CME : Your SA Journal of CPD - Volume 26, Issue 5, 2008
Volume 26, Issue 5, 2008
Author Bridget FarhamSource: CME : Your SA Journal of CPD 26 (2008)More Less
Iron deficiency anaemia is, according to the World Health Organization, the most common and widespread nutritional disorder in the world. What the WHO are talking about is a micronutrient deficiency. As this edition of CME shows, that is only one aspect of anaemia. However, it is worth spending a bit of time thinking about the consequences of this very common micronutrient deficiency.
Author Karen GuntherSource: CME : Your SA Journal of CPD 26, pp 232 –236 (2008)More Less
Uncomplicated iron deficiency anaemia (IDA) is usually easy to diagnose and treat. However, most of us have been faced at times with uninterpretable iron studies or an inexplicable failure of patients to respond to therapy. The aim of this article, therefore, is not to be comprehensive but rather to provide a practical, clinical approach with particular comment on common dilemmas experienced in diagnosing and managing IDA. Some understanding of iron physiology is very helpful in interpreting iron studies and I have included this where relevant.
Author Geoffrey BihlSource: CME : Your SA Journal of CPD 26, pp 238 –240 (2008)More Less
Anaemia of chronic disease (ACD) is a multifactorial anaemia often coexistent with iron deficiency. Worldwide, anaemia of chronic disease is the second most common anaemia. Diagnosis generally requires the presence of chronic infection, inflammation, or cancer; marginal normocytic and later microcytic anaemia; and abnormal values for iron studies. The major issue is that the bone marrow erythroid mass fails to expand appropriately in response to anaemia. Treatment is to reverse the underlying disease and, if the disease is irreversible, to give erythropoietin.
Author Deborah JacobsonSource: CME : Your SA Journal of CPD 26, pp 242 –244 (2008)More Less
Iron deficiency (ID) is the most common nutritional disorder in the world, affecting over one billion people, particularly women of childbearing age and preschool-aged children. At least half of the anaemia worldwide is directly due to dietary ID. Factors contributing to ID include diets low in iron, reduced iron availability, increased iron requirements to meet growth demands, and losses due to parasitic infections. These factors often operate concurrently.
Author Peter H. BarrowSource: CME : Your SA Journal of CPD 26, pp 246 –249 (2008)More Less
In premenopausal women menstrual blood loss is the commonest, but not the only, cause of iron deficiency. In men and women over 50, gastrointestinal (GIT) blood loss becomes more important and may be the only marker of significant GIT pathology, such as colonic or gastric cancer. There are many other GIT causes for iron deficiency anaemia, including poor dietary intake, previous gastrectomy, NSAID use and malabsorbtion (most likely due to coeliac disease in patients of European origin, even in South Africa).
Source: CME : Your SA Journal of CPD 26, pp 251 –253 (2008)More Less
Although the contribution of transfusion-transmitted infection to the HIV epidemic has not been accurately assessed, according to the World Health Organization, globally an estimated 5 - 10% of HIV infections are due to blood transfusion. Since breaking onto the scene 26 years ago, HIV has proven an indefatigable foe. Over 60 million people have been infected with this retrovirus, and 25 million have already died of AIDS. HIV infection is hitting the hardest in the developing world. AIDS was first recognised in the summer of 1981. Young gay men began falling ill and dying of opportunistic infections their immune systems should have fended off. By late 1982, epidemiological evidence indicated that AIDS was an infectious disease transferred by bodily fluids and by exposure to contaminated blood or blood products. Without a test for AIDS, blood banks had difficulty safeguarding the blood supply, and most refused to screen donors for homosexuality. Surrogate markers, such as hepatitis B core antigen, proved imperfect at best. Thus, the blood supply remained unsafe for years, and many people were transfused with contaminated blood.
Source: CME : Your SA Journal of CPD 26, pp 254 –256 (2008)More Less
Haemoglobin solutions intended to transport oxygen in the plasma were first conceived and developed as an alternative to red cell transfusion. Although many different haemoglobin formulations have been manufactured and submitted to extensive clinical trials in humans, most of these products have now been abandoned because of safety concerns; only the Biopure product, Hemopure, remains available for clinical use.
Author J.G. OosthuysenSource: CME : Your SA Journal of CPD 26 (2008)More Less
Blood is an expensive and increasingly scarce commodity. Moreover, the transfusion of homologous blood carries the risk of major transfusion reactions and transmission of infective agents such as the hepatitis and HI viruses. Therefore, there is a worldwide resistance to homologous blood transfusion, and a policy of bloodless surgery is becoming increasingly popular.
Primary drug-induced anaemia and the importance of adverse drug reaction (ADR) monitoring : clinical pharmacologySource: CME : Your SA Journal of CPD 26, pp 257 –258 (2008)More Less
Drug-induced blood dyscrasias, while uncommon compared with other reported ADRs, are associated with significant drug-related fatalities, varying from mild thrombocytopenia through to life-threatening aplastic anaemia and thrombosis. An understanding of the mechanism is essential for effective management and identification of possible causal agents. Anaemia, together with neutropenia and thrombocytopenia, are common presentations of drug-induced dyscrasias. A basis for understanding the pathogenesis, clinical presentation, and differential diagnosis of primary drug-induced anaemias is the focus of this article.
Author Chris BatemanSource: CME : Your SA Journal of CPD 26, pp 266 –267 (2008)More Less
Fat burner ad misleading
Cape Town lab nails TB rapid diagnostic test
'Private health care costs unjustifiable'
Drug addicts put strain on city hospitals
Strong African voice needed for cluster bomb ban treaty
Six kidney transplants in 1 day
US medical errors - 238 337 deaths
Finally - a reason to drink!