South African Family Practice - Volume 57, Issue 3, 2015
Volume 57, Issue 3, 2015
Author A.M.E. Du PlessisSource: South African Family Practice 57, pp 24 –28 (2015)More Less
Attention-deficit/hyperactivity disorder is a common neurobehavioural disorder that compromises the core symptoms of developmentally inappropriate levels of inattention, impulsivity and hyperactivity. Many patients are still not diagnosed, or do not receive appropriate sustained treatment, in spite of a general greater awareness of the disorder. With such a high prevalence, the clinician needs to be well-informed about the presentation, treatment and challenges associated with this complex disorder.
Source: South African Family Practice 57, pp 29 –33 (2015)More Less
The purpose of this article is to provide brief insight into delayed onset muscle soreness (DOMS), a phenomenon that is often experienced by recreational and elite athletes. The negative implications of DOMS include pain, decreased motivation to continue training, and decreased performance. While performance issues may be more relevant to the elite athlete, pain and decreased motivation are particularly relevant to recreational athletes wishing to sustain a regular level of physical activity. The article is aimed at general practitioners (GPs) who may encounter athletes presenting with DOMS, and who will benefit from understanding the proposed mechanisms, signs and symptoms of the condition. Numerous researchers have hypothesised that certain interventions may prevent or minimise the symptoms thereof, and all GPs could benefit from understanding the available options for athletes, and the scientific evidence that supports these options.
Source: South African Family Practice 57, pp 34 –38 (2015)More Less
Proton-pump inhibitors (PPIs) are a class of drugs that profoundly suppress gastric acid secretion, and thus have become the treatment of choice for gastro-oesophageal reflux disease and peptic ulcer disease. PPIs are considered safe and effective. It is essential that clinicians understand the appropriate use of PPIs, given the significant economic burden of inappropriate prescribing and safety concerns. Long-term safety concerns and possible drug interactions have led to a more conservative approach to PPI use. Some of these concerns may have been overstated, but they serve to highlight the need for ongoing vigilance because even a small increased risk of an adverse event may translate to a large number, considering that the use of PPIs is widespread. This review focuses on the use of oral PPIs in the ambulatory setting, and recent concerns regarding the adverse effects of PPIs.
Source: South African Family Practice 57, pp 39 –51 (2015)More Less
The management of the diabetic foot is often a costly endeavour due to the magnitude of foot complications that can arise when not managed within the multi-disciplinary team. The International Working Group on the Diabetic Foot (IWGDF 2011) states that: "A strategy that includes prevention, patient and staff education, multidisciplinary treatment of foot ulcers, and close monitoring can reduce amputation rates by 49-85%". This document is based on the work done by the IWGDF and fully endorses International Consensus Document on the Management and Prevention of the Diabetic foot (2011). Other Guidelines that play a predominant role in adapting the International Guidelines to the South African and also African context are comprehensively detailed in the SEMDSA guidelines (2012), NICE guidelines (2008), Wound Bed Preparation Guidelines (2011), SIGN guidelines (2010) and the International Best Practice Guidelines: Wound Management in Diabetic Foot Ulcers (2103). Wound Care for the Diabetic Foot poses unique challenges due to the predisposing risk factors as well as the psychological impact on both the patient, family and care givers. It is also noted that a Diabetic Foot Ulcer (DFU) is a pivotal event in the life of a person with diabetes and is seen as a clear marker of serious under lying disease. Rapid wound deterioration is inevitable if wound care interventions are not done early to avoid ultimate amputation. The purpose of this document is to describe the basic principles in managing the diabetic foot by focussing on both prevention and ulcer treatment within the African context.
Is there a difference between an angiotensin-converting enzyme inhibitor and an angiotensin-specific receptor blocker for the treatment of hypertension? : reviewAuthor J.A. KerSource: South African Family Practice 57, pp 52 –53 (2015)More Less
The renin-angiotensin system (RAS) and angiotensin II, in particular, play a central role and have been implicated in the spectrum of cardiovascular disease (CVD), beginning with hypertension, diabetes mellitus, atherosclerosis, myocardial infarction (MI), strokes and heart failure.
The contribution of family physicians to district health services : a national position paper for South Africa : forumSource: South African Family Practice 57, pp 54 –61 (2015)More Less
This position paper on Family Medicine in South Africa was written for the National Department of Health in 2014 for the purposes of delivering a comprehensive assessment of the contribution that family physicians could make to the health system, and the issues that need to be addressed in order to realise this contribution. The paper mainly addresses issues in the public sector. It outlines the policy environment, health and health services context, the contribution of family physicians, their role in relationship to other healthcare workers, the initial evidence of their impact, the implications for posts and career pathways and the current state of training programmes, as well as providing key recommendations. The paper represents the viewpoint of the South African Academy of Family Physicians and the College of Family Physicians of South Africa, and attempts to speak with one voice on the current situation and need for future action.
Author Chris EllisSource: South African Family Practice 57 (2015)More Less
I started general practice the wrong way around. I designed what was the most ideal practice setting for me, and I have been trying to get back there ever since. I started in rooms in a shopping centre, and only employed one nursing sister. Her name was Sister Zurlinski and she was made in heaven.