CME : Your SA Journal of CPD - Volume 31, Issue 2, 2013
Volume 31, Issue 2, 2013
Author Bridget FarhamSource: CME : Your SA Journal of CPD 31 (2013)More Less
Life expectancy is increasing across the globe. A recent article in the British Medical Journal points out that it is nearly 100 years since the British monarchy started sending messages to 'current citizens of [the monarch's] realms or UK Overseas Territories' who reached the age of 100. In 1917, King George V sent 24 of these messages. By 1952, this figure had increased to 255 and in 2011 the figure had increased 40-fold to 9 736.
Author W. NelSource: CME : Your SA Journal of CPD 31, pp 37 –41 (2013)More Less
Gastrointestinal symptoms such as dyspepsia, heartburn, epigastric pain, nausea and vomiting are extremely common and have been experienced by the majority of people at some stage in their lifetime. These complaints are often as a result of pathology in the upper gastrointestinal tract. Correlation between the clinical presentation (symptoms, signs and endoscopic findings) and pathology, including the degree and precise localisation of the disease process, is unfortunately notoriously poor. This is mainly due to the absence of a somatic nerve supply to the gut wall. The stomach is a common site of pathology responsible for upper gastrointestinal symptoms, which may have an extremely wide range of causes.
Source: CME : Your SA Journal of CPD 31, pp 41 –45 (2013)More Less
This article focuses on a pragmatic approach to the assessment of alcohol dependence and an overview of some of the most effective interventions. The acute medical management of the withdrawal process is beyond the scope of this article. This article concentrates on alcohol dependence, as this is the most common addiction. In turn, as most of the non-pharmacological interventions can be used in the general management of all addictions, regardless of the specific drug of abuse, we also focus on some of these interventions that have an established evidence base. In South Africa the goal of treatment is usually abstinence, but there is ongoing debate about moderation in alcohol use versus abstinence, particularly in managing the young individual on the path to dependence.
Source: CME : Your SA Journal of CPD 31, pp 46 –49 (2013)More Less
The last 10 years have seen exciting developments in the availability of new evidence-based treatments for depression. This includes the registration of new antidepressants (ADs) as well as new information about the effectiveness of ADs and psychological therapies. Many 'alternative' therapies, including exercise, herbal remedies, green tea and massage therapies, are promoted for depression, but discussion of these is beyond the scope of this article. Most new literature and conference proceedings focus on new drugs and treatment-resistant depression, leaving little room for questioning some of the basic assumptions. Evidence-based methods of review and the global access to information through the internet have led to new questions and information about the treatment of depression.
Source: CME : Your SA Journal of CPD 31, pp 49 –53 (2013)More Less
Whereas the majority of trauma survivors recover without clinical sequelae, 10 - 20% of these individuals develop the syndrome of post-traumatic stress disorder (PTSD). In the USA, the National Comorbidity Survey estimated that between 5% and 9% of the general population suffer from PTSD. In the primary healthcare setting the prevalence of PTSD is estimated to be two to three times higher. The South African Stress and Health Study (SASH) - the first large population-based study of mental disorders in South Africa - found anxiety disorders, as a class, to be the most prevalent 12-month and lifetime disorder, while the 12-month prevalence of PTSD was 2.3%.
Source: CME : Your SA Journal of CPD 31, pp 53 –54 (2013)More Less
Barrett's oesophagus (BO) is defined as the occurrence of metaplastic, specialised columnar epithelium lining the distal part of the oesophagus. Evidence points to this as a metaplastic condition in reaction to ulceration and re-epithelialisation, the columnar epithelium replacing the normal stratified squamous epithelium. Only specialised columnar epithelium consisting of a villiform growth pattern containing columnar, goblet, Paneth and endocrine cells (i.e. intestinal metaplasia (IM)) located above the lower oesophageal sphincter (LOS) qualifies as BO.
Source: CME : Your SA Journal of CPD 31, pp 54 –56 (2013)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 31, pp 55 –58 (2013)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 J. KockSource: CME : Your SA Journal of CPD 31, pp 57 –61 (2013)More Less
Author T. DanillerSource: CME : Your SA Journal of CPD 31, pp 61 –63 (2013)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 31, pp 63 –65 (2013)More Less
Author Michael CarterSource: CME : Your SA Journal of CPD 31 (2013)More Less
Vitamin D deficiency is associated with an increased risk of pulmonary tuberculosis (TB), oral thrush and wasting among people starting HIV therapy in Tanzania, investigators report in the online edition of the Journal of Infectious Diseases. People with vitamin D deficiency were almost three times more likely to develop TB than those with adequate levels of the vitamin.
Author Chris BatemanSource: CME : Your SA Journal of CPD 31, pp 68 –70 (2013)More Less
International - Lung infection identified using 'breath-print'
International - Mussels' stickiness inspires surgical adhesive
Africa - Zimbabwe orders medical aids to pay up - or else
South Africa - Bulk of hospital CEO posts filled - Motsoaledi
South Africa - Cuban med schools for KZN