CME : Your SA Journal of CPD - Volume 31, Issue 3, 2013
Volume 31, Issue 3, 2013
Tackling the McDreamy complex - a UCT medical student's perspective on neurosurgery : editor's choiceSource: CME : Your SA Journal of CPD 31, pp 72 –73 (2013)More Less
The modern glamorisation of the medical profession has seen a television series character inspire a new generation of 'wannabe' neurosurgeons. With the boom in interest stemming from the public perception of neurosurgery, it seemed appropriate to investigate the constructs of the modern medical student, focusing on their interaction with the field and what neurosurgery might have to offer in their training and beyond.
Author G. FieggenSource: CME : Your SA Journal of CPD 31 (2013)More Less
This is the first time that an entire issue of this journal has been placed in the hands of neurosurgeons and I would like to begin by thanking the editor for doing so. At first glance, this may seem an odd choice for a publication aimed at primary care practitioners, but after glancing through the contents (and reading some of the articles) I hope you will agree that the invitation was not misplaced.
Source: CME : Your SA Journal of CPD 31, pp 75 –79 (2013)More Less
Approach to a neurosurgical emergency begins with an appropriate history of surrounding events followed by general examination and focused neurological examination. This should be performed while applying general supportive care. After outlining a general approach to the patient presenting with a neurosurgical emergency, the more common clinical scenarios will be discussed.
Source: CME : Your SA Journal of CPD 31, pp 80 –84 (2013)More Less
Although neurological conditions may present with specific clinical patterns, practitioners often encounter patients with vague symptom complexes. In this context, a common trap is to assume that the condition is non-organic in origin, thereby possibly missing an important diagnosis. It is easy to be frustrated with such a patient - should they simply be reassured, or should one investigate further?
Source: CME : Your SA Journal of CPD 31, pp 85 –90 (2013)More Less
Intracranial pressure (ICP) is the tension within the cranial vault. Typically recorded in millimetres of mercury (mmHg), ICP in adults is normally 5 - 10 mmHg, in children 3 - 7 mmHg, and in infants 1.5 - 6 mmHg. The mmHg value is multiplied by 1.36 to determine the equivalent value in cmH2O. This is usually obtained when using a manometer after lumbar puncture. ICP varies over the course of the day and is influenced by changes in posture, position and pressure fluctuations in other compartments (e.g. a Valsalva manoeuvre will markedly increase the resting ICP). Raised ICP can be defined in many ways, but in the acute setting it commonly refers to pressure greater than 20 - 25 mmHg for more than 5 minutes.
Source: CME : Your SA Journal of CPD 31, pp 91 –95 (2013)More Less
Head trauma is a very common problem - most parents will agree that it is just about impossible for any child (especially boys) to escape a blow to the head, either from a fall, an accident or a collision playing sport. Happily, most of these are trivial, but there is a wide range of diagnostic terms on offer, some of which are confusing and even contradictory, so we start this article by defining what we mean.
Source: CME : Your SA Journal of CPD 31, pp 102 –106 (2013)More Less
Intracranial haemorrhage accounts for 15 - 20% of strokes and has risen in incidence by 18% over the past 10 years to 24.6/100 000. This has been ascribed to increased use of antiplatelet and anticoagulant medication for conditions such as atrial fibrillation, as well as an ageing population with untreated hypertension and diabetes. Because this increase in incidence has also occurred in low-to-middle income countries, one can anticipate an increased incidence in South Africa. Subarachnoid haemorrhage is a less common form of stroke than hypertensive haemorrhage, with an incidence of 6 - 7/100 000.
Source: CME : Your SA Journal of CPD 31, pp 107 –109 (2013)More Less
A wide array of neurological abnormalities occur in childhood, with a significant proportion of these attributable to congenital causes. The classic congenital neurosurgical condition is open spina bifida or myelomeningocele, but this is just one example of a wide spectrum of conditions commonly referred to as neural tube defects or, more correctly in clinical practice, as dysraphism.
Source: CME : Your SA Journal of CPD 31, pp 109 –111 (2013)More Less
Source: CME : Your SA Journal of CPD 31, pp 112 –113 (2013)More Less
The transition from childhood into adulthood - a challenge in living with cerebral palsy : more about... neurosurgerySource: CME : Your SA Journal of CPD 31, pp 113 –114 (2013)More Less
The number of people living with cerebral palsy (CP) continues to grow, largely due to increased survival of low-birthweight infants and improved life expectancy. Despite extensive research and impressive progress in medical care, there is still no intervention that can reverse the brain injury causing CP. The focus of care in CP is therefore on appropriate combinations of interventions to improve overall function and participation in the community in childhood. Although CP is defined as a non-progressive disorder, it is accompanied by secondary disturbances which need life-long medical care. The question many parents face is, 'Where do you find support for your child with CP when he/she gets older?'.
Author Gus CairnsSource: CME : Your SA Journal of CPD 31 (2013)More Less
Researchers from Cornell University in New York have found that the average HIV viral load of people not taking anti-retroviral medication (ART) in Africa, and especially in southern and eastern Africa, is higher than the viral loads of untreated patients in other parts of the world. The so-called 'community viral load' (CVL) off treatment was nearly four times higher on average in sub-Saharan Africa as a whole, and 5.5 times higher in southern African countries excluding South Africa, than it was in North America.
Author Chris BatemanSource: CME : Your SA Journal of CPD 31, pp 118 –119 (2013)More Less
International - New Zealand to follow Oz on brand-free cigarette packs?
International - USA programme ups contraceptive use by at-risk teens
Africa - Somalia and Niger most vulnerable to conflict/disaster
South Africa - Budget speech shows NHI going slower than expected
South Africa - Cheap healthcare for domestic workers
South Africa - Doctors' overtime claims to be audited