Biomedical subjects

S G Reinach

Publications and source records attributed to S G Reinach.

At least 37 records · Page 2Linked to original sources

PubMed1991

Evaluation of stannous fluoride and chlorhexidine sprays on plaque and gingivitis in handicapped children.

The objective of this study was to evaluate the effect of twice-daily oral sprays of 2 ml chlorhexidine (0.2%) and 2 ml stannous fluoride (0.2%) as the sole oral hygiene measure on plaque and gingivitis in handicapped children. 52 institutionalized mentally handicapped individuals (aged 10-26 years) were divided into 4 groups to participate in a 9-week, double-blind, randomized clinically controlled trial, which included a cross-over. For the first 3 weeks, groups 3 and 2 had their mouths sprayed with chlorhexidine and stannous fluoride, respectively. Following a 3-week wash-out interval, groups 1 and 4 were sprayed with chlorhexidine and stannous fluoride, respectively. The alternate groups received a placebo, water. Plaque (PI) and gingival indices (GI) were recorded. Subgingival plaque samples were collected and counts of spirochaetes, motile rods and cocci were taken using darkfield microscopy. By the 9th week of trial, the PI and GI were reduced by 48% and 52% for the stannous fluoride group. In the chlorhexidine group, reductions of 75% (PI) and 78% (GI) were achieved. Pair-wise comparisons of placebo, stannous fluoride and chlorhexidine using the U-test of Mann-Whitney revealed significant (p less than 0.05) differences for both PI and GI scores in the placebo/stannous fluoride and placebo/chlorhexidine pair by the 9th week of the trial. In the stannous fluoride/chlorhexidine pair, only the PI was significantly reduced for those on chlorhexidine. Coccoid cells were more dominant at sites with low PI and GI scores (stannous fluoride and chlorhexidine groups), while spirochaetes and motile rods were more frequent at sites with high PI and GI scores (placebo group).

Adolescent↗

PubMed1990

Respiratory health status of children in the eastern Transvaal highveld.

A study was undertaken to determine if there were detectable effects on the respiratory health status of children resident in the eastern Transvaal highveld as a consequence of their exposure to community air pollution, comparing them with children in areas ostensibly less polluted. A prevalence study was conducted in white schoolchildren from 11 schools in the eastern Transvaal highveld (1,031 children) and from 11 schools in non-polluted towns in the Transvaal (978 children). A questionnaire was completed by each child's mother, and height and weight were measured and spirometry recorded on a vitalograph. Cough, wheeze, asthma and chest illnesses were more frequently reported from polluted areas compared with non-polluted areas, taking into account parental smoking and home cooking fuel (odds ratios 1.34, 1.20, 1.15 and 1.88, respectively). After correcting for age, children in the polluted area were 0.83 cm shorter (P = 0.035). However, there were no significant differences in forced vital capacity and forced expiratory volume in 1 second after standardising for height, age, parental smoking and home cooking fuel. We conclude that, in children, exposure to pollution in the eastern Transvaal highveld may cause respiratory symptoms and chest illness and may affect height but does not measurably affect lung function, as assessed by spirometry.

Air Pollution↗

PubMed1990

Survey of certification practices for patients admitted to Sterkfontein Hospital.

The involuntary hospitalisation of psychiatric patients continues to be a controversial issue. All patients certified and admitted to Sterkfontein Hospital under Sections 9 and 12 of the Mental Health Act, No. 18 of 1973, over a 4-week period were surveyed. Almost 40% were admitted as urgent certifications. The majority of the patients in the sample were black, single, urban and had either primary or limited high school education. Most patients had been referred from academic/teaching and provincial hospitals. The average duration of hospital stay was 7.2 weeks, with only 1 patient eventually being transferred to a ward for chronic patients within the hospital, which suggests that Sterkfontein Hospital functions largely as an acute psychiatric facility. There was a discrepancy of approximately 30% between the assessments of the certifying and ward doctors, probably as a result of differing uses of terminology. Not only are more community psychiatric services needed, but communication between psychiatry and the other medical disciplines should be improved.

