume 39, Issue 2

Abstract: Background: There are limited data on the clinical characteristics and outcomes of patients with myasthenia gravis (MG) admitted to the intensive care unit (ICU) at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH).: Objectives: The aim was to ... ...

Abstract	Background: There are limited data on the clinical characteristics and outcomes of patients with myasthenia gravis (MG) admitted to the intensive care unit (ICU) at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH). Objectives: The aim was to study the clinical characteristics and outcomes of patients with MG admitted to the CMJAH over two decades. Methods: A retrospective study was undertaken of patients with MG admitted to the multidisciplinary ICU of CMJAH over a 20-year period, from 1998 to 2017. Demographic data, clinical features, management and outcomes of patients were assessed and reviewed from the case records. Results: Thirty-four patients with MG were admitted to the ICU during this period: 24 female and 10 male. The mean age ± SD was 37.4 ± 13.0 years, with a range of 16 - 66 years. Four patients were human immunodeficiency virus (HIV)-positive. The mean length of stay (LOS) in ICU was 10.6 ± 20.1 days, ranging from 1 to 115 days. Two patients were diagnosed with MG in the ICU after failure to wean from the ventilator. Overall, 22 patients were intubated and ventilated on admission. Morbidities included self-extubation, aspiration pneumonia and iatrogenic pneumothorax. History of thymectomy was present in 12 patients. The treatments received for MG included pyridostigmine (73.5%), corticosteroids (55.9%), azathioprine (35.3%), plasmapheresis (26.5%) and intravenous immunoglobulin (8.8%). The overall mortality in the ICU was 5.9%. Conclusion: MG is a serious disorder with considerable morbidity and mortality. It is, however, a potentially manageable disease, provided that appropriate ICU resources are available. Contributions of the study: This study provides further insight into the characteristics and outcomes of myasthenia gravis patients in ICU, within a South African context.
Language	English
Publishing date	2023-07-28
Publishing country	South Africa
Document type	Journal Article
ZDB-ID	1218506-1
ISSN	2078-676X ; 1562-8264
ISSN (online)	2078-676X
ISSN	1562-8264
DOI	10.7196/SAJCC.2023.v39i2.561
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Article ; Online: Error, Reliability and Health-Related Digital Autonomy in AI Diagnoses of Social Media Analysis.

Alvarado, Ramón / Morar, Nicolae

The American journal of bioethics : AJOB

2021 Volume 21, Issue 7, Page(s) 26–28

MeSH term(s)	Artificial Intelligence ; Humans ; Reproducibility of Results ; Social Media
Language	English
Publishing date	2021-09-18
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	2060433-6
ISSN	1536-0075 ; 1526-5161
ISSN (online)	1536-0075
ISSN	1526-5161
DOI	10.1080/15265161.2021.1926589
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Article: Synthesis and stereochemistry of new 1,3-thiazolidine systems based on 2-amino-2-(mercaptomethyl)propane-1,3-diol: 4,4-bis(hydroxymethyl)-1,3-thiazolidines and c-5-hydroxymethyl-3-oxa-7-thia-r-1-azabicyclo[3.3.0]octanes

Morar, Cristina / Sacalis, Carmen / Lameiras, Pedro / Soran, Albert / Khartabil, Hassan / Antheaume, Cyril / Bratu, Ioan / Moldovan, Oana / Darabantu, Mircea

Tetrahedron. 2013 Nov. 25, v. 69, no. 47

2013

Abstract: The thiaminalisation of 2-amino-2-(mercaptomethyl)propane-1,3-diol [‘2-(hydroxymethyl)cysteinol’] with aryl(di)aldehydes is reported. The resulting new class of 2-aryl-4,4-bis(hydroxymethyl)-1,3-thiazolidines is investigated by NMR and IR spectroscopy in ...

