Browsing by Author "King, J A"

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    Inadequacy of primary health care test request guidelines - lack of evidence base
    (2009) Stanfliet, J C; King, J A; Pillay, T S
    Evidence suggests that 3 - 4% of patient encounters in primary health care result in blood tests being requested. There is compelling evidence of significant misuse and poor utilisation of many laboratory tests, which results in an economic burden and other problems including further investigation of false-positive results. Patients have high expectations that blood tests be performed and have little understanding of the limitations of testing. The frequency of test ordering is much higher in the USA and Canada, for example, than in the UK, without any overt difference in the quality of care. There are suggestions that 30 - 50% of tests are unnecessary, and that about 15% of abnormal results are not acted upon.
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    Insulin resistance induced by antiretroviral drugs: Current understanding of molecular mechanisms
    (2009) Ismail, W I W; King, J A; Pillay, T S
    The increase in incidence of HIV infection continues to be a major public health problem across the world, but more especially in sub-Saharan Africa. Treatment with highly active antiretroviral therapy (HAART) has improved the prognosis of patients with AIDS, but it has also increased the incidence of various metabolic disorders, in particular insulin resistance accompanied by dyslipidaemia, hyperglycaemia and lipodystrophy. This is often accompanied by frank type 2 diabetes and increased mortality from cardiovascular disease. It is important to understand the mechanistic basis for these side-effects as the incidence of these is likely to increase as the rollout of antiretroviral drugs continues.