The abnormal chest X-ray – when to refer to a specialist

No Abstract

Risk factors for oesophageal, lung, oral and laryngeal cancers in black South Africans

The authors used data collected from 1995 to 1999, from an on-going cancer case–control study in greater Johannesburg, to estimate the importance of tobacco and alcohol consumption and other suspected risk factors with respect to cancer of the oesophagus (267 men and 138 women), lung (105 men and 41 women), oral cavity (87 men and 37 women), and larynx (51 men). Cancers not associated with tobacco or alcohol consumption were used as controls (804 men and 1370 women). Tobacco smoking was found to be the major risk factor for all of these cancers with odds ratios ranging from 2.6 (95% CI 1.5–4.5) for oesophageal cancer in female ex-smokers to 50.9 (95% CI 12.6–204.6) for lung cancer in women, and 23.9 (95% CI 9.5–60.3) for lung cancer and 23.6 (95% CI 4.6–121.2) for laryngeal cancer in men who smoked 15 or more grams of tobacco a day. This is the first time an association between smoking and oral and laryngeal cancers has been shown in sub-Saharan Africa. Long-term residence in the Transkei region in the southeast of the country continues to be a risk factor for oesophageal cancer, especially in women (odds ratio=14.7, 95% CI 4.7–46.0), possibly due to nutritional factors. There was a slight increase in lung cancer (odds ratio=2.9, 95% CI 1.1–7.5) in men working in ‘potentially noxious’ industries. ‘Frequent’ alcohol consumption, on its own, caused a marginally elevated risk for oesophageal cancer (odds ratio=1.7, 95% CI 1.0–2.9, for women and odds ratio=1.8, 95% CI 1.2–2.8, for men). The risks for oesophageal cancer in relation to alcohol consumption increased significantly in male and female smokers (odds ratio=4.7, 95% CI=2.8–7.9 in males and odds ratio=4.8, 95% CI 3.2–6.1 in females). The above results are broadly in line with international findings

Pneumocystis carinii Pneumonia (PCP) at Ga-Rankuwa hospital

No Abstract. Central African Journal of Medicine Vol. 45 (5) 1999: pp. 127-12

The implications of large home range size in a solitary felid, the Leopard (Panthera pardus)

The size of the home range of a mammal is affected by numerous factors. However, in the normally solitary, but polygynous, Leopard (Panthera pardus), home range size and maintenance is complicated by their transitory social grouping behavior, which is dependent on life history stage and/or reproductive status. In addition, the necessity to avoid competition with conspecifics and other large predators (including humans) also impacts upon home range size. We used movement data from 31 sites across Africa, comprising 147 individuals (67 males and 80 females) to estimate the home range sizes of leopards. We found that leopards with larger home ranges, and in areas with more vegetation, spent longer being active and generally traveled faster, and in straighter lines, than leopards with smaller home ranges. We suggest that a combination of bottom-up (i.e., preferred prey availability), top-down (i.e., competition with conspecifics), and reproductive (i.e., access to mates) factors likely drive the variability in Leopard home range sizes across Africa. However, the maintenance of a large home range is energetically expensive for leopards, likely resulting in a complex evolutionary trade-off between the satisfaction of basic requirements and preventing potentially dangerous encounters with conspecifics, other predators, and people