Abstract	The thiaminalisation of 2-amino-2-(mercaptomethyl)propane-1,3-diol [‘2-(hydroxymethyl)cysteinol’] with aryl(di)aldehydes is reported. The resulting new class of 2-aryl-4,4-bis(hydroxymethyl)-1,3-thiazolidines is investigated by NMR and IR spectroscopy in tandem with DFT calculations, permitting structural assignments that are discussed in terms of conformational analysis, anomeric effects and ring-chain tautomerism. These acquired data are subsequently exploited. After treatment with formaldehyde, the subsequent (double) regio- and diastereoselective oxaminalisation of the 1,3-thiazolidine building-block affords the first non-symmetric series of a thiazolidin-oxazolidine fused system singly functionalised at the C-5 position. An unexpected rearrangement, which consists of the partial relocation of the Ar ligand from the 1,3-thiazolidine to the 1,3-oxazolidine ring, is observed as a major influence on the substitution of the Ar ring. The first single crystal X-ray analysis of the title bicyclic system, which discloses the homo- and/or heterochiral non-bonding interactions, is also presented.
Keywords	X-radiation ; chemical reactions ; formaldehyde ; infrared spectroscopy ; molecular conformation ; nuclear magnetic resonance spectroscopy ; octanes ; stereochemistry
Language	English
Dates of publication	2013-1125
Size	p. 9966-9985.
Publishing place	Elsevier Ltd
Document type	Article
ZDB-ID	204285-x
ISSN	1464-5416 ; 0040-4020 ; 0563-2064
ISSN (online)	1464-5416
ISSN	0040-4020 ; 0563-2064
DOI	10.1016/j.tet.2013.09.070
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: HLA class I and class II antigens in sarcoidosis.

Morar, R / Duarte, R / Wadee, A A / Feldman, C

South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde

2022 Volume 112, Issue 12, Page(s) 904–910

Abstract: Background: Sarcoidosis is a multisystem granulomatous disorder. Its exact cause is unknown, but it is believed that an external agent may cause the characteristic immune reaction in genetically susceptible individuals. There is therefore general ... ...

Abstract	Background: Sarcoidosis is a multisystem granulomatous disorder. Its exact cause is unknown, but it is believed that an external agent may cause the characteristic immune reaction in genetically susceptible individuals. There is therefore general recognition that genetic vulnerability to sarcoidosis is one of the potential risk factors. HLA is encoded by genes in the major histocompatibility complex on chromosome 6. These surface cells are important in presentation of antigen and play a key part in the body's immune response to external antigens. Various HLA subtypes are more common in people with sarcoidosis than in those without. Variances in vulnerability, presentation, progression and prognosis have been related to different HLA phenotypes. HLA genes offer information into the factors driving sarcoidosis and prognosticating tools. However, in Africa, including South Africa (SA), there are no data on HLA types in relation to sarcoidosis. Objectives: To determine HLA class I and II associations in SA sarcoidosis patients. Methods: Phenotype frequencies of HLA-A, B and C and DQB1 and DRB1 were calculated for 51 consecutive patients with biopsy-proven sarcoidosis attending the respiratory clinic at Charlotte Maxeke Johannesburg Academic Hospital and 63 controls, who were potential organ donors. The frequencies of the tested HLA loci were determined by direct counting. The significance of the associations between the various loci tested for and the presence or absence of sarcoidosis was estimated from 2 × 2 tables using the χ2 test. Results: Of the 51 patients, 70.6% were female. The mean age was 44.6 years. Analysis of HLA class I and class II phenotypes in sarcoidosis patients revealed a significant association with HLA-B15, C4, C7, C12, C15, C16, C17, DQ3, DR8 and DR11. In addition, a significant negative (protective) association with HLA A9, A28, B12, B17 and DR2 was observed. Conclusion: This HLA study in SA patients suggests that genetic factors play a role in the causation of sarcoidosis. Some HLA subtypes have a significant association with sarcoidosis in SA patients, while other subtypes may be protective. The study supported the association of HLA antigens with sarcoidosis and implies that there is a genetic predisposition to sarcoidosis in the SA population.
Language	English
Publishing date	2022-12-01
Publishing country	South Africa
Document type	Journal Article
ZDB-ID	390968-2
ISSN	2078-5135 ; 0038-2469 ; 0256-9574
ISSN (online)	2078-5135
ISSN	0038-2469 ; 0256-9574
DOI	10.7196/SAMJ.2022.v112i12.16586
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Article ; Online: Smoking cessation among people with mental illness