Adolescent↗

PubMed1990

The prevalence of micro-albuminuria and glomerular hyperfiltration in young patients with IDDM.

We have assessed the prevalence of two risk factors for diabetic nephropathy, i.e., micro-albuminuria and a raised glomerular filtration rate (GFR), in 127 insulin-dependent diabetic patients aged 13-36 years. Micro-albuminuria (albumin excretion rate (AER) 20-200 micrograms/min) was found in 46 subjects (36%) and GFR was elevated (greater than 135 ml/min/1.73 m2) in 43 (34%). The prevalence of supranormal GFR declined and that of micro-albuminuria rose progressively with the increasing duration of diabetes. While age and sex distribution were similar in subjects with and without raised AER, duration of diabetes was significantly longer, blood pressure (BP) was significantly greater and age of onset was lower in the micro-albuminuria group. Blood pressure was significantly elevated only in the patients with AER of 70-200 micrograms/min; there was a linear trend for BP to rise as AER increased. Stepwise logistic regression analysis indicated that duration of diabetes (P less than 0.0001), age of onset of diabetes (P less than 0.005) and current glycaemic control (HbA1) (P less than 0.01) were risk factors for micro-albuminuria. The association with a rising blood pressure appears to be secondary to the renal involvement. In this cross-sectional study an association of micro-albuminuria with a raised GFR could not be demonstrated.

Adult↗

PubMed1990

Measles, mumps and rubella immunization at nine months in a developing country.

The antibody responses and reactogenicity of a measles, mumps and rubella vaccine in 9-month-old and 15-month-old black children in South Africa were compared. The antibody response to the measles component was marginally better in the older group, but no differences were observed in the response to the mumps and rubella components. Reactogenicity was similar in the two age groups. Therefore it is possible that a trivalent measles, mumps and rubella vaccine can safely and effectively replace routine measles immunization at 9 months of age in this population. Whether routine immunization policy should incorporate such a vaccine depends on the extent of acceptance of measles vaccination. In urban populations of developing countries with high rates of measles immunization, routine vaccination at 9 months might interrupt circulating wild type rubella and provide sufficient herd immunity to protect susceptible women of childbearing age. It also should decrease significantly the complications associated with wild type mumps infection. The replacement of measles vaccine by a trivalent vaccine may be very cost-effective.

Black or African American↗

PubMed1990

Dental caries prevalence and CPITN of 12-year-old rural schoolchildren in Transkei.

The study investigated the prevalence and pattern of caries with particular reference to tooth and surface type and the CPITN of 12-y-old rural schoolchildren in Engcobo, Transkei. 349 schoolchildren, with a 4:6 male:female ratio were examined. The fluoride content of the water varied from 0-0.5 p.p.m. The results indicate that caries levels are low--47 per cent of the sample was caries-free. Both the median DMFT and DMFS was 1.0 (with a mean 1.7 and 2.8). The D component comprised 89 per cent, the M-10 and F-1 per cent of the total DMFT. Amongst boys, caries was distributed almost equally between the maxillary (112) and mandibular (114) arches whereas for girls more teeth were affected in the mandibular arch. Molar teeth in boys and girls accounted for 90 per cent of all teeth affected with the first molars accounting for 50 per cent and the second molars 40 per cent. In the maxillary and mandibular arch for the total group, a greater number of first molars were affected than the second molars. For girls in both the maxilla and mandible, the second molars were affected more frequently than the first molars. Overall the occlusal surfaces were affected most frequently followed by the buccal, distal, lingual and mesial. Gingival bleeding and calculus were prevalent in most sextants. Less than 6 per cent of the total subjects had no periodontal disease. Calculus was found in over 70 per cent of the children. The vast majority of the sample (94 per cent) needed oral hygiene instruction.

Child↗

PubMed1990

Hypertension as a cause of end-stage renal failure in South Africa.

