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- Journal of Endocrinology, Metabolism and Diabetes in South Africa
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- Volume 14, Issue 2, 2009
Journal of Endocrinology, Metabolism and Diabetes in South Africa - Volume 14, Issue 2, 2009
Volume 14, Issue 2, 2009
Author G. Janse van RensburgSource: Journal of Endocrinology, Metabolism and Diabetes in South Africa 14, pp 1 –2 (2009)More Less
Foot ulceration and amputation cause extensive burden on individuals and health care systems. One of the reasons for the poor outcome of foot complications in developing countries is the lack of patient education. Due to the multi-factorial pathology of diabetic foot ulceration, the person with diabetes should receive health education which is tailored to the individual's risk status, promote self care and address misconceptions. It is therefore recommended that providers of foot care should participate in ongoing professional education development programmes to obtain skills to assist people in adopting positive self-care behaviour.
Author Stephen HoughSource: Journal of Endocrinology, Metabolism and Diabetes in South Africa 14 (2009)More Less
JEMDSA undoubtedly has the potential to publish top papers in the field of endocrinology, metabolism and diabetes. The fact that it is independently peer-reviewed, accredited for research output, eligible for a Department of Education subsidy, and boasts an open-access website, will undoubtedly pave the way for it to become the undisputed local leader in the field. JEMDSA aims to eventually be indexed in larger data bases such as Copernicus, EMBASE, Medline and ISI, but we are fully aware that this is a long and arduous task that lies ahead.
Author Fraser PirieSource: Journal of Endocrinology, Metabolism and Diabetes in South Africa 14, pp 73 –74 (2009)More Less
Source: Journal of Endocrinology, Metabolism and Diabetes in South Africa 14, pp 77 –79 (2009)More Less
The possibility that wine, consumed in modest amounts, can have health benefits has been highlighted frequently in the public and scientific press and was recently briefly reviewed in the South African medical literature. Much of the benefit is attributed to the antioxidant activity of wine. In contrast, concern was recently expressed about exposure to heavy metal ions in wines even at intakes of 250 mL/day, partly because they may promote oxidative stress. A brief review of heavy metals, their content in wine as well as in food, and their possible adverse effects on health is thus opportune.
Cardiovascular disease is prevalent in the developed world and is rising in the developing world. Preventive measures that involve lifestyle are appropriate, with the possible inclusion of the consumption of wine. Trends and potential hazards of some heavy metals were updated recently, with a warning that intakes may still be on the increase, especially in the developing world. If the heavy metal content of wine is significant, the beneficial effect of wine to lessen cardiovascular risk may be outweighed by other adverse effects in the very long term.
Source: Journal of Endocrinology, Metabolism and Diabetes in South Africa 14, pp 81 –84 (2009)More Less
The rising prevalence of obesity is a worldwide problem affecting not only the developed world but also developing nations such as South Africa. Excess body fat deposition is caused by an imbalance between energy intake and energy expenditure and there are many genetic and environmental factors that can influence this balance. The present article will describe these factors and discuss the complex interaction between the environment and the human genome that may underlie the current obesity epidemic.
