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Biomedical subjects

G Joubert

Publications and source records attributed to G Joubert.

At least 91 records · Page 5Linked to original sources
PubMed1990

The coexistence of major coronary heart disease risk factors in the coloured population of the Cape Peninsula (CRISIC study).

A cross-sectional study of risk factors for coronary heart disease in a random sample of 976 people from a South African coloured population revealed this group to be at great risk. The prevalences of individual and of coexisting reversible risk factors--hypercholesterolaemia, hypertension and smoking--were highest in the older subjects, who use medical services more often. One or more of the three risk factors was present in 80% of men aged 45 years or over. Smoking was the most common single risk factor for both sexes, and almost 30% of women aged 45 years or over were hypertensive. Hypertension and smoking was the most common combination for males and hypertension and hypercholesterolaemia the most common for females. Medical personnel could identify and treat these very-high-risk patients if they were to screen for all the risk factors after identifying any one risk factor. Younger people at risk and particularly younger men, who rarely utilise health services, should be reached at their workplace for early identification of risk factors.

Adolescent↗
PubMed1990

Anthropometric profile of the coloured population of the Cape Peninsula.

Study of a sample of 976 randomly selected coloured persons 15-64 years of age living in the Cape Peninsula included measurement of height, weight and mid-arm circumference and calculation of the body mass index (BMI). The mean height of the men was 167.6 cm and that of the women 156 cm. Mean weight, BMI and mid-arm circumference for men were 65.9 kg, 23.4 and 27.5 cm respectively and those for women 65.8 kg, 27.1 and 28.9 cm respectively. The prevalence of underweight for men (BMI less than 20) was 23.6% and for women (BMI less than 19) 9.8%; 17.7% of men were overweight (BMI greater than or equal to 25) and 3.7% obese (BMI greater than or equal to 30), while 35.2% of women were overweight (BMI greater than or equal to 24) and 18.8% obese. Overweight and obesity were more common among the older coloured women than among a group of South African white women of the same age. Obese women in the age group 35-44 years were 4.8 times more likely to be hypertensive than women of normal weight in the same age group (odds ratio; 95% confidence interval 2.2-4). Older women did not show this association. There were too few obese men to analyse in this manner. Many of the obese participants did not see themselves as obese. Only 19.7% of men and 45.2% of women had attempted to lose weight during the year preceding the study, in many cases using methods known to be ineffective. The coloureds of the Cape Peninsula were found to be a population with shorter stature than South African white and American populations. Some young participants of both sexes and some older men were underweight, while among older women there was a high prevalence of overweight and obesity. The findings may suggest previous undernutrition in both sexes, with a marked tendency to current overnutrition in adult females.

Adolescent↗
PubMed1990

Ascites and serum bilirubin value predict survival in acute variceal bleeding.

Factors affecting the outcome of acute variceal haemorrhage treated by injection sclerotherapy were analysed. The data on 82 patients undergoing their first admission for acute variceal bleeding were collected prospectively. Using multiple logistic regression analysis and multiway contingency table analysis only the presence of ascites and an elevated serum bilirubin value contributed independently to survival out of a total of 26 discontinuous and 12 continuous variables. A derived regression equation was constructed to predict survival using the data from the 82 patients and this was tested against the observed outcome in a different group of 113 patients also undergoing their first variceal haemorrhage treated by injection sclerotherapy, the data from whom were also collected prospectively. Using a cut-off point of P = 0,71, the equation accurately predicted death for 91% of patients who died and accurately predicted survival for 65% of patients who survived. Overall accuracy of prediction was 73%.

Acute Disease↗
PubMed1989

The impact of diarrhoeal disease on childhood deaths in the RSA, 1968-1985.

Diarrhoeal disease remains a major cause of morbidity and mortality in children in the RSA. In 1984, 8,984 deaths from diarrhoea of children under 5 years of age were registered, representing 27.7% of all registered deaths in this age group. Assuming a case/fatality ratio (deaths per 100 episodes of diarrhoea) of 0.6, it is estimated that 1.5 million cases of diarrhoea in children occurred during 1984 in the RSA. Analysis of diarrhoeal disease mortality rates revealed that the group at highest risk is black and coloured children under the age of 1 year. Over the period 1968-1985 there have been steady declines in diarrhoeal disease mortality rates for whites, coloureds and Asians. Uncertainty exists as to the true mortality rate in black children. A marked seasonal cycle is evident in diarrhoeal disease mortality rates for blacks and coloureds with peaks occurring in the period December-March. No seasonal effect on mortality is evident in the white and Asian groups. A nationally co-ordinated diarrhoea control programme is urgently needed in the RSA. This would involve a primary prevention component involving improved water supply, sanitation and sewerage, and a death prevention component emphasising the use of oral rehydration solutions. The seasonality in mortality suggests that the health education component of this programme should be aimed at the period just preceding the summer/autumn epidemic.

