CME : Your SA Journal of CPD - Volume 30, Issue 9, 2012
Volume 30, Issue 9, 2012
Author Bridget FarhamSource: CME : Your SA Journal of CPD 30 (2012)More Less
The tobacco industry has long held a susceptible group of the public in its sway. As a child I remember the Marlborough cigarette adverts - the rolling plains of North America and an impossibly rugged, handsome man riding into the sunset on his beautiful horse - cigarette in hand. I heard that the man in the advert died of lung cancer. I have no idea whether or not this was true, but statistically we have known for a very long time now that cigarette smoking is the single most important risk factor for at least two types of lung cancer. We also now know that cigarette smoking is the single largest risk factor for a host of otherwise preventable causes of premature death and that it has a directly additive effect on many others.
Author Johannes ClaassenSource: CME : Your SA Journal of CPD 30, pp 306 –313 (2012)More Less
The sore throat is one of the most common conditions encountered in a general practice and overtreatment is a common occurrence. Not only are antibiotics overprescribed, but the antibiotics chosen are often more expensive and of a broader spectrum than needed. Although not much has changed over the years a few very basic management principles remain important.
Author Iain ButlerSource: CME : Your SA Journal of CPD 30, pp 314 –317 (2012)More Less
Hearing loss is one of the most common conditions that affects newborn babies worldwide. The spectrum of hearing loss ranges from mild loss of hearing affecting one ear, to profound hearing loss in both ears. Identification of hearing loss in young children is difficult because most cases are non-syndromic (i.e. there are no other dysmorphic features). Awareness of risk factors for hearing loss will contribute to the identification of only 50% of neonatal cases. Universal newborn hearing screening is now the accepted international standard. Management of these cases involves a multi-professional team and must be initiated as early as possible. In cases of severe to profound hearing loss, there is a limited window of opportunity to allow for development and integration of central auditory function. One of the major hurdles in the management of childhood hearing loss is the scarcity of schools that can educate children with hearing impairments.
Author J. GrobbelaarSource: CME : Your SA Journal of CPD 30, pp 318 –329 (2012)More Less
'There can be few physicians so dedicated to their art that they do not experience a slight decline in spirits when they learn that their patient's complaint is giddiness. This frequently means that after exhaustive enquiry it will still not be entirely clear what it is that the patient feels wrong and even less so why he feels it.'
This is especially true in a busy practice. My aim is to provide some knowledge of basic anatomy and physiology, but, more importantly, a stepwise approach to a dizzy patient. Of course it is very easy to over-complicate or over-simplify this topic. However, by the end of this article you should be able to distinguish vertigo from other forms of dizziness. You will also be able to differentiate vertigo further into peripheral and central pathologies and advise the correct treatment options. It is estimated that approximately 90% of individuals over 65 years of age have visited their physician at least once with vertigo as their primary complaint. Complex cases should, however, be identified and referred to a specialised unit.
Author Werner HoekSource: CME : Your SA Journal of CPD 30, pp 330 –333 (2012)More Less
South Africa has the highest incidence of HIV- and AIDS-infected individuals in the world, with 5.3 million living with HIV and AIDS. The interpretation of HIV prevalence trends in South Africa is increasingly complex due to the simultaneous implementation of both preventive and treatment programmes. The number of individuals on antiretroviral treatment (ART) is rising, leading to improvement in survival rates. The longer survival rate influenced the way HIV-associated manifestations present, including the manifestations in the head and neck region.
Author Theresa ErasmusSource: CME : Your SA Journal of CPD 30, pp 335 –336 (2012)More Less
Chronic suppurative otitis media (CSOM) is a stage of ear disease in which there is chronic infection of the middle-ear cleft, i.e. the eustachian tube, middle ear and mastoid, and in which a non-intact tympanic membrane (e.g. perforation or tympanostomy tube) and discharge (otorrhoea) are present. The perforation can result as a complication or as sequelae of acute otitis media, trauma or extrusion or removal of a tympanostomy tube. Prevalence surveys, which vary widely in disease definition, sampling methods and methodological quality, show that the global burden of illness from CSOM involves 65 - 330 million individuals with draining ears, 60% of whom (39 - 200 million) suffer from significant hearing impairment.
Author T. DanillerSource: CME : Your SA Journal of CPD 30, pp 336 –338 (2012)More Less
Rhinosinusitis is one of the most common conditions presenting to clinicians worldwide, and can potentially have an enormous and a devastating socioeconomic impact. The majority of infections are viral in origin, and acute bacterial infection occurs in only 0.5 - 2% of cases. The dilemma and diagnostic challenge are therefore to distinguish acute viral rhinosinusitis (AVRS) from acute bacterial rhinosinusitis (ABRS).
Source: CME : Your SA Journal of CPD 30, pp 339 –345 (2012)More Less
This is the first in our third series of clinical vignettes that are centred on everyday presentations. Each emphasises practical aspects of team-based care, having relevance for general practitioners, specialists and paramedical professionals alike. Disorders arising in blood and bone marrow result in some of the commonest symptoms and signs for which patients seek medical advice. A carefully taken history and meticulous physical examination, complemented by thoughtful and judicious use of laboratory tests, provide the clinical basis for a working diagnosis. Advanced haematology may be needed to extend evaluation to the bone marrow and plasma while supplementary imaging or radionuclide technology further links primary care practitioner or specialist to the experienced haematologist. Such a multidisciplinary and fully interactive approach offers the preferred way to problem solving and optimum management.
Source: CME : Your SA Journal of CPD 30, pp 346 –347 (2012)More Less
An increasing number of patients with severe complicated Plasmodium falciparum malaria are presenting to South African hospitals, having travelled through malaria-endemic countries from Central and East Africa. This report concerns an immigrant from Pakistan who developed severe cerebral malaria.
Starting HIV treatment reduces risk of tuberculosis, even for patients with higher CD4 cell counts : AIDS briefAuthor Michael CarterSource: CME : Your SA Journal of CPD 30 (2012)More Less
Starting antiretroviral therapy reduces the risk of tuberculosis for HIV-positive adults in developing countries by 65%, according to the results of a meta-analysis published in PLoS Medicine. The benefits of HIV therapy were significant at all CD4 cell counts, including above 350 cells/mm3, the current World Health Organization (WHO) threshold for initiation of antiretroviral treatment. The investigators therefore believe that their findings should be taken into account when therapy at higher CD4 cell counts is being considered.
Author Chris BatemanSource: CME : Your SA Journal of CPD 30, pp 351 –353 (2012)More Less
International : Hotter climes reduce heart attacks - Japanese study
Syria - two months of surgical interventions
Africa : Sierra Leone - cholera emergency declared
Angola - over 5 000 children vaccinated against measles
South Africa : TAC threatens to take Gauteng Health to court
Gauteng health cuts debt by R3.4 billion
Seventy-seven thousand abortions in SA in 2011
Abon HIV testing kits not approved by WHO