We reviewed the data of 3,632 patients with end-stage renal failure entered into the South African Dialysis and Transplantation Registry over a six-year period. The male to female ratio was 1.4:1. Of these patients, 48.8% were white, 26.2% black, 17.6% coloured and 7.4% Asian. Essential hypertension was the cause of end-stage renal failure in 15.9% of patients. Malignant hypertension was the diagnosis in 57% of the essential hypertensives. Hypertension was responsible for 34.6% of end-stage renal failure in blacks, 20.9% in coloureds, 4.3% in whites and 13.8% in Asians. In the age group 30-39 years, 37.4% of patients with malignant hypertension commenced dialysis, while 28.4% and 28.8% of benign hypertensives commenced dialysis in the 30-39 and 40-49 age groups, respectively. The survival at 36 and 72 months was the same whether hypertension was the cause of end-stage renal failure or not, and whether the hypertension was malignant or benign. Cardiac causes were responsible for most of the deaths. The percentage of deaths from cardiac causes was similar in patients with renal failure from essential hypertension and other causes (33.2% and 29.3% respectively). Hypertension is the commonest cause of end-stage renal failure in black South Africans and the most common preventable cause of end-stage kidney disease in the country.

Adult↗

PubMed1990

Twenty-four hour ambulatory blood pressure in therapeutically resistant hypertensive patients.

Circadian blood pressure and heart rate rhythms were determined in essential and renal hypertensive patients who failed to respond to drug therapy. Indirect ambulatory blood pressure and heart rate recordings were measured in 31 subjects for 24 hours. Essential hypertensive patients exhibit 'white coat hypertension', are normotensive outside the clinic and have a higher awake than sleep blood pressure. Blood pressure and heart rate of renal hypertensive patients do not increase in the presence of a physician and there is no difference between awake and sleep values. In contrast to patients with essential hypertension, the circadian fluctuations of blood pressure were depressed in renal hypertensive patients. We conclude that essential hypertensive patients who appear clinically uncontrolled are in fact well controlled in their domestic environment, whereas renal hypertensive patients are consistently uncontrolled. Ambulatory monitoring may help in differentiating the various types of patient and in the evaluation of antihypertensive therapy.

Adult↗

PubMed1989

Diarrhoeal diseases and oral fluid therapy in the Gelukspan health ward.

This study reports the results on diarrhoeal disease and oral fluid therapy (OFT) obtained during a survey on maternal knowledge and child health in the Gelukspan health ward (GHW) in 1985-1986. We studied 210 women sampled by means of a multistage sampling procedure. Strict selection criteria ensured that the baby had been born in the GHW, that it was the first-born and the only child, and that it had been cared for by the mother from birth until the time of interviewing. All the children were between 12 and 24 months old. Information was collected by interviewing the mother and by analysing data on the home-retained 'Road to Health' cards (RTHCs) of the study children. Ninety-three per cent of the children had an RTHC and 97% of these had at least one record about reasons to visit the health service. Most visits were 'well' visits (71%), 18% were associated with respiratory tract complaints, and 12% were associated with gastro-intestinal complaints (most commonly diarrhoea). Sixty-three per cent of children with data on visits to the health services attended at least once with gastro-intestinal complaints during the first year of life. About two-thirds of the mothers knew the composition of an acceptable oral fluid solution for home therapy of diarrhoeal disease. Only 40% knew how frequently it should be given and only a quarter knew how much to give. After multivariate analysis the only independent variables that remained predictors of knowledge on OFT were maternal knowledge on signs and symptoms of dehydration (SSD) and frequency of gastro-intestinal complaints as recorded on the RTHC.(ABSTRACT TRUNCATED AT 250 WORDS)

Cross-Sectional Studies↗

PubMed1989

Factors influencing breast-feeding in an urban community.

In an attempt to answer the question of what influences mothers' decisions on how to feed their babies, a questionnaire was administered to 200 mothers when their babies were approximately 1 year of age. The questions covered a wide variety of factors, including socio-economic, educational, housing and family details, employment, ante- and perinatal experiences, maternal beliefs, support systems and actual feeding practices. Those mothers who had breast-fed their babies for longer than 36 weeks were compared with those who had stopped before 12 weeks. The most important factors distinguishing the two groups, as decided by stepwise regression analysis, were the beliefs that breast-feeding helps teething and does not make the baby irritable; also female babies were more likely to be breast-fed and the postnatal income of the mother was important. It is believed that these factors, together with the other, less statistically significant differences, should be used when formulating breast-feeding promotion strategies. The importance of income, and therefore of employment, underlines the necessity for legislation requiring large-scale employers of women to provide crèches and breast-feeding breaks for female staff.

