CME : Your SA Journal of CPD - Volume 25, Issue 11, 2007
Volume 25, Issue 11, 2007
Source: CME : Your SA Journal of CPD 25 (2007)More Less
We have reached the final edition of CME for 2007. Medically, it has been an interesting year in South Africa - with all the negative connotations of the Chinese proverb that hopes that you may live in 'interesting times'. This edition is on referral - an important aspect of primary care in both sectors of the health service, and one that is going to become increasingly difficult in the public sector with its massive cuts in funding for the tertiary hospitals.
Author Vanessa BurchSource: CME : Your SA Journal of CPD 25, pp 518 –519 (2007)More Less
Source: CME : Your SA Journal of CPD 25, pp 520 –525 (2007)More Less
It is not possible to give absolute instructions as to when patients should be referred. Only guidelines can be offered to practitioners to interpret and implement, based on an understanding of their own abilities and competence and a knowledge of the support structures and staff available in the area in which they practise.
Author Olga MzileniSource: CME : Your SA Journal of CPD 25, pp 526 –533 (2007)More Less
- Chest X-rays are an important investigation in lung disease. However, history and physical examination are crucial steps in the evaluation of the patient and should be performed before reading chest X-rays.
- X-ray abnormalities need to be combined with clinical findings to make a diagnosis.
- If you are not sure, seek assistance from a specialist.
- Consolidation or air-space shadowing is caused by opacification of air-containing spaces of the lung.
- Collapse or atelectasis is due to partial or complete volume loss in a lung or lobe.
- Physical examination is required to determine if the mass is intrapulmonary or cutaneous.
- Intrapulmonary lesions are well defined and are projected over the lung on frontal and lateral projections. Extrapulmonary mass lesions are in contact with other soft-tissue structures.
- The summation of multiple, small, linear opacities on the chest X-ray may produce the appearance of multiple small nodules. Likewise the superimposition of multiple small nodules may produce a granular or ground-glass pattern.
- Hilar abnormalities may be vascular and non-vascular.
- Pleural effusions collect in the posterior costophrenic angle and as little as 100 - 200 ml may appear above the diaphragm.
Author W.F. MollentzeSource: CME : Your SA Journal of CPD 25, pp 534 –542 (2007)More Less
- Diabetes mellitus is a chronic condition that remains an important cause of morbidity and mortality in South Africa.
- Diabetes mellitus requires lifelong care best delivered in a structured manner by a team of skilled health care professionals.
- Patients should be educated to accept increasingly more responsibility for their condition.
- Primary health care workers including medical practitioners provide the mainstay of diabetes care in South Africa and are best positioned to structure diabetes care optimally according to available resources.
- Glycaemic, metabolic and blood pressure goals should be aggressively pursued.
- The psychological and social needs of patients should not be neglected.
Source: CME : Your SA Journal of CPD 25, pp 544 –555 (2007)More Less
Author Brian RaynerSource: CME : Your SA Journal of CPD 25, pp 556 –557 (2007)More Less
Source: CME : Your SA Journal of CPD 25, pp 557 –562 (2007)More Less