PubMed Health⌕ Search

Biomedical subjects

J C De Villiers

Publications and source records attributed to J C De Villiers.

At least 19 recordsLinked to original sources
PubMed2004

Evaluation of clinical teaching and professional development in a problem- and community-based nursing module.

In South Africa the main focus is on primary health care. This affects the education and training of nurses, and training schools must respond by developing appropriate teaching modules. A school of nursing developed, implemented and revised a problem- and community-based learning module over a period of three years (1996-1998). This student-centered module focuses on students' needs, active participation, collaboration, accountability, self-assessment, self-study, life-long learning and appropriate skills. In the formal clinical teaching environment PBL was the main approach. However, this approach was also supported by a variety of strategies, for example group discussions and scenarios. The knowledge, attitudes and professional development skills acquired in the PBL approach were then applied informally in the community setting (CBE). The purpose of the study was to evaluate a first year clinical teaching module as part of an extensive programme. A quantitative research method, a descriptive design, and a variety of data collection techniques were used. Conclusions were that clinical teaching was effective within the problem- (PBL) and community-based (CBE) approaches; 78% of respondents were positive about the clinical learning environment; 61% stated that expectations were met; 81% preferred group activities, and 67% indicated that they had developed professional skills. Facilitators agreed that clinical teaching met the requirements of PBL & CBE. The pass rate also improved.

Attitude of Health Personnel↗
PubMed2001

Acromegaly in the developing world--a 20-year teaching hospital experience.

A retrospective analysis was conducted to examine the long-term outcome of surgery, by a single pituitary surgeon and radiotherapy for acromegaly at Groote Schuur Hospital, Cape Town, using modern criteria for the definition of cure. Seventy-two patients (F/M ratio 1.3:1), aged 16-74 years, were eligible for inclusion. The mean follow-up period was 8.3 years. Macroadenomas were present in 79%, microadenomas in 15% and tumour size was not documented in 6%. Pretreatment GH levels were, > or = 40 m U/l in 56 patients. Postoperatively, 21% of patients were cured, 40% controlled and 40% had hypopituitarism. After radiotherapy (mean follow-up 8.7 years) 43% were cured, 66% controlled and 78% had hypopituitarism. At follow-up 37% of patients traced had died. The most common cause of death was vascular disease. The poor surgical results may be attributed to late presentation in the developing world setting, as evidenced by tumour size and invasiveness, and the degree of GH elevation. Emphasis on early diagnosis of non-invasive tumours is necessary to improve the cure rate and reduce mortality,

Acromegaly↗
PubMed1995

Pituitary function after selective adenomectomy for Cushing's disease.

This retrospective analysis was undertaken to determine whether selective adenomectomy for Cushing's disease can achieve acceptable cure rates while causing minimal pituitary dysfunction. Tumour size, histology and pituitary function were evaluated in 34 consecutive patients (26 F: 8 M, mean age 33.6 years) undergoing transphenoidal adenomectomy for Cushing's disease from 1975 to 1992. Follow-up averaged 5.8 years. Cure was defined as resolution of symptoms and signs and normalization of urinary cortisol excretion. Sixty-three per cent of patients achieved cure after selective adenomectomy, repeat adenomectomy cured an additional four patients. Twenty-eight per cent required bilateral adrenalectomy and/or pituitary irradiation. Postoperative pituitary function remained completely intact in 81%. Secondary hypogonadism occurred in 8%, hypothyroidism in 155 and permanent diabetes insipidus in 4%. There was recurrence in 26% after a mean of 4.6 years (range 1-7). It is concluded that selective adenomectomy can achieve acceptable cure rates with a low prevalence of postoperative hypopituitarism, although an increase of recurrence may be the result of conservative surgery.

Adenoma↗
PubMed1992

The congenital bregmatic dermoid: an African cyst?

Thirty-five children with bregmatic dermoids were operated on at the Red Cross War Memorial Children's Hospital and Groote Schuur Hospital between 1969 and 1990. Most children were under 1 year of age; 20 were males and 15 females. Thirty-one were African or of African descent, two were Indian and two Caucasian, an ethnic distribution which roughly approximates the ethnic ratio of patients attending our hospital. Most were investigated with skull X-rays and CT scan, but MRI was performed where further clarity was needed. Other lesions mimicking bregmatic dermoids included four haemagiomas, two hamartomas, two lipomas and one encephalocoele through the anterior fontanelle. One bregmatic lipoma was associated with a lipoma of the corpus callosum. All bregmatic cysts were removed through a simple elliptical incision and on connection with the central nervous system or its coverings was encountered in any patient. The pathology in all specimens reviewed (75%) revealed skin appendages to be present in the cyst wall. No epidermoids were found in this series. This series is the largest to date and adds another 31 patients of African descent to the accumulated literature which suggests that although universally distributed, the bregmatic dermoid still appears to be more common in Africans or their descendants.

Adolescent↗
PubMed1985

Multiple endocrine neoplasia type I.