Attitude↗

PubMed1989

Nutritional assessment in rheumatoid arthritis.

The nutritional status was assessed in a group of 220 patients with rheumatoid arthritis from three communities (coloured 89 patients, white 88 and black 43). The triceps skinfold (TSF) thickness, upper arm muscle circumference (UAMC), body mass index (BMI) and percentage of ideal body weight (% IBW) were measured and the serum albumin value determined. The mean age of the coloured patients was 49.8 years, white 57.7 years and black 44.8 years. Forty-five patients (20.5%) had a reduction of one or more anthropometric measurements (TSF, UAMC and/or %IBW) and a further 6 patients (2.7%) had a reduction of the serum albumin value alone. These 51 patients were considered to be malnourished and had a higher mean erythrocyte sedimentation rate and more severe functional disability than the remainder of the patients. The prevalence of malnutrition was lower if diagnosed only on abnormality of the TSF, UAMC and %IBW, since 25 patients (11.4%) had a reduction of only one measurement, 12 (5.5%) had a reduction of 2 and 8 (3.6%) had a reduction of all three measurements. Obesity (BMI greater than 30) was noted in 10.5% and there were no differences in the functional disability, disease activity and use of steroid therapy in the obese patients compared with the rest of the patients.

Adult↗

PubMed1989

Hypertension, alcohol and cations in urban black and coloured South Africans.

Epidemiological evidence shows a positive relationship between alcohol consumption and blood pressure. High alcohol intake and hypertension are common in urban South African men. Relationships between mean arterial pressure (MAP), serum gamma-glutamyltransferase (GGT) as an index of alcohol intake, age, mass and levels of cations in the serum and erythrocytes were investigated in normotensive and hypertensive black and coloured men. Serum levels of potassium, magnesium and calcium and the red blood cell magnesium level were found to be significantly decreased in the black hypertensives. Serum GGT was equally raised in normotensive and hypertensive blacks and was positively correlated with systolic blood pressure in the hypertensive subjects. The coloured hypertensives were heavier, older and had significantly higher serum GGT levels than their normotensive counterparts. Serum GGT was positively correlated with MAP in the coloured subjects. No consistent relationships were found between GGT and blood cations. These data suggest that in younger black subjects alcohol is associated with systolic blood pressure only once hypertension has developed. Other factors, such as cations, may be more important than alcohol in the pathogenesis of hypertension in this group. Alcohol consumption is an important risk factor in coloured hypertensives.

Adult↗

PubMed1989

Community-acquired pneumonia of diverse aetiology: prognostic features in patients admitted to an intensive care unit and a "severity of illness" core.

In a retrospective study of 73 patients with community-acquired lobar pneumonia of diverse aetiology admitted to an intensive care unit, an attempt was made to identify those factors among the demographic and clinical features and results of initial laboratory investigations that were predictive of the ultimate outcome. A lower mean white cell count (p = 0.03), platelet count (p = 0.02), total serum protein (p = 0.005) and albumin (p = 0.02) and a higher mean serum creatinine (p = 0.03) and phosphate level (p = 0.02) appeared to be predictive of a poor prognosis. The most significant variable predictive of mortality, was the presence of bacteraemia (p = 0.0005). Severity of illness scoring systems by omitting microbiological data appear to underestimate predicted patient mortality. The mortality rate of critically ill patients with community-acquired lobar pneumonia remains high, despite advances in antimicrobial chemotherapy and intensive care unit facilities, particularly in the presence of certain negative prognostic factors of which the presence of bacteraemia is the most important.

Adult↗

PubMed1989

Handedness and deformities, radiographic changes, and function of the hand in rheumatoid arthritis.

