Primary hyperparathyroidism (PHPT) is a disorder of mineral metabolism characterised by incompletely (PTH) regulated, excessive secretion of parathyroid hormone (PTH) from one or more of the four parathyroid glands. It is usually first suspected on the basis of an elevated serum calcium concentration (corrected for the albumin level), or symptoms thereof – the so called “bones, stones, moans and groans syndrome”.... Read more
Hypercalcaemia is a relatively common clinical problem. Primary hyperparathyroidism and malignancy are the most common causes of hypercalcaemia... Read more
Cystic fibrosis (CF) is one of the most common life-limiting autosomal recessive conditions in South Africa. CF is increasingly being recognised in all of South Africa.... Read more
The prevalence of chronic kidney disease (CKD) and end- stage renal disease is increasing worldwide. Initial diagnosis relies on estimation of the glomerular filtration rate (GFR), and examination of urinary sediment and protein-excretion to establish the presence of kidney damage.... Read more
Fasting glucose levels are affected by the duration of fasting and the effect of circadian rythmicity, the latter being the predominant factor. Both glucose and insulin levels are highest in the early morning,... Read more
Overt vitamin D deficiency manifesting as osteomalacia or rickets is now uncommon in developed countries.... Read more
Drugs of abuse screening (DOAS) is well established in the workplace and in professional sports. It is increasingly being used in casualties and/or emergency departments for the medical management of patients with an altered mental state and in trauma patients.... Read more
Testosterone is the principal male sex hormone, and is secreted primarily by the Leydig cells of the testicles in the presence of luteinizing hormone (LH). Small amounts are also secreted by the adrenal glands. Testosterone plays a key role in the development of male reproductive tissues (testis and prostate),... Read more
Anti-Müllerian hormone (AMH) is a 140 kDa dimeric glycoprotein belonging to the TGF-B (transforming growth factor beta) superfamily.... Read more
Exposure to metals in the workplace presents serious and significant health risks. The hazards that metals present are a function of the toxic properties of metals and include the duration, dose and route of exposure, and health history of the individuals exposed to them. Controlling and preventing metal exposures often involves a multidisciplinary team, usually beginning with the primary healthcare provider.... Read more
Alcohol use disorders (AUD) were reclassified by the DSM-5i in 2013. The DSM-5 replaced the DSM-IV, which differentiated alcohol abuse (problem drinking without compulsive use) from alcohol dependence (compulsive drinking).... Read more
Gestational diabetes mellitus (GDM) has traditionally been defined as any degree of hyperglycaemia in pregnancy, including overt diabetes mellitus (DM), impaired glucose tolerance and impaired fasting glycaemia (as defined in the criteria for non-pregnant adults). The GDM guidelines had mainly focused on the increased risk of future maternal DM.... Read more
Newborn screening (NBS) is a public health measure that is recognised worldwide. It is aimed at the early screening, diagnosis and management of selected, inherited diseases. Such diseases are selected based on the current ability to detect and treat them, and the demonstration of the positive economic impact of such interventions.... Read more
Recognising the risk of osteoporosis and starting preventative action timeously has become increasingly important. Annually, osteoporosis is responsible for around 9 million fractures worldwide. The lifetime risk of sustaining an osteoporotic fracture above the age of 50 years is up to 40% in women and 20% for men.... Read more
The monitoring of cholinesterase levels plays a fundamental role in assessing exposure to organophosphates and carbamate pesticides. The biological monitoring of workers exposed to organophosphate or carbamate is a legal requirement in South Africa, in terms of the “Regulations for Hazardous Chemical Substances 1995” under section 43 of the Occupational Health and Safety Act (Act No. 85 of 1993).... Read more
Arterial blood gas (ABG) analysis plays an essential role in the following: objective evaluation of a patient’s oxygenation and ventilation status, monitoring of response to therapeutic interventions (e.g. after administration of supplemental oxygen or mechanical ventilation or insulin in diabetic ketoacidosis).... Read more