During the 13-year period 1970-1983 only 7 cases of multiple endocrine neoplasia type I (MEN I) were seen at Groote Schuur Hospital, suggesting that the associated gene is rare in this area. Only 1 of these patients was black. Endocrine associations were as follows: hyperparathyroidism--6 cases, pituitary hypersecretion--6 cases (3 each involving growth hormone and prolactin), and pancreatic hypersecretion--3 cases (2 of gastrinoma and 1 of insulinoma). The presenting features were predictably diverse and depended on the component which manifested first. There was little difficulty in reaching a diagnosis on routine investigation. All patients with hyperparathyroidism underwent a 3 1/2-gland parathyroidectomy as the first treatment procedure, normocalcaemia being achieved in 5 cases, but persistent hypercalcaemia in the 6th suggested a supernumerary gland. A pituitary adenoma was removed in 4 cases, but persistent prolactinaemia necessitated bromocriptine therapy in 3. Successful distal pancreatectomy was undertaken in a patient with insulinoma and a patient with gastrinoma, and a further patient with gastrinoma awaits surgery. The overall prognosis in cases of MEN I appears to depend on the most aggressive component, often the pancreatic lesion; our patients have run a surprisingly benign course with only 1 late death, from hypertensive heart disease.

Adult↗
PubMed1984

Cerebral cysticercosis in children in South Africa.

Sixty-one children with cerebral cysticercosis are presented. The commonest clinical manifestation was epilepsy with or without focal signs in 43% of children, followed by the syndrome of raised intracranial pressure in 34% and meningoencephalitis in 13%. The CT scan was positive in 93% of cases and the HAI test in 86% of children so examined. Both were positive in 80%. Skull X-ray revealed evidence of calcification and/or raised intracranial pressure in 60%. Two children died, one each with subacute sclerosing panencephalitis and tuberculous meningitis. Of those who improved on discharge, 43% had epilepsy and 32% neurological deficit of an obvious nature. The parasitology, pathogenesis, pathology and diagnosis of cerebral cysticercosis are briefly reviewed. Present therapy and the suggested use of a specific anti-cysticeral drug are discussed. Case histories are presented to draw attention to the variability of the clinical picture and the particular importance of recognising the acute parenchymatous form of the disease in children which may present with critically elevated intracranial pressure.

Adolescent↗
PubMed1982

Medical, legal and administrative aspects of cadaveric organ donation in the RSA.

A shortage of donors remains the major limiting factor as regards the number of kidney and heart transplants performed in South Africa each year. The medical, legal and administrative aspects of cadaveric organ donation in this country are reviewed. The pathophysiology of brain death and the criteria necessary for a definite diagnosis are described, together with the criteria for the selection of cadaveric organ donors. The statutory requirements pertaining to the removal of human hearts and kidneys for the purposes of transplantation are detailed. The subsequent management of the brain-dead donor up to the time of excision of the required organ is described, and a note regarding the preservation and transportation of the donor organs is added.

Age Factors↗
PubMed1981

Barriers to rehabilitation of the head-injured patient.

Most patients who suffer a head injury will recover fully, with or without the assistance of a rehabilitation programme. In those who fail to recover, the magnitude of the injury to the brain or other systems is not usually the cause. Severe cerebral injury causes permanent disability in a small but significant number of people, but lesser injuries may cause disturbances of cognitive and other psychological functions which prevent the head-injured patient's return to his former status far more frequently. The patient's personality and emotional disposition, his socio-economic situation and environmental factors at home and at work all have an important bearing on his eventual rehabilitation. If a patient fails to rehabilitate adequately after head injury, many factors may therefore be found to be responsible.

Adolescent↗
PubMed1981

The sphenoid sinus mucocoele.

Mucocoeles, mucopyocoeles and empyemas of the sphenoid sinus are rare, but potentially dangerous. Their occurrence is accompanied by a multitude of clinical symptoms and signs, which confuse the diagnosis and may lead to its mismanagement. The treatment of this condition is surgical and in its early states essentially simple. At Groote Schuur Hospital over a 6-year period (1972-1977) 6 patients with mucocoeles, mucopyocoeles or abscesses of the sphenoid sinuses have been seen. Their clinical presentation, radiological findings and surgical treatment are described and discussed. Correctly managed this condition should completely resolve; however, there is a mortality associated with delay or misdiagnosis.

Adult↗
PubMed1980

Combined neurogenic and vascular claudication.

Patients with pain or discomfort in the legs during exercise which is relieved by rest should not automatically be labelled as having intermittent claudication due to vascular insufficiency; the greatest imitator of this condition is radiculopathy associated with a narrow lumbar spinal canal. Problems involved in differentiating the neurogenic and vascular components in such cases are described on the basis of experience in the Department of Neurosurgery at Groote SChuur Hospital.

Adult↗
PubMed1977

Peripheral cerebral arterial aneurysms caused by stabbing.

Aneurysms of peripheral cerebral arteries caused by stabs of the vault are described in 2 patient. The importance of early recognition of this potentially fatal complication of an apparently benign injury of the head is emphasized.

Adult↗
PubMed1975

Subcutaneous lumbosacral lipomas.

Twenty-four patients with subcutaneous lumbosacral lipomas are discussed. The neurological involvement of the lower limbs with incontinence is stressed, the high incidence of intrathecal tethering is shown, and early exploration is advocated.

Adolescent↗