CARDIOVASCULAR JOURNAL OF AFRICA • Volume 25, No 2, March/April 2014
AFRICA
43
From the Editor’s Desk
As I expertly skirt some potholes in a town centre through which
we are travelling, I ponder the upcoming edition of the journal.
An editorial needs to be written and time is running short. I
cannot afford to lose a tyre or worse, a wheel or axle today. In
my head I peruse the articles while being mindful of the road.
An interesting take on the Baker hypothesis hails from Poland
(Zamecznik
et al
., page 73). I wonder what roads in Poland are
like. The group assessed six- to 10-year-old children and stratified
them into groups of appropriate for gestational age (AGA) and
small for gestational age (SGA). They further sub-stratified
into symmetric (everything small, but proportionately so) and
asymmetric (low birth weight, but appropriate length and head
circumference). I imagine a malnourished, thin baby with a
visibly large head and eyes.
This is a rather interesting study. At school-going age there
was no difference in anthropometric measurements, yet the
average blood pressure differed between the groups, being higher
in the SGA group, with some intragroup differences caused by
the type of growth stunting. They refer to articles supporting
their findings (Woelk
et al
.
1
and Thame
et al.
2
). I must make time
to have a look at these.
I skirt another pothole. What are roads like, I wonder, in
Lagos, Nigeria, the source of our next article? The economy
I believe has been exploding, and gross domestic product, a
measure of wealth creation, has surpassed that of South Africa.
Nigeria has been a source of sophisticated work on cardiac
function, which has recently been published in the journal. In
this issue, Ale and co-workers studied left ventricular mass and
QT dispersion (QT
d
) in prehypertensive individuals. The QT
interval is of special interest to me, and QT
d
has its traps, called
slaggate
in my home language, literally translated as potholes.
This is encapsulated in one of the articles referred to (Sahu
et al.
3
). Ale and co-workers concluded that echocardiography,
albeit expensive, may be a good tool for risk stratification in
prehypertension, but that the usefulness of the ECG is limited.
A thud, as I encounter a pothole, breaks my train of thought.
Yes, I am still in South Africa. This makes me think of the
review by Naidoo
et al.
(page 83) on diabetes mellitus and the
use of sulphonylureas; the good and bad aspects. Looking at
the authorship, it is not quite free of industrial interest, yet it
is timely. The authors used the opportunity to introduce some
new kids on the block, albeit expensive and not time-tested,
the di-peptidyl peptidase IV inhibitors, glucagon-like peptide
analogues and sodium glucose co-transporter inhibitors. Use of
the last is limited in a resource-constrained environment, but they
suggest that, where hypoglycaemia is not a problem, there may
be a place for their use where public safety is concerned, such as
bus drivers with diabetes mellitus.
And so the journey continues. I hope I can recover the train
of thought when home. Yes, once again there are a few articles
from Turkey, one from Ankara and one from Çanakkale (I
must go and look on my map where these cities are). These
studies documented arrhythmias in neonates (Binnetoglu
et
al.
, page 58), cardiovascular involvement in Bechet’s disease
(Ulusan
et al.
, page 63) and the effect of topical hypothermia
on postoperative inflammatory markers (Kadan
et al.
, page 67).
From South Africa, not surprisingly, as this country has more
HIV-positive individuals than any other (
en/), Nel and Naidoo (page 50) present an article on endocarditis,
HIV and echocardiographic findings. A technical article (Steyn
et al.
, page 44) draws attention to the fact that in radionucleotide
imaging, different software does not measure ejection fractions
equally. Once again, the print issue is complemented by online-
only publication of a case report.
Ah, I am home at last.
PAUL A BRINK, MB ChB, PhD,
Department of Internal Medicine, Faculty of Health Sciences,
University of Stellenbosch and Tygerberg Hospital, Tygerberg
References
1.
Woelk GB, Emanuel I, Weiss NS, Psaty BM. Birth weight and blood
pressure among children in Harare, Zimbabwe.
Arch Dis Child Fetal
Neonatal Ed
1998;
79
: 119–122.
2.
Thame M, Osmond C, Wilks RJ, Bennett FI, McFarlane-Anderson N,
Forrester TE. Blood pressure is related to placental volume and birth
weight.
Hypertension
2000;
35
: 662–667.
3.
Sahu P, Lim PO, Rana BS, Struthers AD. QT dispersion in medicine;
electrophysiological Holy Grail or fool’s gold.
Q J Med
2000;
93
:
425–431.
