CME : Your SA Journal of CPD - Volume 28, Issue 9, 2010
Volume 28, Issue 9, 2010
Author Bridget FarhamSource: CME : Your SA Journal of CPD 28 (2010)More Less
As we come to the end of this round of public sector industrial action it is time to take stock of several things. Employees in the public sector are poorly paid - and of course I am concentrating on the health sector here, although this is no less true for other parts of the public sector such as education.
Author Eugene G. WeinbergSource: CME : Your SA Journal of CPD 28, pp 406 –407 (2010)More Less
In the preface to their textbook Clinical Allergy published in 1967 Sheldon, Lovell and Mathews wrote : 'The practice of allergy is a challenge to the physician's ingenuity and medical ability. Also it is a great deal of fun. An interest which brings great personal satisfaction and diversion, allergy presents a wide variety of cases. The relief which treatment provides for many patients may be complete and sometimes is quite dramatic. Not unlike a detective, the allergist must track down the offending agent which bothers his patient. Often the search is extended into such fields as otolaryngology, psychiatry, dermatology, neurology, chemistry, botany and even into other realms which may have little direct relationship to medicine. The identification and elimination of the allergenic factor or, where this is impossible, building up of the patient's tolerance to this environmental allergen is the main activity which keeps the allergist at work. There is a need for more physicians who practise a good quality of allergy based on a sound medical background.'
Source: CME : Your SA Journal of CPD 28, pp 408 –410 (2010)More Less
Asthma is a problem throughout the world and its prevalence appears to be increasing. Its cause is unknown and therefore prevention is difficult. With the highly effective medications that are now available it is possible, in principle, to control asthma, enabling almost every asthmatic to achieve a life free of symptoms and exacerbations with normal lung function. Many clinicians have found that it can be very difficult to corroborate that control has in fact been achieved.
Author Cassim MotalaSource: CME : Your SA Journal of CPD 28, pp 412 –416 (2010)More Less
The estimated prevalence of cow's milk allergy (CMA) varies between 2% and 7.5%, being higher in children than adults. Cow's milk allergy can develop in exclusively or partially breast-fed infants, when cow's milk protein (CMP) is introduced into the feeding regimen. The incidence of CMA is lower in exclusively breast-fed infants (0.5%) compared with formula-fed or mixed-fed infants, and clinical reactions in the breast-fed group are mostly mild to moderate. This might be related to lower levels of CMP in breast milk compared with cow's milk, immunomodulators in breast milk and differences in gut flora between breast-fed and formula-fed infants.
Author Ahmed Ismail ManjraSource: CME : Your SA Journal of CPD 28, pp 418 –424 (2010)More Less
There are good data suggesting that the prevalence of allergic rhinitis is increasing in South African children. The prevalence has increased from 30.4% to 38.5% between 1995 and 2002. No single reason explains this increase, and there may be a multitude of reasons.
Allergic rhinitis is often trivialised because it is not associated with any significant mortality or morbidity. This may be true in the context of South Africa, where we face major challenges such as AIDS, TB and malnutrition. However, allergic rhinitis significantly affects the quality of life of patients. It affects children in the form of learning problems and is also associated with co-morbidities such as sinusitis, otitis media, worsening of asthma and allergic conjunctivitis.
Author Paul C. PotterSource: CME : Your SA Journal of CPD 28, pp 426 –432 (2010)More Less
It is important for every practitioner to be familiar with the common allergens in South Africa to be able to make a specific allergy diagnosis in specific patients.
South Africa, because of its wide range of ecological biomes, is home to most of the common indoor and outdoor aero-allergens recognised globally. It also has a number of indigenous grass, tree and insect allergens, which appear to be unique to Africa.
One may be exposed to allergens indoors or outdoors, during everyday life, or via inhalant, ingestant or cutaneous routes, but also in an occupational environment.
Author Michael E. LevinSource: CME : Your SA Journal of CPD 28, pp 433 –434 (2010)More Less
Asthma in Africa is associated with unique challenges. Among these are the many diverse areas in the country with different allergen and environmental exposures. Areas of the country and sectors of the population have poor access to care and inadequate drug availability, and in many patients there are educational, language and cultural barriers that have an impact on patient care.
Author Shaunagh EmanuelSource: CME : Your SA Journal of CPD 28, pp 435 –437 (2010)More Less
Author Harris A. SteinmanSource: CME : Your SA Journal of CPD 28, pp 437 –438 (2010)More Less
Individuals with pollen allergy often report adverse effects after the ingestion of a wide variety of foods from plants. Because of the increasing prevalence of pollen allergy, this association has in recent years gained greater recognition. The clinical effects are usually restricted to the oral cavity and include oral pruritus, swelling of the lips, tongue and throat, hoarseness, pharyngitis, and laryngeal oedema. These localised symptoms, caused by fruit, vegetables and spices, have been termed oral allergy syndrome (OAS). Immunoglobulin E antibodies (IgE) to the aeroallergen cross-react with the proteins in fresh fruit(s) and vegetable(s) to cause symptoms. Symptoms that patients experience are usually mild and do not require immediate medical attention. Rarely, some patients may experience severe and systemic reactions, such as severe laryngeal oedema, urticaria, asthma, or even food-induced anaphylaxis. This variation has resulted in a debate over whether such reactions may be considered a severe form of OAS or, as other authors contend, OAS includes only mild symptoms.
Author Sarah KarabusSource: CME : Your SA Journal of CPD 28, pp 438 –440 (2010)More Less
Penicillin and penicillin-based antibiotics are the most frequently used agents for treating common infections but are also the antibiotics that most often cause allergic reactions. Many patients are diagnosed as having penicillin allergy. However, on testing, it has been found that as many as 90% of individuals labelled as having penicillin allergy have no evidence of the condition.
Source: CME : Your SA Journal of CPD 28 (2010)More Less
Estate planning is widely used to achieve the most appropriate financial outcome for a family.
The process needs to take into account the financial needs of surviving spouses, children, other dependants (e.g. parents) and even possibly grandchildren. Although tax considerations should never be ignored, they should not be taken into account in a way which could result in the needs of dependants being subordinated. For example, although it may be tax efficient for a man to bequeath all his assets to his children or grandchildren to reduce potential taxes payable on the death of his wife, it is usually very inappropriate to expect a surviving spouse to have to rely on her children for financial support.
Source: CME : Your SA Journal of CPD 28 (2010)More Less
Author Chris BatemanSource: CME : Your SA Journal of CPD 28, pp 443 –444 (2010)More Less
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