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- Volume 16, Issue 2, 2011
Journal of Endocrinology, Metabolism and Diabetes in South Africa - Volume 16, Issue 2, 2011
Volume 16, Issue 2, 2011
Author Stephen HoughSource: Journal of Endocrinology, Metabolism and Diabetes in South Africa 16 (2011)More Less
This edition of JEMDSA again contains something for everyone. Klisiewicz and Huddle review the management of type 2 diabetes. Although directed at our general practitioner colleagues, the paper addresses most aspects of importance in the practical management of this pandemic disease, eloquently combining own experience and knowledge with international and local SEMDSA guidelines. Ross and Levitt have produced a seminal paper on the aetiology, diagnosis and management of patients with Addison's disease, based on insights gained from a large local cohort.
Author K.R.L. HuddleSource: Journal of Endocrinology, Metabolism and Diabetes in South Africa 16, pp 75 –84 (2011)More Less
A 55-year-old Asian man presents with a history of intense thirst, polyuria, blurring of vision and weight loss over a period of several weeks. He is obese with a waist circumference of 110 cm and a body mass index (BMI) of 32 kg/m2. His blood pressure is 170/110 mmHg. Laboratory investigations indicate the following: random blood glucose 13.6 mmol/l, haemoglobin A1c (HbA1c) 9.5%, total serum cholesterol 6.8 mmol/l, low-density lipoprotein (LDL) cholesterol 3.5 mmol/l, high-density lipoprotein (HDL) cholesterol 0.7 mmol/l, triglycerides 3.2 mmol/l, and serum creatinine normal. His urine shows glycosuria and microalbuminuria.
Diagnosis and management of Addison's disease : insights gained from a large South African cohort : review articleAuthor N.S. LevittSource: Journal of Endocrinology, Metabolism and Diabetes in South Africa 16, pp 86 –92 (2011)More Less
The prevalence of Addison's disease in South Africa is lower than in Western countries. This is concerning, since patients could be dying, undiagnosed. Enhanced awareness of this highly treatable condition is warranted. The epidemiology, aetiology, clinical presentation, screening and management of Addison's disease are discussed. Autoimmunity predominated as the underlying aetiology mostly in patients of European descent. A low threshold is required for screening, intervention and follow-up of all patients for cardiovascular risk factors, given the atherogenic profile observed among Addison's disease sufferers in South Africa.
Source: Journal of Endocrinology, Metabolism and Diabetes in South Africa 16, pp 94 –100 (2011)More Less
Human immunodeficiency virus (HIV) infection and the pharmacological treatment thereof have both been shown to affect mitochondrial function in a number of tissues, and each may cause specific organ pathology through specific mitochondrial pathways. HIV has been shown to kill various tissue cells by activation of mitochondrial apoptosis. Nucleoside analogues, used extensively to treat HIV infection, are known to influence a number of steps affecting mitochondrial DNA integrity. This review describes the basic physiology, pharmacology and pathophysiology of HIV infection and the nucleoside analogues regarding mitochondrial function and discusses the progress made in this field with respect to the measurement of these effects and the prediction of potential drug toxicity.
Diabetes mellitus : preliminary health-promotion activity based on service-learning principles at a South African national science festival : original researchSource: Journal of Endocrinology, Metabolism and Diabetes in South Africa 16, pp 101 –106 (2011)More Less
Objectives: To investigate the effects of a service-learning-based health promotion elective in influencing knowledge of diabetes mellitus (DM) and ways to prevent it.
Method: A computer-based quiz, an information poster, interactive models and a take-home information leaflet on DM were developed as part of an exhibit during the 2009 National Festival of Science and Technology held in Grahamstown, South Africa. Predominantly school students visited the exhibit and took part in the quiz and other educational activities.
Results: The majority of the 119 junior and 332 senior quiz participants were male students attending government schools in the Eastern Cape, South Africa. After an educational intervention, there was significant improvement in the junior quiz participants' overall percentage knowledge scores (p-value = 0.024), while the senior quiz participants showed a markedly significant improvement in the overall percentage knowledge scores (p-value < 0.001). The results showed significant gender differences for both the pre- and post-intervention mean percentage scores among both groups, with better scores for female participants.
Conclusion: The health-promotion elective was successful in raising awareness of DM. This approach may offer an additional tool that can be used in the continuous, concerted health promotion activities and advocacy by all healthcare professionals to address the prevention of DM.
Source: Journal of Endocrinology, Metabolism and Diabetes in South Africa 16, pp 107 –110 (2011)More Less
A patient was managed in our endocrinology unit with ectopic Cushing's syndrome from an adrenocorticotropic hormone-producing neuroendocrine carcinoma of the anal canal. There was limited response to standard therapy, which made it difficult to correct the electrolyte and metabolic derangements associated with the disease. This is a summary of the challenges encountered during treatment.
Source: Journal of Endocrinology, Metabolism and Diabetes in South Africa 16, pp 111 –114 (2011)More Less
This is a report of a maxillary brown tumour caused by primary hyperparathyroidism (HPT) secondary to parathyroid carcinoma. A 62-year-old man presented with a large swelling in the right maxilla, which caused right-sided nasal obstruction, intermittent bleeding and diplopia. A computed tomography scan demonstrated an expansible, destructive soft tissue mass centred on the right ethmoid sinus, extending from the maxilla to the orbital floor. Histology showed a central giant cell granuloma of bone, thought to be a brown tumour of HPT and this was supported by serum calcium of 3.0 mmol/l and serum parathyroid hormone of 880 ng/l (normal 7 to 40 ng/l). Parathyroid imaging was consistent with a left lower parathyroid adenoma. The patient underwent removal of the parathyroid gland, left hemithyroidectomy and central node dissection. Histology confirmed parathyroid carcinoma. Surgical removal of the brown tumour was offered but declined. The symptoms improved and the maxillary swelling gradually reduced in size. The management of brown tumours is controversial, but a pragmatic approach is essential to a successful outcome. The general consensus seems to be adequate treatment of the HPT and surgical excision of the brown tumour only if the mass effect of the lesion is troublesome.
Author A.J. De WeerdSource: Journal of Endocrinology, Metabolism and Diabetes in South Africa 16 (2011)More Less
What happens to hip fracture patients in placebo-controlled trials for osteoporosis?
Hip fracture patients are removed from the trials and treated by their own private doctors, hopefully also for osteoporosis. One will never see any hip fracture mortality figures in any placebo controlled osteoporosis trial.