Source: Journal of Endocrinology, Metabolism and Diabetes in South Africa 14, pp 86 –95 (2009)More Less
The description of polycystic ovaries dates back as far as 1721 but it was Stein and Leventhal who first reported the disorder, that we now know as the polycystic ovary (or ovarian) syndrome (PCOS), in seven women with amenorrhoea, enlarged ovaries with multiple cysts and hirsutism. These patients were treated with ovarian wedge resection and of the seven all had return of their menstrual cycles, and two conceived. With the advent of hormonal assays in the late 1960's and early 1970's, the diagnostic focus expanded to include endocrine abnormalities in the hypothalamic-pituitary-gonadal (HPG) axis. Elevated luteinising hormone (LH) levels and hyperandrogenaemia were therefore added to the diagnostic criteria for PCOS. The advent of pelvic ultrasonography in the late 1970's allowed for the non-invasive detection of polycystic ovarian morphology. However, this tool confounded matters when it was discovered that polycystic ovaries was a ''common finding in normal women'', and that it also occurred in diverse endocrine disorders such as hypothyroidism, hyperprolactinaemia, congenital adrenal hyperplasia and hypothalamic amenorrhoea. The finding of polycystic ovaries in normal women has been variably referred to as polycystic ovarian disease (PCOD), polycystic ovaries (PCO) and polycystic ovarian morphology (PCOM). We prefer the to use the term PCOM in this setting as it simply describes the ultrasound appearance of the ovaries without any syndromic connotations. Despite the strong link between diabetes mellitus and PCOS, it was only in 1980 when Burghen and coworkers first described hyperinsulinaemia and insulin resistance in PCOS. This has subsequently been confirmed by many others. The identification of PCOS now encompasses a heterogeneous presentation but has at its core three principal features:
ii. Anovulation, and / or
iii. Polycystic ovarian morphology (PCOM) on ultrasonography
Source: Journal of Endocrinology, Metabolism and Diabetes in South Africa 14, pp 96 –98 (2009)More Less
Author E.F. DelportSource: Journal of Endocrinology, Metabolism and Diabetes in South Africa 14, pp 99 –101 (2009)More Less
A 28-year-old woman presented with a thyroid storm while pregnant. Thyroid storm in pregnancy is a rare, life threatening endocrinological emergency. The diagnosis and management can be challenging. Even with early aggressive therapy the maternal mortality is still high and adverse effects on the pregnancy and fetus are common.
Source: Journal of Endocrinology, Metabolism and Diabetes in South Africa 14, pp 102 –105 (2009)More Less
Objective: To assess the accuracy and precision of five currently available blood glucose meters in South Africa
Background: Since the introduction of glucometers, there has been an ongoing, competition-driven development in both meter and strip technology, which has allowed for greater accuracy and reliability of results. Despite the advances in technology, there is significant variation amongst these glucometers necessitating a proper evaluation before use.
Methods: Glucose levels in capillary blood samples from 115 patients attending the diabetic clinic at Tygerberg Hospital were measured with each meter, and compared with the laboratory reference method.
Results: The coefficients of variation (CVs) (imprecision) of most meters were acceptable at less than 5%, with a bias ranging from 1.7 to 6.8%. None of the glucometers satisfied the American Diabetes Association (ADA) recommendation of less than 5% bias.
Conclusions: The study highlights the need for an objective and independent comparison of all glucometers in South Africa, as the variability observed can impact on patient care.
Factors influencing non-attendance of clinic appointments in diabetic patients at a Gauteng hospital in 2007/2008 : original researchSource: Journal of Endocrinology, Metabolism and Diabetes in South Africa 14, pp 106 –109 (2009)More Less
Objective: To determine the factors influencing non-attendance with clinic appointments in diabetic patients at a Gauteng Hospital in 2007/2008,
Setting: Two diabetes clinics situated at a secondary-level hospital, that offer more specialised outpatient care to adult patients with type 1 and 2 diabetes.
Design: Between 21 November 2007 and 12 March 2008, a convenience sample of consecutive non-attending diabetic patients (n = 76) was prospectively recruited for the study. A survey of the non-attending patients was conducted, using two data collection methods, namely face-to-face interviews and telephone interviews. Patient demographics, reasons for non-attendance, perceived severity of diabetes, and perceived encouragement from others to attend were investigated. The characteristics of the non-attending patients and the reasons for non-attendance were explored.
Results: Of the 520 patients who were booked during the study period, 35% were not compliant with their clinic visit. The mean age of the patients was 51 years (range 18-85). All patients perceived diabetes to be a serious disease. Of the interviewed patients, 83% perceived their health to be either good or excellent, and 95% claimed that a clinic visit assisted them in managing their diabetes. Only 20% of the patients diarised their appointment dates, while the rest simply used the appointment card given by the clinic. Patients had various reasons for not complying with their clinic appointments, with forgetting being the most frequently dominant response (22%).
Conclusion: Forgetfulness, which was found to be the major cause of non-attendance, can easily be addressed in ensuring the attendance of scheduled clinic visits.
Author M-T. Van der MerweSource: Journal of Endocrinology, Metabolism and Diabetes in South Africa 14, pp 112 –113 (2009)More Less
Author S. LipschitzSource: Journal of Endocrinology, Metabolism and Diabetes in South Africa 14, pp 115 –118 (2009)More Less