Anaphylaxis in Family Practice

Manifestations of anaphylaxis may occur within seconds or minutes after exposure to a causative antigen. Almost any substance can be implicated as a potential precipitating agent. Reactions may be slow, progressive, or rapidly fatal within minutes. Any healthcare worker involved in the administration of medications or the care of patients, whether a doctor, dentist, nurse, paramedic or allied health professional, is ethically obliged to be able to appropriately manage the potential consequences of such an action – a life-threatening anaphylactic reaction. South African Family Practice Vol. 50 (1) 2008: pp. 29-3

Resuscitation preparedness for general practice

General practices are not exempted from situations dealing with dire emergencies. For general practitioners to be effective in coping with such situations, they should at all times be prepared to resuscitate patients. This article gives an overview of the preparation required to manage such events. (SA Fam Pract 2003;45(1):9-13) Keywords: Resuscitation, emergency medicine, preparednes

Identification of solar nebula condensates in interplanetary dust particles and unequilibrated ordinary chondrites

Orthopyroxene and olivine grains, low in FeO, but containing MnO contents up to 5 wt percent were found in interplanetary dust particles (IDP) collected in the stratosphere. The majority of olivines and pyroxenes in meteorites contain less than 0.5 wt percent MnO. Orthopyroxenes and olivines high in Mn and low in FeO have only been reported from a single coarse grained chondrule rim in the Allende meteorite and from a Tieschitz matrix augite grain. The bulk MnO contents of the extraterrestrial dust particles with high MnO olivines and pyroxenes are close to CI chondrite abundances. High MnO, low FeO olivines and orthopyroxenes were also found in the matrix of Semarkona, an unequilibrated ordinary chondrite. This may indicate a related origin for minerals in extraterrestrial dust particles and in the matrix of unequilibrated ordinary chondrites

Assemblage of Presolar Materials and Early Solar System Condensates in Chondritic Porous Interplanetary Dust Particles

Anhydrous chondritic porous inter-planetary dust particles (CP IDPs) contain an assortment of highly primitive solar system components, molecular cloud matter, and presolar grains. These IDPs have largely escaped parent body processing that has affected meteorites, advocating cometary origins. Though the stardust abundance in CP IDPs is generally greater than in primitive meteorites, it can vary widely among individual CP IDPs. The average abundance of silicate stardust among isotopically primitive IDPs is approx. 375 ppm while some have extreme abundances up to approx. 1.5%. H and N isotopic anomalies are common in CP IDPs and the carrier of these anomalies has been traced to organic matter that has experienced chemical reactions in cold molecular clouds or the outer protosolar disk. Significant variations in these anomalies may reflect different degrees of nebular processing. Refractory inclusions are commonly observed in carbonaceous chondrites. These inclusions are among the first solar system condensates and display 16O-rich isotopic compositions. Refractory grains have also been observed in the comet 81P/Wild-2 samples re-turned from the Stardust Mission and in CP IDPs, but they occur with much less frequency. Here we conduct coordinated mineralogical and isotopic analyses of CP IDPs that were characterized for their bulk chemistry by to study the distribution of primitive components and the degree of nebular alteration incurred

Identification of a Compound Spinel and Silicate Presolar Grain in a Chondritic Interplanetary Dust Particle

Anhydrous chondritic porous interplanetary dust particles (CP IDPs) have undergone minimal parent body alteration and contain an assemblage of highly primitive materials, including molecular cloud material, presolar grains, and material that formed in the early solar nebula [1-3]. The exact parent bodies of individual IDPs are not known, but IDPs that have extremely high abundances of presolar silicates (up to 1.5%) most likely have cometary origins [1, 4]. The presolar grain abundance among these minimally altered CP IDPs varies widely. "Isotopically primitive" IDPs distinguished by anomalous bulk N isotopic compositions, numerous 15N-rich hotspots, and some C isotopic anomalies have higher average abundances of presolar grains (~375 ppm) than IDPs with isotopically normal bulk N (<10 ppm) [5]. Some D and N isotopic anomalies have been linked to carbonaceous matter, though this material is only rarely isotopically anomalous in C [1, 5, 6]. Previous studies of the bulk chemistry and, in some samples, the mineralogy of select anhydrous CP IDPs indicate a link between high C abundance and pyroxene-dominated mineralogy [7]. In this study, we conduct coordinated mineralogical and isotopic analyses of samples that were analyzed by [7] to characterize isotopically anomalous materials and to establish possible correlations with C abundance

New Manganese Silicide Mineral Phase in an Interplanetary Dust Particle

Comet 26P/Grigg-Skjellerup was identified as a source of an Earth-crossing dust stream with low Earth-encounter velocities, with peak anticipated fluxes during April in 2003 and 2004 [1]. In response to this prediction, NASA performed dedicated stratospheric dust collections using high altitude aircraft to target potential interplanetary dust particles (IDPs) from this comet stream in April 2003. Several IDPs from this collection have shown unusually low noble gas abundances [2] consistent with the predicted short space exposure ages of Grigg-Skjellerup dust particles [1]. High abundances of large D enrichments [3] and presolar grains [4] in IDPs from this collection are also consistent with an origin from the comet Grigg-Skjellerup. Here we report a new mineral from one of the cluster IDPs of the "Grigg-Skjellerup" collection, L2055. Our report focuses on an unusual manganese-iron-chromium silicide phase that, to our knowledge, has not been observed previously in nature. This unique phase may also shed light on the genesis of the enigmatic low-Fe,Mn-enriched (LIME) olivine that has been previously reported in IDPs and meteorites [5]

Development of a portfolio of learning for postgraduate family medicine training in South Africa: a Delphi study

<p>Abstract</p> <p>Background</p> <p>Within the 52 health districts in South Africa, the family physician is seen as the clinical leader within a multi-professional district health team. Family physicians must be competent to meet 90% of the health needs of the communities in their districts. The eight university departments of Family Medicine have identified five unit standards, broken down into 85 training outcomes, for postgraduate training. The family medicine registrar must prove at the end of training that all the required training outcomes have been attained. District health managers must be assured that the family physician is competent to deliver the expected service. The Colleges of Medicine of South Africa (CMSA) require a portfolio to be submitted as part of the uniform assessment of all registrars applying to write the national fellowship examinations. This study aimed to achieve a consensus on the contents and principles of the first national portfolio for use in family medicine training in South Africa.</p> <p>Methods</p> <p>A workshop held at the WONCA Africa Regional Conference in 2009 explored the purpose and broad contents of the portfolio. The 85 training outcomes, ideas from the WONCA workshop, the literature, and existing portfolios in the various universities were used to develop a questionnaire that was tested for content validity by a panel of 31 experts in family medicine in South Africa, via the Delphi technique in four rounds. Eighty five content items (national learning outcomes) and 27 principles were tested. Consensus was defined as 70% agreement. For those items that the panel thought should be included, they were also asked how to provide evidence for the specific item in the portfolio, and how to assess that evidence.</p> <p>Results</p> <p>Consensus was reached on 61 of the 85 national learning outcomes. The panel recommended that 50 be assessed by the portfolio and 11 should not be. No consensus could be reached on the remaining 24 outcomes and these were also omitted from the portfolio. The panel recommended that various types of evidence be included in the portfolio. The panel supported 26 of the 27 principles, but could not reach consensus on whether the portfolio should reflect on the relationship between the supervisor and registrar.</p> <p>Conclusion</p> <p>A portfolio was developed and distributed to the eight departments of Family Medicine in South Africa, and the CMSA, to be further tested in implementation.</p