Black or African American↗
PubMed1989

Analysis of prognostic factors in 568 patients treated for breast cancer by surgery.

The Tygerberg Breast Clinic serves a heterogeneous population, and it is therefore possible to analyse prognostic factors influencing survival and to identify any possible differences between these groups. From 1978 to 1985, 568 breast cancer patients (52% white and 48% colored) were treated surgically in Tygerberg Hospital. Stage for stage, all patients received identical treatment. Colored patients were seen at a younger age, with more advanced disease, had lower estrogen receptor values, and more nodes involved. Cox's regression analysis of age, receptor value, stage, nodal involvement, race, menopausal status, treatment, and study period in the evaluation of disease-free survival and overall survival confirmed stage and lymph node status as prognostic factors. Estrogen receptor status, menopausal status, age at presentation, treatment, study period, and race did not enter the regression, except in stage I, where race was a variable. A target group for directing educational intervention is identified.

Breast Neoplasms↗
PubMed1989

Water excretion and plasma vasopressin in psychotic disorders.

To investigate the pathogenesis of water intoxication in psychotic disorders, a standard water load test was given to 23 unmedicated patients with schizophrenic or schizoaffective disorders. Levels of plasma arginine vasopressin were measured concurrently. Compared with 28 healthy volunteers, the psychotic patients had significantly smaller cumulative urine output and higher minimum urine osmolalities. Patients whose current illness had lasted less than 24 weeks exhibited the most severe antidiuretic state and also had the highest plasma arginine vasopressin levels. Water intoxication in acute exacerbations of psychosis may develop as a result of impaired excretory mechanisms.

Adolescent↗
PubMed1988

Morbidity profile of the Mamre community.

Various morbidity parameters in Mamre, a village of 4,623 residents in the western Cape, are described. Acute morbidity (either injury or illness) occurring in the 2 weeks before the survey was reported by 4% of respondents. Investigation of several chronic conditions for which people said that they were receiving treatment yielded rates of 57/1,000 for hypertension, 29/1,000 for 'nerves', 13/1,000 for diabetes and 19/1,000 for tuberculosis; 9.9% of respondents reported disability. Reported morbidity increased with age, was commoner in women than in men, and agreed with perceptions of individuals' health. Tuberculosis, inadequate sewerage and water facilities, alcohol abuse and dusty roads were perceived to be the main health problems by the community. The morbidity profile and the relatively high rate of pscyhosocial problems found are consistent with a process of urbanisation in a predominantly working-class community.

Adolescent↗
PubMed1988

Mamre Community Health Project--demographic, social and environmental profile of Mamre at baseline.

Demographic, social and environmental information was collected from 4,623 residents in 870 Mamre households: 34.3% of the population were under 15 years and 4.4% over 65 years of age, while 2.7% of adults had had no education, 42.1% had only primary school education, 51.1% secondary school education and 4.1% had had some tertiary education. Education and age were inversely related. Of employable adults 64.7% were working. Community, social and personal services and manufacturing accounted for 76% of the male and 92% of the female jobs. Cape Town or Atlantis was the workplace for 78% of male and 87.2% of female workers. Of the labour supply 17.2% were unemployed; 75% of employed people were semi-skilled and unskilled workers. There was a mean of 5.3 persons per household, with a median of 3 rooms per household. Of the houses 18.4% were older than 80 years; 38% of households had inside taps and 98% had outside tap(s). Sewage disposal by the bucket system was used in 86% of households while 13% used flush toilets. The mean amount of money spent on fuel was R10.92 per person per month. The Mamre community is well past the initial phase of rural-urban transition in terms of its sociodemographic profile. At present, critical environmental infrastructural changes are being introduced.

Demography↗
PubMed1988

Anthropometric assessment of children in Mamre.