Tejil Morar / Lesley Robertson

South African Family Practice, Vol 64, Iss 1, Pp e1-e

A South African perspective

2022 Volume 9

Abstract: Tobacco use is recognised as a serious, worldwide public health concern. Smoking cessation is of great interest across a wide range of medical specialities, including family medicine. However, smoking cessation among people with mental illness (PWMI) has ...

Abstract	Tobacco use is recognised as a serious, worldwide public health concern. Smoking cessation is of great interest across a wide range of medical specialities, including family medicine. However, smoking cessation among people with mental illness (PWMI) has attracted scant attention in South African literature. This is despite PWMI suffering disproportionately from the damages of tobacco. The harms of smoking are not limited to physical health but extend to mental health. This article discusses the need for multifaceted smoking cessation treatments for PWMI in the public health sector, taking into consideration the prevalence and unique drivers of smoking in this population. A brief overview of patterns of tobacco use, associated harms and smoking cessation interventions in South Africa is given; all within the context of mental illness.
Keywords	smoking ; tobacco ; smoking cessation ; mental illness ; south africa ; Medicine ; R
Language	English
Publishing date	2022-08-01T00:00:00Z
Publisher	AOSIS
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Book ; Thesis: Einfluß der Anthropometrie von postmortalen menschlichen Testobjekten auf die biomechanischen Meßgrößen

Morar, Rene

1993

Author's details	vorgelegt von Rene Morar
Language	German
Size	128 S. : Ill., graph. Darst.
Document type	Book ; Thesis
Thesis / German Habilitation thesis	Heidelberg, Univ., Diss., 1994
HBZ-ID	HT006330728
Database	Catalogue ZB MED Medicine, Health

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Article ; Online: Prognostic implications of coronary artery stenosis and coronary spasm in patients with stable angina: 5-year follow-up of the Abnormal COronary VAsomotion in patients with stable angina and unobstructed coronary arteries (ACOVA) study.

Seitz, Andreas / Morár, Nathalie / Pirozzolo, Giancarlo / Athanasiadis, Anastasios / Bekeredjian, Raffi / Sechtem, Udo / Ong, Peter

Coronary artery disease

2021 Volume 31, Issue 6, Page(s) 530–537

Abstract: Background: In the Abnormal COronary VAsomotion in patients with stable angina and unobstructed coronary arteries study, we showed that 62% of patients with stable angina and unobstructed coronary arteries had coronary spasm. In this study, we sought to ...

