CME : Your SA Journal of CPD - Volume 31, Issue 4, 2013
Volume 31, Issue 4, 2013
Author Bridget FarhamSource: CME : Your SA Journal of CPD 31 (2013)More Less
Much of the current controversy around diet and health is based on the idea that atherosclerotic disease is a modern disease of lifestyle. We eat too much fat, smoke and drink too much and take too little exercise - and our arteries clog up and we die of cardiovascular disease. In fact, in modern times, we tend to die of cardiovascular disease in extreme old age - something that many proponents of a 'healthy' lifestyle conveniently ignore. Now, research into the prevalence of atherosclerosis in ancient times suggests that it is far from a modern disease, and that it appears to be a marker of old age.
Author A.A. StultingSource: CME : Your SA Journal of CPD 31 (2013)More Less
Welcome to this edition of CME, dedicated to ophthalmology. I have always believed that the general practitioner (GP) is the backbone of medicine in South Africa and the more the GP is equipped to manage medical conditions, the better for the patient. The same is true for ophthalmology. Often the patient's final visual acuity will depend on diagnosing early, correct initial management and timely referral to the ophthalmologist.
Author J. RiceSource: CME : Your SA Journal of CPD 31, pp 123 –126 (2013)More Less
Good glucose control and the treatment of hypertension and hyperlipidaemia remain the key strategies in preventing diabetic retinopathy and its progression. Unfortunately, some degree of retinopathy will eventually develop in almost all type 1 diabetics and over 60% of type 2 diabetics over a 20-year period.
Source: CME : Your SA Journal of CPD 31, pp 127 –129 (2013)More Less
Corticosteroids are the most effective way to treat ocular inflammation. They relieve symptoms rapidly and often prevent permanent damage. These medications, however, must be used with caution, as use of steroid-containing topical drops can lead to serious side-effects.
Source: CME : Your SA Journal of CPD 31, pp 130 –133 (2013)More Less
Twenty-five thousand children in South Africa are blind, mainly because of congenital cataracts, congenital glaucoma, malignant tumours (retinoblastoma), retinopathy of prematurity, inflammation and injuries. Strabismus, amblyopic and refractive errors cause many more children to have reduced vision. Unfortunately, half of these children who go blind will die within 2 years, mainly due to accidents.
Author J.F. OlivierSource: CME : Your SA Journal of CPD 31, pp 134 –137 (2013)More Less
Conjunctival lesions are frequently seen in the eye clinic, because the conjunctiva is readily seen and patients notice any change in their ocular appearance. This discussion does not attempt to classify lesions, but only highlights some of the more common lesions that are seen.
Author R. DollandSource: CME : Your SA Journal of CPD 31, pp 138 –142 (2013)More Less
Cancer chemotherapy research is a multibillion-dollar industry, which began in the early 20th century when mustard gas was used in World War I as a chemical warfare agent and was found to be a suppressor of haematopoiesis.
Chemotherapeutic drugs work by impairing mitosis at the DNA and/or RNA level. The drugs are cytotoxic and kill cells by promoting apoptosis or frank necrosis. Chemotherapy may be intended to be either curative or palliative and is therefore used in several different ways. Chemotherapeutic drugs can be used in combination with radiation therapy and surgery, for chemoreduction preoperatively, and postoperatively when there is residual tumour or risk of recurrence, and as palliative therapy to decrease the tumour load and increase life expectancy.
Author L. VisserSource: CME : Your SA Journal of CPD 31, pp 143 –146 (2013)More Less
It is estimated that there are 5.6 million people in South Africa living with the human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS). A relatively small percentage of them are on highly active antiretroviral therapy (HAART) although numbers are steadily increasing. As their CD4 cell counts decrease, these people will become more likely to develop certain opportunistic infections, immune-related diseases and tumours. A large number (70-75%) of them will develop ocular disease sometime during the course of their illness and it may be the first sign of HIV infection.
Source: CME : Your SA Journal of CPD 31, pp 147 –151 (2013)More Less
Cranial nerve III (CN III) innervates the superior, inferior, medial recti and the inferior oblique muscles. It also innervates the levator palpebrae superioris and carries with it the parasympathetic innervations to the pupil. Involvement of CN III will produce a symptom complex that involves one or several of these muscles and usually results in double vision
Source: CME : Your SA Journal of CPD 31, pp 156 –157 (2013)More Less
Author M.J. LabuschagneSource: CME : Your SA Journal of CPD 31, pp 157 –159 (2013)More Less
Source: CME : Your SA Journal of CPD 31, pp 159 –163 (2013)More Less
Glaucoma has been called the 'silent thief of the night' because patients may lose their peripheral vision slowly over a period of time with no symptoms in many cases. In South Africa, the prevalence of glaucoma in people older than 40 years of age is between 4.5% and 5.3%. In whites 1 in 40 people over the age of 40 years will develop glaucoma (2%). The prevalence in African-Americans and African-Caribbeans over 40 years of age is 4 times higher. Seventy million people world-wide suffer from glaucoma.
Author Keith AlcornSource: CME : Your SA Journal of CPD 31 (2013)More Less
Offering people the opportunity to self-test at home and then start antiretroviral therapy after counselling at home, together with home delivery of antiretroviral drugs, increased the number of people linked to care after testing and started on treatment almost threefold, a randomised study in Malawi has shown.
Author Chris BatemanSource: CME : Your SA Journal of CPD 31, pp 167 –169 (2013)More Less
International - Preventing abusive drug patenting : India's lessons for SA
International - MDR-TB: New online treatment training from WMA
International - Single suture : anti-doping agency warns athletes of black market drug
Africa - Focus on drug resistance in TB and malaria at upcoming congress
South Africa - Competition Commission probe into private healthcare 'overdue'
South Africa - NHI a critical consideration in policy changes
South Africa - DSPs and PPNs â?? profits beating quality care?