The nutritional status of the children attending the crèche and the primary school in Mamre was assessed using standards derived by the National Center for Health Statistics in the USA. The results for children aged under 11 years are presented. Of the 75 children at the crèche 9% were below the 3rd percentile of weight for age, 11% below the 3rd percentile of height for age and 1% below the 3rd percentile of weight for height. A significantly larger proportion of boys than of girls were under the 3rd percentile of height for age. Of the 430 primary school children aged under 11 years 10.2% were below the 3rd percentile of weight for age, 10.9% below the 3rd percentile of height for age and 4.4% below the 3rd percentile of weight for height. A significantly larger proportion of primary school boys aged 8-10 years than of girls were below the 3rd percentile of weight for height. Significantly more girls aged 5-7 years than girls aged 8-10 years were underweight for age.

Age Factors↗
PubMed1988

Determinants and consequences of alcohol abuse and cigarette consumption in Mamre.

The extent, determinants and consequences of cigarette consumption and alcohol abuse in Mamre are investigated in this article. Among both males and females smoking rates were found to be higher in the 25-44-year-old group than in the 45-64-year group. Males smoked more than females. In the 25-44-year age group a relationship between employment status and smoking as well as between level of education and smoking was established. Odds ratios for smoking of 1,78 for males and 2,42 for females were found in the 25-44-year age group, while odds ratios in the unemployed group were 1,81 for males and 1,79 for females. Alcohol was reported to be a problem in 32.0% of households of which the head was an unskilled manual worker, compared with 9.1% of households of which the head was a professional or a white-collar worker. A positive association was found between alcohol being a problem in the household and the presence of a disabled person in the house, independent of employment status (odds ratio 1,8, 95% confidence interval 1,2-2,5). Respondents who viewed their health as satisfactory or bad were more likely than those with good or excellent health to come from households where alcohol was reported as a problem (odds ratio 1,9, 95% confidence interval 1,4-2,5).

Adult↗
PubMed1988

Crowding and alcohol abuse as risk factors for tuberculosis in the Mamre population. Results of a case-control study.

As part of a community health programme, a population-based case-control study was undertaken to determine whether crowding and alcohol are risk factors for tuberculosis in Mamre. Forty notified cases of tuberculosis were compared with 84 randomly selected controls. Cases and controls were group-matched for age and sex. Seventy-six per cent of dwellings had a housing density ratio greater than 100%. There was no association between crowding and tuberculosis, but cases lived in houses that were significantly older than those of controls (odds ratio, 4,8, 95% confidence interval 1,5-15,6). There was an association between alcohol problems in the household and tuberculosis (odds ratio adjusted for employment status 2,2, 95% confidence interval 1,3-3,8). Further studies using refined methods are needed to evaluate the role of crowding in tuberculosis. The need for alcohol intervention campaigns in conjunction with tuberculosis control programmes directed at high-risk groups should be considered.

Adolescent↗
PubMed1988

Deaths related to smoking in South Africa in 1984 and projected deaths among coloureds and blacks in the year 2000.

Using a World Health Organization/International Agency for Research on Cancer classification of causes of death, we found that 34.5% of deaths among whites were attributable to smoking-related causes in 1984. The comparable figures for Asians, coloureds and blacks were 24.5%, 14.5% and 3.9% respectively. Age- and sex-specific death rates in 1984 for 35- to 64-year-olds among coloureds were greater than those among whites. Taking into account the expected ageing of the black population and the increased use of tobacco by blacks, smoking-related deaths are expected to increase by between 140 and 1,200% by the year 2000. Smoking-related diseases by 2000 will make a severe impact on the delivery of health services.

Adult↗
PubMed1988

Cross-sectional study of uranium mine workers to develop predictive equations for lung functions with reference to chronic obstructive pulmonary disease.

As the first part of a prospective epidemiological study of the lung function and dust exposure of workers at the Rössing Uranium Mine in SWA/Namibia, various measurements of lung function of 1,407 workers were carried out. This was necessary in order to follow up any chronic obstructive pulmonary disease that might develop. The opportunity was used to test existing prediction formulae and to develop formulae for normal values for workers at the Rössing mine.

Adult↗
PubMed1988

The pathology of chronic Drechslera campanulata toxicosis in inbred rats.