Abstract	Background: In the Abnormal COronary VAsomotion in patients with stable angina and unobstructed coronary arteries study, we showed that 62% of patients with stable angina and unobstructed coronary arteries had coronary spasm. In this study, we sought to assess the 5-year prognosis in these patients. Methods: Data regarding the following endpoints were obtained: death, non-fatal myocardial infarction, coronary event (=cardiac death or non-fatal myocardial infarction), persistent angina and repeated coronary angiography. Quality of life was assessed using the Seattle Angina Questionnaire. Results: Among patients with unobstructed coronary arteries there were three deaths (2.9%) and no non-fatal myocardial infarction. Among those with obstructive CAD 15 died (13.8%) and three had a non-fatal myocardial infarction (2.8%). Patients with obstructive CAD had a higher rate of all-cause death and coronary events compared to those without (P = 0.004). Persistent angina was more prevalent in patients with unobstructed coronaries (P = 0.042). Prognosis of patients with unobstructed coronaries regarding hard clinical events, persistent angina and repeated coronary angiography was independent of the presence of coronary spasm (all P > 0.05). However, spasm patients were more likely to take nitrate medication at follow-up (P = 0.029). Conclusion: Patients with stable angina and unobstructed coronary arteries have a favorable prognosis regarding mortality and non-fatal myocardial infarction after 5 years compared to patients with obstructive CAD irrespective of the presence of coronary artery spasm. However, persistent angina remains a common issue in patients with unobstructed coronary arteries leading to a similar frequency of repeated invasive procedures as in patients with obstructive CAD.
MeSH term(s)	Aged ; Coronary Angiography/methods ; Coronary Stenosis/diagnosis ; Coronary Stenosis/physiopathology ; Coronary Vasospasm/diagnosis ; Coronary Vasospasm/physiopathology ; Coronary Vessels/diagnostic imaging ; Coronary Vessels/physiopathology ; Follow-Up Studies ; Humans ; Middle Aged ; Prognosis ; Prospective Studies ; Quality of Life ; Time Factors ; Vasodilation/physiology
Language	English
Publishing date	2021-08-04
Publishing country	England
Document type	Clinical Trial ; Journal Article
ZDB-ID	1047268-x
ISSN	1473-5830 ; 0954-6928
ISSN (online)	1473-5830
ISSN	0954-6928
DOI	10.1097/MCA.0000000000000876
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Article ; Online: Altered microRNA expression in patients with sarcoidosis.

Morar, Rajen / Dickens, Caroline / Dix-Peek, Therese / Duarte, Raquel / Feldman, Charles

Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG

2023 Volume 40, Issue 3, Page(s) e2023037

Abstract: Background Sarcoidosis is a granulomatous multisystem disease of uncertain aetiology. The disease has major inflammatory and immune components; however, the immunopathogenesis is not well understood. Micro ribonucleic acids (microRNAs) are classes of ... ...

Abstract	Background Sarcoidosis is a granulomatous multisystem disease of uncertain aetiology. The disease has major inflammatory and immune components; however, the immunopathogenesis is not well understood. Micro ribonucleic acids (microRNAs) are classes of miniature, single-stranded, non-coding RNAs. Their key recognised role includes mediating the silencing of target genes post-transcriptionally. Recently, the role of miRNAs has gained interest in numerous disorders, suggested as being involved in pathogenesis of those diseases and acting as disease markers. Very little is known about the role of miRNAs in sarcoidosis, with nothing known regarding miRNAs in South African patients. The main objective, therefore, was to investigate the serum expression of approximately 800 miRNAs in patients with sarcoidosis compared with race-, age- and gender-matched healthy controls. Methods A total of six patients and six matched controls participated in this study. Whole blood samples were collected in EDTA tubes, processed and the plasma retained. RNA was extracted from the stored plasma samples using the QIAGEN miRNeasy Mini Kit® and concentrated using a salt-ethanol precipitation. The extracted miRNA was profiled using an nCounter® miRNA human v3 expression assay and data analysed using the nSolver™ Analysis Software. Results After excluding one sample/control pair because of cellular RNA contamination, the remaining five patient and five matched control samples were analysed, and 145 miRNAs were found to be potentially differentially expressed. On applying a Bonferroni correction, the only miRNA that was significantly different was miRNA let-7a-5p, which was significantly overexpressed (141-fold change; p<0.0003) in patients compared with controls. Conclusion This is the first miRNA report of differentially expressed miRNAs in the serum of patients with sarcoidosis and matched healthy controls in South Africa. The results obtained suggest that miRNAs may play a role in sarcoidosis pathogenesis. Whether these molecules have diagnostic or prognostic implications, needs future studies recruiting larger patient cohorts.
Language	English
Publishing date	2023-09-13
Publishing country	Italy
Document type	Journal Article
ZDB-ID	1339192-6
ISSN	2532-179X ; 1124-0490
ISSN (online)	2532-179X
ISSN	1124-0490
DOI	10.36141/svdld.v40i3.13399
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