South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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Randomized Controlled Trial Comparative Study Clinical Trial
Plasma cortisol levels in normal volunteers receiving either betamethasone valerate or desoximetasone by topical application.
Desoximetasone (Topisolon; Hoechst), a new topical steroid, and betamethasone 17-valerate were compared with respect to their effects on hypothalamic-pituitary-adrenal function as evidenced by plasma cortisol concentrations. Three grams of each test preparation were applied daily for 21 days to intact skin of the ventral aspects of alternate forearms of 15 normal volunteers. Five received betamethasone 17-valerate 0.1%, 5 desoximetasone 0.05%, and 5 desoximetasone 0.25%. ⋯ These values were compared with the mean control values by analysis of covariance. There was no significant difference in plasma cortisol levels. The value of performing similar studies on larger skin areas and with larger doses is discussed.
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A patient with embryonal rhabdomyosarcoma, who presented with septic criminal abortion, is discussed. The fact that the correct diagnosis was obscured by the unusual sequence of events is commented upon, and the need for critical evaluation of apparently clear-cut cases is demonstrated.
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A summary of the literature shows that there are well-marked seasonal variations in mortality for total deaths, for respiratory and cardiovascular diseases and for diabetes, the mortality rate being higher in winter than in summer. These seasonal variations in mortality are seen in infants under 1 year of age and in older people but not in youths and young adults. The amplitude of the seasonal variation in mortality increases with increasing age because of the higher incidence of cardiovascular and respiratory mortality in older people. ⋯ Comparison was made of the seasonal variations in mortality rates for all causes of death and for respiratory and ischaemic heart disease (IHD) deaths of Whites over 40 years of age in Durban and Johannesburg. This showed that the seasonal variation for all causes of death is greater in Johannesburg than in Durban, i.e. proportionately more older Whites die during winter in Johannesburg than in Durban. The reason for this difference is that the seasonal variation in respiratory disease mortality is much greater in Johannesburg than it is in Durban, but the seasonal variation in IHD mortality is the same in the two cities.
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The morbidity and mortality of illegal abortion are briefly discussed with reference to South Africa, where it seems that 1 in every 8-10 pregnant women deals with an unwanted pregnancy in this way. A review of the literature regarding legal abortion has been undertaken, detailing mortality and morbidity with various methods in many countries. The medical problems resulting from a permissive abortion policy have been highlighted, and an attempt has been made to define the place of medically induced abortion in health services, as it is understood by countries with extensive experience in this field. It is hoped that this contribution will help to define the real issues in the current abortion debate in South Africa.