South African Family Practice最新文献_第9页

Ten-year predictors of major adverse cardiovascular events in patients without angina. 无心绞痛患者主要心血管不良事件的十年预测因素。

IF 1

South African Family Practice Pub Date : 2023-08-04 DOI: 10.4102/safp.v65i1.5629

Preesha Premsagar, Colleen Aldous, Tonya Esterhuizen

{"title":"Ten-year predictors of major adverse cardiovascular events in patients without angina.","authors":"Preesha Premsagar, Colleen Aldous, Tonya Esterhuizen","doi":"10.4102/safp.v65i1.5629","DOIUrl":"10.4102/safp.v65i1.5629","url":null,"abstract":"Background: Longstanding cardiovascular risk factors cause major adverse cardiovascular events (MACE). Major adverse cardiovascular events prediction may improve outcomes. The aim was to evaluate the ten-year predictors of MACE in patients without angina.Methods: Patients referred to Inkosi Albert Luthuli Hospital, Durban, South Africa, without typical angina from 2002 to 2008 were collected and followed up for MACE from 2009 to 2019. Survival time was calculated in months. Independent variables were tested with Cox proportional hazard models to predict MACE morbidity and MACE mortality.Results: There were 525 patients; 401 (76.0%) were Indian, 167 (31.8%) had diabetes at baseline. At 10-year follow up 157/525 (29.9%) experienced MACE morbidity, of whom, 82/525 (15.6%) had MACE mortality. There were 368/525 (70.1%) patients censored, of whom 195/525 (37.1%) were lost to follow up. For MACE morbidity, mean and longest observation times were 102.2 and 201 months, respectively. Predictors for MACE morbidity were age (hazard ratio [HR] = 1.025), diabetes (HR = 1.436), Duke Risk category (HR = 1.562) and Ischaemic burden category (HR = 1.531). For MACE mortality, mean and longest observation times were 107.9 and 204 months, respectively. Predictors for MACE mortality were age (HR = 1.044), Duke Risk category (HR = 1.983), echocardiography risk category (HR = 2.537) and Ischaemic burden category (HR = 1.780).Conclusion: Among patients without typical angina, early ischaemia on noninvasive tests indicated microvascular disease and hyperglycaemia, predicting long-term MACE morbidity and MACE mortality.Contribution: Diabetes was a predictor for MACE morbidity but not for MACE mortality; patients lost to follow-up were possibly diabetic patients with MACE mortality at district hospitals. Early screening for ischaemia and hyperglycaemia control may improve outcomes.","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":"65 1","pages":"e1-e9"},"PeriodicalIF":1.0,"publicationDate":"2023-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10476236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41153610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An introduction to gender affirming healthcare: What the family physician needs to know. 性别确认医疗保健的介绍:家庭医生需要知道的。

IF 1

South African Family Practice Pub Date : 2023-07-31 DOI: 10.4102/safp.v65i1.5770

Madeleine Muller, Elma De Vries, Anastacia Tomson, Christine McLachlan

{"title":"An introduction to gender affirming healthcare: What the family physician needs to know.","authors":"Madeleine Muller, Elma De Vries, Anastacia Tomson, Christine McLachlan","doi":"10.4102/safp.v65i1.5770","DOIUrl":"https://doi.org/10.4102/safp.v65i1.5770","url":null,"abstract":"Gender affirming healthcare (GAHC) is a relatively new field in primary health care that describes a range of gender affirming practices, including hormone therapy, for transgender and gender diverse (TGD) people. In 2019, gender affirming hormones were approved by South African National Essential Medicine List Committee (NEMLC) for tertiary-level care, and in October 2021 the Southern Africa HIV Clinicians Society published a GAHC guideline for South Africa. Unfortunately, TGD people still experience discrimination and stigmatisation in healthcare facilities in South Africa, leading to poor access to care and higher health risks with poorer outcomes. Gender affirming care in the primary health care clinic can improve access to health care, with improved provision of preventative services. This article defines key transgender concepts, describes the informed consent process and outlines the initiation and monitoring of both feminising and masculinising hormone treatment for TGD people. Staff at healthcare facilities need to receive training on gender affirming practices and how to ensure a safe environment for TGD clients.","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":"65 1","pages":"e1-e5"},"PeriodicalIF":1.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10483305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10186272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

