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Biomedical subjects

F P de Villiers

Publications and source records attributed to F P de Villiers.

At least 19 recordsLinked to original sources
PubMed2001

Increase in childhood asthma admissions in an urbanising population.

OBJECTIVE: In South Africa, rapid urbanisation has increased the risk of childhood asthma. This report reviews the pattern of asthma admissions to the Paediatric Department of Ga-Rankuwa Hospital, South Africa, from 1986 to 1996. DESIGN: Inpatient admission data were reviewed for 1986-1996. A detailed analysis of the records of asthma patients admitted between 1992 and 1996 was done. Outpatient data were reviewed from 1992. SETTING: Ga-Rankuwa Hospital, situated on the border of the Gauteng and North West provinces of South Africa and serving a large black population in various stages of urbanisation. MAIN OUTCOME MEASURES: Trends in admission numbers and demographic characteristics. RESULTS: Asthma admissions were 2.5 times higher in 1996 than 1986. The greatest increase in admissions was in the 1-47-month age group. The male to female ratio was 1.5:1. More patients came from urban than from rural areas. Admissions peaked during the summer. Re-admissions occurred most frequently within 3 months of the first admission. CONCLUSION: Paediatric asthma admissions have shown an increase in the past decade. This may be associated with changes in the environment of the community. There is a need for preventive programmes for asthma at community and national level.

Adolescent↗
PubMed1999

The effect of admission on oral rehydration-related knowledge.

In South Africa there has been an unenthusiastic response to oral rehydration therapy. Parents and patients still demand hospital therapy for gastro-enteritis, even in cases that can be successfully managed at home using oral rehydration solution (ORS). The aims of this study were to assess whether a period of contact with health workers (doctors, nurses and medical students) had an effect on the carers' knowledge of gastro-enteritis. Fifty carers of children aged 2 years and less with gastro-enteritis were interviewed on admission and on discharge from the paediatric short-stay facility. Eighty-eight per cent of the babies had had acute gastro-enteritis (for less than 7 days). According to the carers (44% on admission and 52% on discharge), teething was the commonest cause of gastro-enteritis. On discharge, 50% of carers did not know any of the signs and symptoms of dehydration. Sixty-seven per cent of carers had first tried ORS at home, but of these only 49% could prepare an acceptable solution. Clinics are the commonest source of information about ORS (according to 78% of carers). All the carers said they had received no health education in the hospital. On discharge only one career knew that she had been given a follow-up date and why she had to bring the child for follow-up. Contact with health workers during a period of admission to the paediatric short-stay facility had no impact on caretakers' knowledge of gastro-enteritis and its management.

Adolescent↗
PubMed1997

Blood glucose control and compliance of diabetic children.

AIM OF STUDY: Non-compliance is an important factor hindering good control in diabetics. The aim of this study was to identify areas of poor compliance with the diabetes management regimen in the children attending our clinic. DESIGN: A questionnaire was administered to 57 patients who attend the Paediatric Diabetes Clinic. It was designed to elicit socio-demographic data and information about the diabetic regimen. Prior to the administration of the questionnaire, patients were classified as being well, satisfactorily or poorly controlled, based on their average glycosylated Haemoglobin results over the past year. RESULTS: All the patients used home blood glucose monitoring (HBGM)-79% of the poorly controlled children tested twice daily or less whereas 53% of the well controlled children tested three times or more daily. The timing of injections was frequently incorrect. 42% of all patients had been admitted to hospital after diagnosis and more than 60% of them never tested their blood glucose in relation to exercise. The patients' knowledge about their disease was generally good. The mean age of the poorly controlled group was almost 19 months older than that of the well controlled group. Poorly controlled children had also had diabetes for longer and they lived significantly further from the hospital. A higher percentage of poorly controlled patients were in charge of their own treatment while those in the well controlled group were less reliant on doctors for insulin dose adjustments.

Adolescent↗
PubMed1996

Accumulating experience in a child abuse clinic.

OBJECTIVE: To examine the patient profile encountered in the first year of operation of the Child Abuse and Neglect Clinic of the Transvaal Memorial Institute. DESIGN: Record review of all cases presenting to the Clinic from May 1988 to April 1989. RESULTS: Females comprised just over 80% of the 227 patients. Sexual abuse was the presenting complaint in 89.8%. Most were young, 7% under 3 and 55% under 10 years of age. Almost one-third of the boys and 5.0% of the girls had chronic signs of anal abuse. Of the girls 56% had signs of chronic and 10% signs of acute vaginal abuse. Where the certainty of sexual abuse was high, 60% of the girls and 45% of the boys had suffered penetrative abuse. The perpetrators were almost invariably known to the child; biological family members accounted for 38% of perpetrators, and if all relations are included (biological, step and 'common law'), family members were the perpetrators in 66% of cases. Strangers were the perpetrators in only 7% of our cases. The majority of perpetrators were male. Behaviour problems were recorded in 73% of cases. Many different problems were noted; the most common were school problems (21%), masturbation (19%), 'clingy' behaviour (12%), and withdrawal and depression (11.5%). CONCLUSIONS: Certainty of diagnosis should be specified. We use four categories: proven, highly suspected, unproven but still suspected, and no abuse. For sexual abuse we also differentiate between penetrative, non-penetrative, 'type uncertain' and no abuse. Training of other health personnel in child abuse management is now a priority in our setting.