Cultures on autoclaved maize of the phytopathogenic fungus, Drechslera campanulata, were incorporated into diets and fed to male inbred BDIX rats. In a pilot trial, a diet containing 30% D. campanulata culture material killed 5 out of 5 rats in 15-25 days. Lesions included gastric corpus erosions, gastrorrhagia and ulcerative typhlitis. Diets containing 5% or 10% culture material induced erosive to ulcerative typhlitis and oedema and hyperplasia of the ileocaecal lymph nodes in 40 out of 40 rats. Other changes included: mass loss; normocytic, hyperchromic anaemia; leukocytosis with neutrophilia; reductions in plasma proteins, creatinine, calcium and cholesterol; elevated serum enzymes; hepatosis, nephrosis and mycoplasma-like interstitial pneumonia. No lesions were present in control rats, and their profiles were normal. Ulcerative typhlitis induced by D. campanulata in rats resembles that seen in chronic piperonyl butoxide intoxication as well as that due to single treatments of indomethacid, although small intestinal ulcers are more frequent in the latter. Overgrowth of intestinal flora may be involved in ulcer pathogenesis. The pathology of drechsleratoxicosis in rats is compared to that in sheep and goats where necrotic lesions in the forestomach and, to a lesser extent, in the caecum are characteristic findings.

Animals↗
PubMed1987

Hypercholesterolaemia in the coloured population of the Cape Peninsula (CRISIC study).

A cross-sectional study of hypercholesterolaemia in a random sample of 976 subjects showed that hypercholesterolaemia was common in a coloured population. Of the males 17.4% and of the females 16.2% had total serum cholesterol values above 6.5 mmol/l. Using a cut-off point of 5.7 mmol/l the age-standardised prevalence of hypercholesterolaemia was 34.5% for males and 32.9% for females. Age- and sex-specific cut-off points showed that 69.2% of males and 65.9% of females were at risk for coronary heart disease (CHD) by virtue of the total cholesterol level. Of the males 19.1% and of the females 13.4% warranted investigation for possible familial hypercholesterolaemia. A protective high-density lipoprotein cholesterol/total cholesterol ratio was found in 61.2% of males and 51.9% of females. Hypercholesterolaemia was statistically significantly associated with a reported history and a familial history of CHD as well as with hypertension and diabetes in some groups studied. Unlike most cross-sectional studies this study showed that hypercholesterolaemic participants consumed more saturated fat and their diets had a higher Keys score than did normocholesterolaemic participants. Only 16.5% of males and 21.7% of females had modified their diets to prevent heart disease. High levels of total cholesterol were found to be associated with high levels of serum triglycerides and uric acid, high body mass index, high diastolic and systolic blood pressure and higher socio-economic standing. An education programme to initiate the dietary modifications that lead to the lowering of serum cholesterol levels is necessary to reduce CHD in the coloured population.

Adolescent↗
PubMed1987

Smoking patterns in the coloured population of the Cape Peninsula (CRISIC study).

A cross-sectional study of tobacco-smoking habits in a random sample of 976 coloured subjects aged 15-64 years revealed that smoking was common, 57% of men and 41% of women being current smokers and 10.4% of men and 9.6% of women having stopped smoking. Heavy smoking prevailed, indicating by mean daily consumption of 14.2 and 13.1 cigarettes among male and female smokers respectively; only 33.5% of male and 39.6% of female smokers used less than 10 cigarettes per day. Coloured smokers smoked more heavily during the weekend. Both men and women smoked mostly filter cigarettes. Forty-four per cent of male and 49.5% of female smokers stated that they had attempted to stop smoking, mainly for health reasons. More than one-third of the participants had a positive attitude to combating smoking, particularly those with an educational level higher than Standard 7. Former smokers and heavy smokers had a significantly higher prevalence of ischaemic heart disease than the other participants. Smoking was associated with a low body mass index, low high-density lipoprotein cholesterol levels, low socio-economic standing, high alcohol consumption and type A coronary-prone behaviour in men. In 1982 the economically active coloured population of the Cape Peninsula spent an estimated R36.2 million on cigarettes.

Adolescent↗
PubMed1987

Impaired water excretion and elevated plasma vasopressin in patients with alcohol-withdrawal symptoms.

Reports describing the fluid balance status of alcoholics in withdrawal are varied, and conflicting. We examined this question by recording values for a variety of parameters in response to a standard water load test. Compared with age and sex matched healthy volunteers (n = 14), alcoholics in withdrawal (n = 17) exhibited lower cumulative urine output (p = 0.0001), higher minimum urine osmolality (p = 0.0001), lower serum sodium (p = 0.0024 before loading) and elevated plasma arginine vasopressin levels (p = 0.0045 before loading). We believe that these findings are best explained by a resetting of osmoreceptors, a supposition in keeping with contemporary views on the pathogenesis of alcohol dependence and withdrawal. This additional evidence of an antidiuretic state in alcohol withdrawal leads us to question the practice of fluid supplementation in its management and we suggest that this policy be revised.

Adult↗