CME : Your SA Journal of CPD - Volume 30, Issue 7, 2012
Volume 30, Issue 7, 2012
Author J.P. Van NiekerkSource: CME : Your SA Journal of CPD 30 (2012)More Less
A flurry of papers in the SAMJ served to highlight the massive problems caused by alcohol abuse and provide support for the government's stated intention to ban all advertising of alcoholic beverages. How does this square with what appears to be the other side of the coin, namely the call for decriminalising drugs or at least a 'call for a move away from the political rhetoric of a "drug-free society" and challenge government to start the real work of formulating and implementing an evidence-based drug policy'? Such moves to reconsider policies on drugs that challenge the failed 'war on drugs' have strong international support by highly credible authorities.
Author Rajiv T. ErasmusSource: CME : Your SA Journal of CPD 30 (2012)More Less
Chemical pathology is a branch (specialty) of medical science that is concerned with changes in body chemistry in disease conditions. It is also called clinical chemistry or clinical biochemistry. Medical biochemistry is an essential component of the curriculum for all categories of health professionals.
Author Nicholette M. OosthuizenSource: CME : Your SA Journal of CPD 30, pp 230 –234 (2012)More Less
Skill in interpreting biochemical data to correctly identify and treat acid-base disorders is an essential competency for clinicians. Studies have, however, shown that proficiency in this area is lacking and that performance declines as disorders become more complex. This review presents a systematic approach and set of rules that should help clinicians to solve even the most challenging cases.
Author Jocelyn NaickerSource: CME : Your SA Journal of CPD 30, pp 235 –237 (2012)More Less
Glomerular filtration is an essential function of the kidney and the glomerular filtration rate (GFR) is generally accepted as the best overall measure of the functioning renal mass in both health and disease. Measurement of the GFR is based on the plasma clearance of a substance by glomerular filtration. In order for the clearance of a substance to be the same as the GFR the clearance marker should be in a stable concentration in the plasma, eliminated from the blood only by the kidneys, freely filtered by glomeruli, not secreted, synthesised or metabolised within the kidney and not reabsorbed from the filtrate. The GFR varies according to age, gender and body size. By convention the GFR is adjusted to a standard body surface area (BSA) of 1.73 m2 for adults.
Author K.B. SedumediSource: CME : Your SA Journal of CPD 30, pp 238 –240 (2012)More Less
Prostate cancer (Pca) is the second most common cause of cancer worldwide. The incidence rates vary geographically, with the highest rates observed in highly resourced countries. Although lower rates are observed in developing countries, sub-Saharan Africa included, the mortality rate is reported to be higher. This is partly attributable to lack of screening programmes and presentation in advanced stages of the disease in the majority of cases. Like other cancers, the target in the management of Pca is early detection when cure is more likely. Prostate specific antigen (PSA) is widely used as a tumour marker for Pca, both for the detection and staging of the disease, as well as in determining prognosis and monitoring treatment response.
Source: CME : Your SA Journal of CPD 30, pp 241 –243 (2012)More Less
Diseases of the thyroid are among the most prevalent of medical conditions, especially in women, but the symptoms can be relatively nonspecific or mild. For this reason, clinicians have been placing increased reliance on the laboratory for assistance in the diagnosis of thyroid disorders. In the 1950s, only one thyroid test was available, the protein-bound iodine estimate of the serum total thyroxine (T4) concentration which showed a poor sensitivity and specificity for thyroid disease.
Source: CME : Your SA Journal of CPD 30, pp 249 –251 (2012)More Less
The current burden of care imposed on all practising physicians by the four colliding epidemics (lifestyle diseases, tuberculosis, HIV and AIDS, and trauma) in resource-constrained and low- to middle-income countries in sub-Saharan Africa, has prompted the call for a paradigm shift in current medical practice. Unnecessary laboratory tests and consumer demand for certain tests have escalated in recent years, and have contributed to rising healthcare costs.
Author Verena GoundenSource: CME : Your SA Journal of CPD 30, pp 252 –253 (2012)More Less
The American Diabetes Association (ADA) defines pre-diabetes as a fasting plasma glucose (FPG) ≥5.6 mmol/l but <7.0 mmol/l, which is termed impaired fasting glycaemia (IFG), or an abnormal 2-hour response to a 75 g oral glucose tolerance test (OGTT) of at least 7.8 mmol/l and <11.1 mmol/l, which is termed impaired glucose tolerance (IGT), or an HbA1c of 5.7 - 6.4%. It is used to identify individuals with a greater risk of developing overt type 2 diabetes and also those at increased cardiovascular risk. Pre-diabetes represents a continuum in the spectrum between normoglycaemia and overt hyperglycaemia.
Source: CME : Your SA Journal of CPD 30, pp 253 –256 (2012)More Less
Vitamin D was first described in the 20th century when a cause for the high prevalence of rickets was sought. With the fortification of certain foods with vitamin D, the prevalence of rickets decreased and little attention was placed on vitamin D. However, in the past decade there has been a revived interest in vitamin D, as it is thought to be associated with various nonskeletal disorders. Research has found that the prevalence of vitamin D deficiency worldwide is actually much higher than thought, and this has led to a massive increase in the demand for laboratory testing of vitamin D levels.
Author M. HoffmannSource: CME : Your SA Journal of CPD 30, pp 256 –257 (2012)More Less
Cystic fibrosis (CF) is the most common autosomal recessive disorder among white individuals, and occurs in all South African population groups. Recent evidence suggests a prevalence of 1 in 2 000 among white South Africans and 1 in 12 000 in the coloured population. In black South Africans carrier frequency estimates have been used to project the incidence of 1 in 4 624 live births.
Author Johannes KockSource: CME : Your SA Journal of CPD 30, pp 257 –261 (2012)More Less
Author Megan RensburgSource: CME : Your SA Journal of CPD 30, pp 261 –262 (2012)More Less
Cardiac muscle injury is defined as the disruption of normal cardiac myocyte membrane integrity resulting in the loss of intracellular constituents such as troponin, creatine kinase, and myoglobin into the extracellular space. The mechanism of injury includes trauma, toxins and viral infections, but ischaemia or infarction - due to an imbalance between the supply and demand of oxygen - is the most common cause.
Author Keith AlcornSource: CME : Your SA Journal of CPD 30, pp 265 –266 (2012)More Less
The number of people eligible for antiretroviral treatment (ART) will grow by around 6 million as a result of recent World Health Organization (WHO) recommendations on the use of antiretroviral drugs to prevent HIV transmission, Dr Gottfried Hirnschall, head of the WHO's HIV department told the IAPAC Controlling the HIV Pandemic with Antiretrovirals: Treatment as Prevention and Pre-Exposure Prophylaxis Evidence Summit in London.