The correlation of handedness with deformities, radiographic changes, and function of the hand was studied in a large group of patients with rheumatoid arthritis and a dominant right hand. There was no significant difference in the proportion of patients who had swan neck deformity, boutonnière deformity, uncorrectable ulnar deviation, and flexor tenosynovitis in the dominant and non-dominant hands. There were significantly greater radiological changes in the dominant hand, however, and the middle and index fingers were most severely affected. The severe involvement of these fingers may be related to their greater use in daily activities. There was also more severe functional impairment in the dominant hand.

Arthritis, Rheumatoid↗

PubMed1989

The relationship between magnesium, calcium, sodium, potassium and blood pressure in South African adult males.

The interaction between magnesium, calcium, sodium, potassium and blood pressure (BP) was assessed in three urban male groups (n = 463). Each group was at a different phase of urbanisation. 27% of black labourers (n = 296), 37% of city blacks (n = 94) and 14% of "coloureds' (mixed race;n = 73) were hypertensive. In the black labourers, serum Mg, K, Ca and erythrocyte Mg were inversely related to BP. Of all the cations, Mg correlated most closely with BP. In the coloured group, there was a weak inverse relationship between serum magnesium and BP. There were no biochemical abnormalities in the city blacks. During urbanisation or in the early phases of hypertension changes occur in blood cation levels. Mg and its interactions with Ca, Na and K may, in certain individuals, play an important role in the pathogenesis of hypertension.

Adult↗

PubMed1988

Infant feeding in an urban community.

Two hundred randomly selected mothers were interviewed approximately 1 year post-partum to establish how they had fed their babies and the number of attacks of gastro-enteritis these infants had had; 129 of the babies were examined, primarily for their nutritional status. The majority of mothers (97%) began by breast-feeding and 50% were still doing so at 20 weeks. By 4 weeks 20% had introduced formula feeds. Although some mothers introduced solids very early, the overall pattern was very similar to UK data. The infants' mean weight and length compared well with the 50th centile on the Boston Growth Chart. Infants on prolonged breast-feeding were no better off nutritionally than those in whom breast-feeding was stopped before 12 weeks. It could not be demonstrated that prolonged breast-feeding in this community protected infants against gastro-enteritis, probably because few babies were exclusively breast-fed.

Breast Feeding↗

PubMed1988

Renal weights in the southern African black population.

Renal weights of 430 adult black subjects coming to medicolegal autopsy at the Diepkloof State Mortuary, a large urban area southwest of Johannesburg, South Africa, were analyzed. The subjects were from 10 southern African black ethnic groups-Zulu, Sotho, Tswana, Xhosa, Shangaan, Swazi, Venda, Ndebele, Kalanga, and Malawi. The aims of the study were: 1) to ascertain the anatomical "norm" as it pertains to renal weights in this diverse population group; 2) to formulate standard reference tables that might be of use to the practicing pathologist in the southern African arena; 3) to provide a range of values that take into account the variables of age, sex, race, body weight, and body height; and 4) to provide a standard of comparison with anthropological and anatomical studies conducted on North American black, North American Caucasian, Indian subcontinent, Burmese, and Jamaican population groups. In each of the 430 subjects, age, sex, ethnic group, supine body length, body weight, individual left and right renal weights, and causes of death were noted. The latter were divided into 6 categories: 1) penetrating incised wounds; 2) multiple injuries; 3) gunshot wounds; 4) craniocerebral injuries; 5) various miscellaneous nonnatural causes of death; and 6) natural causes of death. The above variables were analyzed by computer and compared with respect to renal weights. No statistically significant differences were observed between the sexes or the age groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1988

Factors associated with oesophageal cancer in Soweto, South Africa.

Cancer of the oesophagus was a rare disease in the South African black population until the last few decades. Increases in incidence have occurred and at present it is the commonest cancer in black men in many parts of South Africa. A case-control study of 200 oesophageal cancer patients and 391 hospital controls has been carried out in order to determine the risk factors in the urban black population of Soweto. The results indicate that the cancer patients were long-term urban residents from a very low socio-economic group. The association between smoking pipe tobacco and oesophageal cancer previously noted in South Africa is confirmed. In addition, consumption of traditional beer was found to be a major risk factor.

Adult↗