From the President's Desk: Part 3, 2023. 来自总统办公桌第 3 部分，2023 年。

IF 1

South African Family Practice Pub Date : 2023-07-21 DOI: 10.4102/safp.v65i1.5791

Robert J Mash

引用次数: 0

Corrigendum: Utilisation of village health workers' services for tuberculosis screening in Lesotho. 更正：莱索托利用乡村保健员服务进行结核病筛查的情况。

IF 1

South African Family Practice Pub Date : 2023-07-20 DOI: 10.4102/safp.v65i1.5759

Regina M Thetsane, Motšelisi Mokhethi, Maseabata Ramathebane, Nthatisi Leseba

引用次数: 0

A review of published research in the South African Family Practice - A clarion call to action. 南非家庭实践》发表的研究综述--行动的号角。

IF 1

South African Family Practice Pub Date : 2023-07-12 DOI: 10.4102/safp.v65i1.5777

Klaus B Von Pressentin, Ramprakash Kaswa, Shane Murphy, Arun Nair

引用次数: 0

Hypertensive Crisis 高血压危象

IF 1

South African Family Practice Pub Date : 2023-07-05 DOI: 10.1007/978-0-387-79948-3_3590

Siti Jaisy Millah Hadaina, Romi Ermawan, Andi Annisa Amaliah Darman, Nimas Resti, Putu Diva Gayatri Jaya Putri, Yusuf Alfin Firmawan

引用次数: 0

Experiences of patients with chronic diseases during the COVID-19 pandemic in the North West province, South Africa. 南非西北省2019冠状病毒病大流行期间慢性病患者的经验

IF 1

South African Family Practice Pub Date : 2023-06-29 DOI: 10.4102/safp.v65i1.5643

Sheillah H Mboweni, Patrone R Risenga

{"title":"Experiences of patients with chronic diseases during the COVID-19 pandemic in the North West province, South Africa.","authors":"Sheillah H Mboweni, Patrone R Risenga","doi":"10.4102/safp.v65i1.5643","DOIUrl":"10.4102/safp.v65i1.5643","url":null,"abstract":"Background: Patients with chronic diseases (PWCDs) were severely affected by the coronavirus disease 2019 (COVID-19) pandemic, as they were prevented from making the necessary visits to health facilities for medical review and to collect their medication. The emergence of the health crisis and inadequate access to quality care affected chronic care management. The perspectives of PWCDs are not known, and therefore the research on which this paper is based sought to investigate the lived experiences of these patients during the COVID-19 pandemic.Methods: A qualitative phenomenological design was used to obtain the lived experiences of PWCDs identified for participation in the study by means of purposive sampling. Patients' experiences were obtained during individual structured interviews, and a checklist was used to gather patient characteristics from their files.Results: Three themes emerged from the study findings, namely poor healthcare services, the socio-economic impact of the COVID-19 pandemic, and the psychological impact of the COVID-19 pandemic. The COVID-19 pandemic had devastating effects on PWCDs, in that they experienced barriers to accessing quality chronic care services and suffered psychological and financial difficulties that affected their health, life, needs and expectations.Conclusion: Policymakers should consider PWCDs when responding to a public health concern in the future.Contribution: The study findings may have an impact on future policies regulating the management of chronic diseases during epidemics, in order to improve patient health outcomes and satisfaction with healthcare services and the chronic care model based on the experiences of PWCDs.","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":"65 1","pages":"e1-e10"},"PeriodicalIF":1.0,"publicationDate":"2023-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10318609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9813059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Medical practitioners' knowledge and awareness of multiple myeloma at public hospitals, Gauteng, South Africa. 南非豪登省公立医院医生对多发性骨髓瘤的知识和意识

