Issue 3, 2025

Modern Medicine is now available for you to read. We have some great articles featured in this edition:

  • Ethics (CPD) – Integrated Care: A Strategy for Addressing Fragmented Healthcare
  • Pulmonology (CPD)– Common Cold
  • Endocrinology (CPD)– Diabetic Kidney Disease The Four Pillars of Therapy
  • Oncology (CPD) – Multiple Myeloma in General Practice: A Guide to Diagnosis and Management
  • A RoundUp Section & many more….

Also, a reminder that, not only do we have CPD questions available within the magazine itself, we also have an online CPD portal that allows you to score even more points by simply completing your test online.

Multiple Myeloma in General Practice A Guide to Diagnosis and Management

Multiple Myeloma in General Practice A Guide to Diagnosis and Management

This article is written on behalf of the Medical and Scientific Advisory Group, Myeloma Australia.
Multiple myeloma (MM) is a clinically aggressive blood cancer, most frequently diagnosed in late adulthood, and requires prompt assessment and treatment to avoid irreversible organ damage. The finding of monoclonal protein on serum or urine testing is a hallmark feature of MM, and other laboratory investigations are readily available to help establish the diagnosis. Patient outcomes are improving because of an expanding range of therapies that produce meaningful improvements in survival and quality of life. Care needs for patients with multiple myeloma can be complex and are best met with a multidisciplinary approach based on shared care between the GP and specialist haematologist.

Modern Medicine – Issue 3, 2025

Diabetic Kidney Disease: The Four Pillars of Therapy

Diabetic Kidney Disease: The Four Pillars of Therapy

Diabetic kidney disease (DKD) is a serious threat to public health in South Africa and globally, as a major cause of end-stage kidney disease, rising healthcare costs and premature mortality. The advent of several highly efficacious therapies over the last decade has dramatically altered the landscape of DKD management. In addition to lifestyle modification, the management of DKD secondary to type 2 diabetes now centres on four ‘pillars’ of treatment: renin-angiotensin system blockade (with ACE inhibitors or angiotensin receptor blockers), sodium-glucose cotransporter-2 inhibitors, nonsteroidal mineralocorticoid receptor antagonists (though not yet available in South Africa) and glucagon-like peptide-1 receptor agonists. Early implementation of these therapies is likely to confer substantial long term gains in survival, free from cardiovascular and kidney disease.

Modern Medicine – Issue 3, 2025

Common Cold

Common Cold

Among human diseases, the common cold stands apart. Not only is it one of the most common human diseases, but because there are so many respiratory viruses that cause colds, it is also one of the most complex. This review discusses the respiratory viruses and notes that all these viruses may cause the illness complex recognised as the common cold. The common cold is discussed as part of the “iceberg concept” of disease which ranges from asymptomatic infection to severe illness and death.

Modern Medicine – Issue 3, 2025

Integrated Care: A Strategy for Addressing Fragmented Healthcare

Integrated Care: A Strategy for Addressing Fragmented Healthcare

The fragmented nature of today’s health systems means that they are becoming increasingly unable to respond to the demands placed upon them. The focus on hospital-based, disease-based and self contained ‘silo’ curative care models undermines the ability of health systems to provide universal, equitable, high-quality and financially sustainable care.

Modern Medicine – Issue 3, 2025

Issue2, 2025

Modern Medicine is now available for you to read. We have some great articles featured in this edition:

  • Ethics (CPD) – The Pursuit of Perfection in Medicine carries a High Price Tag
  • Infection Control (CPD)– Global guidelines for The Diagnosis & Management of Candidiasis
  • Cardiology (CPD)– Atrial Fibrillation: Management In Patients With Heart Failure
  • Psychiatry (CPD) – What To Do when SSRI and SNRI antidepressants don’t work: A GP’s Guide
  • A RoundUp Section & many more….

Also, a reminder that, not only do we have CPD questions available within the magazine itself, we also have an online CPD portal that allows you to score even more points by simply completing your test online.

What to do When SSRI and SNRI Antidepressants don’t Work: A Guide for GPs

What to do When SSRI and SNRI Antidepressants don’t Work: A Guide for GPs

Depression is the most common mental health related presentation in general practice, but only a third of patients achieve remission with first line selective serotonin reuptake inhibitors (SSRIs), and many experience significant adverse effects. When SSRIs and serotonin-noradrenaline reuptake inhibitors (SNRIs) fail or cause intolerable side effects, GPs can switch to other antidepressants within the same class or between different classes. GPs can also increase doses, combine medications or augment treatment with antipsychotics. Although all antidepressants are more effective than placebo, their efficacy and tolerability differ. Consider referring patients for specialist review if treatment failure persists despite trialling other options.

Modern Medicine – Issue 2, 2025

Atrial FibrillationManagement in Patients with Heart Failure

Atrial Fibrillation Management in Patients with Heart Failure

Atrial fibrillation (AF) often occurs in conjunction with heart failure and people with both conditions have increased mortality and morbidity. a combined focus on risk factor reduction and stroke prophylaxis is required, alongside a complex decision regarding suitability and preference for rhythm control over rate control. Most rhythm control medications should be used with caution in people with heart failure with reduced ejection fraction. Interventional approaches, involving complex ablation or cardiac resynchronisation therapy, have also started to change clinical decision-making for AF patients.

Modern Medicine – Issue 2, 2025

Global Guideline for the Diagnosis and Management of Candidiasis CPD: An Initiative of the ECMM in Co-operation with ISHAM and ASM

Global Guideline for the Diagnosis and Management of Candidiasis CPD: An Initiative of the ECMM in Co-operation with ISHAM and ASM

Candida species are the predominant cause of fungal infections in patients treated in hospital, contributing substantially to morbidity and mortality. Candidemia and other forms of invasive candidiasis primarily affect patients who are immunocompromised or critically ill. In contrast, mucocutaneous forms of candidiasis, such as oral thrush and vulvovaginal candidiasis, can occur in otherwise healthy individuals. Although mucocutaneous candidiasis is generally not life-threatening, it can cause considerable discomfort, recurrent infections, and complications, particularly in patients with underlying conditions such as diabetes or in those taking immunosuppressive therapies. The rise of difficult-to treat Candida infections is driven by new host factors and antifungal resistance. Pathogens, such as Candida auris (Candidozyma auris) and fluconazole-resistant Candida parapsilosis, pose serious global health risks. Recent taxonomic revisions have reclassified several Candida spp, potentially causing confusion in clinical practice. Current management guidelines are limited in scope, with poor coverage of emerging pathogens and new treatment options. In this Review, we provide updated recommendations for managing Candida infections, with detailed evidence summaries available in the appendix. This is a shortened version of the original article. For additional information, see the Appendix online.

Modern Medicine – Issue 2, 2025

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