Anal Canal↗
PubMed1995

The effect of lactose maldigestion on the stools of young Tswana children.

During diarrhoeal disease, stool mass is usually increased. Lactose content of stools and stool pH have been used as tests for secondary lactose maldigestion. The effect of a lactose-free diet and various lactose loads on the stools of 30 children with primary adult-type lactose maldigestion was investigated. Stool mass following the lactose tolerance test was the largest (mean = 80 g/day); that following the milk tolerance test less--62 g (not significantly), that on a milk containing diet significantly less (35 g), while stool mass produced on a lactose-free diet (22 g) was significantly less than that produced on any of the three lactose-containing diets. The stool pH on a milk containing diet (mean = 6.3) was significantly higher than those of the three other diets (after lactose tolerance test, pH = 5.85; after milk tolerance test, pH = 5.86; after lactose-free diet, pH = 5.83). Although stool bulk was greater when these lactose maldigesters were consuming a lactose containing diet, it was still considerably less than the stool mass associated with secondary lactose maldigestion, which is believed to be a cause of diarrhoeal disease. In contrast, the primary adult-type of lactose maldigestion does not commonly cause diarrhoea, as shown in this study.

Africa↗
PubMed1992

The doctor as witness in child abuse cases.

Doctors who have to give evidence in cases of physical or sexual child abuse usually find it a stressful experience. Factors that may help to improve the doctor's ability to cope with the situation are discussed in this article. The importance of good medical notes and a good medical examination is stressed. Hints are given on how to minimise the inevitable delays that precede a court appearance. The hearsay rule means that the history the doctor obtains is not accepted as evidence. The medical procedure, which involves using various facts to build up a complete picture, is contrasted with the legal procedure, which involves testing each separate fact in order to create reasonable doubt that the accused may be guilty. Some common questions put to the doctor are discussed here. They include questions as to whether causes other than abuse, such as masturbation, infection or the use of other instruments, could have damaged the hymen or vagina.

Child↗
PubMed1992

Sexually transmitted disease surveillance in a child abuse clinic.

The sexually transmitted disease surveillance system instituted at the Child Abuse and Neglect (CAN) clinic of the Transvaal Memorial Institute for Child Health and Development was evaluated after 1 year. The presenting complaint of the vast majority of the 227 patients was sexual abuse. In more than half (52%), child abuse was medically proven, and it was highly suspected in another 18%. In only 6% did no abuse take place. About half the patients suffered non-penetrative sexual abuse, 40% penetrative abuse and 10% suffered non-sexual abuse. Smears for gonorrhoea were positive in 2 out of 152 patients; for Chlamydia in 1 out of 140; for Gardnerella and Trichomonas in 2 and 1 case, respectively. Syphilis serology yielded 3 positive results out of 162, and hepatitis B, 6 out of 143. No positive results were found in tests for HIV and herpes. With the exception of hepatitis B tests, all positive results occurred in children considered on clinical grounds to have medically proven or highly suspected sexual abuse. These results will allow modification of the surveillance system and testing of those children more likely to test positive, while doing fewer tests overall.

Adolescent↗
PubMed1991

The use of content analysis in the assessment of medical controversies.

Medicine is fraught with controversies, and several strategies have been developed in order to reach rational conclusions. Examples are using more subjects or an improved research design, developing consensus statements or using meta-analysis. An additional strategy is described in this paper. The language content of scientific papers is examined to establish whether the authors use factual (informational) language or emotional appeals (directive language) to convince the reader. This type of content analysis is then applied to a sample controversy. The paper shows that directive language content analysis can be applied effectively to scientific publications to clarify the basis of and reasoning behind some controversies.

Communication↗
PubMed1988

Relationship between milk lactose tolerance and body mass in teenage Tswana schoolchildren.

The Tswana and other black races of southern Africa have a high prevalence of the adult type of primary lactose intolerance. It is possible that nutritional status may affect lactose absorption, so that lactose malabsorbers may be less well nourished than lactose absorbers. However, such a poor nutritional status may have caused, or have been caused by, the lactose malabsorption. It is also possible that another factor, such as chronic diarrhoea, may cause both poor nutrition and lactose intolerance. A random sample of 92 Tswana pupils was taken from a school population of 486. Their heights and weights were measured, and the relative weight and body mass index (weight/height2) calculated for each subject. A milk tolerance test was administered to each subject to establish whether they were lactose tolerant or intolerant. There were 79 (85.9%) lactose intolerant subjects, 7 (7.6%) were probably intolerant and only 6 (6.5%) were lactose tolerant. The nutritional status of the lactose intolerant and tolerant subjects were compared. The two groups did not differ in nutritional status, as measured by their relative weights and body mass indices, and were nutritionally similar to a reference population of Tswana schoolchildren.

Adolescent↗
PubMed1988

Spontaneous bile duct perforation in an infant. A case report.

A case of spontaneous perforation of the common bile duct in a 4-month-old girl is described. Perforation of the biliary tract is rare, but must be suspected in a child with pale stools, minimal or no jaundice and biliary ascites. Treatment is surgical. Patency of the distal biliary tract must be demonstrated by intra-operative cholecystocholangiography; drainage without repair of the perforation is then appropriate. If there is distal biliary tract obstruction, a biliary-intestinal anastomosis is needed. The difficulty of diagnosis is highlighted by the time between presentation and operation reported in many published cases; suggestions are made to aid a more rapid diagnosis.

Common Bile Duct Diseases↗