IF 1

South African Family Practice Pub Date : 2023-06-27 DOI: 10.4102/safp.v65i1.5644

Andiswa M Pooe, Abegail N Dlova, Sam T Ntuli

{"title":"Medical practitioners' knowledge and awareness of multiple myeloma at public hospitals, Gauteng, South Africa.","authors":"Andiswa M Pooe, Abegail N Dlova, Sam T Ntuli","doi":"10.4102/safp.v65i1.5644","DOIUrl":"https://doi.org/10.4102/safp.v65i1.5644","url":null,"abstract":"Background: Multiple myeloma (MM) is a plasma cell malignancy associated with morbidity and mortality worldwide, and most patients are referred for specialist care very late with complications. The low index of suspicion among medical practitioners is among the reasons for the delay in MM diagnosis and management. This study aimed to determine the level of awareness and knowledge of MM among medical practitioners working in public hospitals of Tshwane Municipality, Gauteng Province, South Africa.Methods: A cross-sectional descriptive study on 74 doctors working in three district, one regional and one central hospital using a convenience sampling.Results: Seventy-four medical practitioners participated in this study. Their median age was 37 years with an interquartile range of 43-30 years. The majority (85%) of the respondents were aware of MM, while 74% were knowledgeable regarding MM presentations and diagnostic investigations.Conclusion: The findings highlighted a high level of awareness and knowledge of MM among the study population, but almost all of the participants requested an educational information brochure on MM.Contribution: Medical practitioners have a high level of awareness of multiple myeloma; however, there is a discrepancy between this level of awareness and the delayed presentation of patients at the public hospitals. As primary healthcare in South Africa is nurse-driven, the study indicates that not all primary healthcare providers may be aware of this disease. Future awareness campaigns should target other primary healthcare providers, including nurses and private general practitioners.","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":"65 1","pages":"e1-e6"},"PeriodicalIF":1.0,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10331045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10169763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

First-time traumatic anterior shoulder dislocation: Approach for the primary health care physician. 首次外伤性肩前脱位:初级保健医生的方法。

IF 1

South African Family Practice Pub Date : 2023-06-26 DOI: 10.4102/safp.v65i1.5744

Ntambue Kauta, James Porter, Mubashir A Jusabani, Stefan Swanepoel

{"title":"First-time traumatic anterior shoulder dislocation: Approach for the primary health care physician.","authors":"Ntambue Kauta, James Porter, Mubashir A Jusabani, Stefan Swanepoel","doi":"10.4102/safp.v65i1.5744","DOIUrl":"https://doi.org/10.4102/safp.v65i1.5744","url":null,"abstract":"Traumatic anterior shoulder dislocation is a very common injury encountered in emergency rooms as well as in the primary health care physician's office. This injury occurs either in the setting of competitive or recreational sports injuries or as a high-energy injury during a fall or a road traffic accident. Common complications such as a recurrent dislocation can be predicted, monitored and prevented. Early appropriate treatment of associated cuff tears or fractures is associated with improved outcomes. There is a plethora of literature on the assessment and management of the primary anterior shoulder dislocation in specialised fields such as sports medicine, orthopaedic surgery and shoulder surgery. These studies are often highly technical, addressed to a particular subset of readers and often deal with one aspect of the management of the injury. This narrative aims to provide the reader with a simplified, evidence-based assessment and management approach for the first-time acute anterior shoulder dislocation. Emphasis is on closed reduction techniques, position and duration of immobilisation, and return to activities of life or sports. Risk factors for recurrence and other indications for primary referral to the orthopaedic surgeon are discussed. Other forms of shoulder instability such as posterior shoulder dislocation, inferior dislocation and multidirectional instability will not be the focus of this narrative.","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":"65 1","pages":"e1-e7"},"PeriodicalIF":1.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10331046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9813060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Long COVID: An approach to clinical assessment and management in primary care. Long COVID：基层医疗临床评估和管理方法。

IF 1

South African Family Practice Pub Date : 2023-06-23 DOI: 10.4102/safp.v65i1.5751

Rubeshan Perumal, Letitia Shunmugam, Kogieleum Naidoo

{"title":"Long COVID: An approach to clinical assessment and management in primary care.","authors":"Rubeshan Perumal, Letitia Shunmugam, Kogieleum Naidoo","doi":"10.4102/safp.v65i1.5751","DOIUrl":"10.4102/safp.v65i1.5751","url":null,"abstract":"Long COVID is an emerging public health threat, following swiftly behind the surges of acute infection over the course of the COVID-19 pandemic. It is estimated that there are already approximately 100 million people suffering from Long COVID globally, 0.5 million of whom are South African, and for whom our incomplete understanding of the condition has forestalled appropriate diagnosis and clinical care. There are several leading postulates for the complex, multi-mechanistic pathogenesis of Long COVID. Patients with Long COVID may present with a diversity of clinical phenotypes, often with significant overlap, which may exhibit temporal heterogeneity and evolution. Post-acute care follow-up, targeted screening, diagnosis, a broad initial assessment and more directed subsequent assessments are necessary at the primary care level. Symptomatic treatment, self-management and rehabilitation are the mainstays of clinical care for Long COVID. However, evidence-based pharmacological interventions for the prevention and treatment of Long COVID are beginning to emerge. This article presents a rational approach for assessing and managing patients with Long COVID in the primary care setting.","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":"65 1","pages":"e1-e10"},"PeriodicalIF":1.0,"publicationDate":"2023-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10331047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9867267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0