In this edition of Modern Medicine, we feature an ethics article on the impact of AI in our lives; clinical articles include a topical piece on the concurrent treatment of obesity and diabetes, and there’s also a Urology focus feature, including an article on OAB and another on microscopic haematuria; finally, there’s a COPD-linked article on the impact of ‘flu on the disease. They’re all good reads, and we encourage you to give them a look.
Microscopic Haematuria: A Practical Guide for GPs
Microscopic haematuria is a subtle finding that can reflect causes ranging from benign transient conditions to serious renal or urological disease. Formal urine microscopy is essential to confirm haematuria and assess for glomerular features such as dysmorphic red blood cells, casts and proteinuria. A systematic, risk-stratified evaluation is required, as it may indicate urological or glomerular disease despite often being asymptomatic and benign. Referral to a urologist is indicated for intermediate- or high-risk patients, whereas referral to a nephrologist is required when glomerular features are present or renal disease is suspected.
Managing the ‘Urgency’ of an Overactive Bladder
Overactive bladder (OAB) is defined as a syndrome of urinary urgency usually accompanied by increased
daytime urinary frequency and nocturia in the absence of infection and localised pathological causal factors with or without urinary incontinence (UI). Clinical trial results have demonstrated that
mirabegron, a selective β3-adrenoceptor agonist, offers substantial clinical efficacy and good
adherence rates over 12 months for managing the symptoms associated with overactive bladder.
Concurrent Management of Type 2 Diabetes and Obesity
Type 2 diabetes is prevalent in South Africa, with most diagnosed patients also being affected by comorbid obesity. Weight loss can mitigate otherwise substantial risk in people with obesity and diabetes. Strategies for the management of weight in patients with type 2 diabetes include lifestyle modifications, which should be interested early; pharmacotherapy and surgery. Glucagon-like peptide-1 receptor agonists and dual incretin agonists are among the most effective medications to manage type 2 diabetes and obesity concurrently. Surgical intervention is a treatment option for the minority of people with type 2 diabetes and obesity.
Chronic obstructive pulmonary disease (COPD) is a prevalent respiratory condition associated with increased morbidity and mortality, particularly during respiratory infections such as influenza. The interaction between COPD and influenza is multifaceted, involving compromised immune responses, chronic inflammation, and impaired lung function. Influenza infection can exacerbate COPD, leading to acute exacerbations, hospitalisations, and higher mortality. This review examines the pathophysiological
mechanisms underlying the exacerbation of COPD by influenza, evaluates its impact on patient outcomes, and explores the role of comorbidities in shaping disease severity. We also assess the effectiveness of influenza vaccination in preventing severe outcomes and discuss strategies to improve vaccination uptake
among COPD patients. Current evidence highlights the importance of tailored prevention and management approaches, as well as the need for further research into biomarkers and optimal therapeutic strategies to mitigate the burden of influenza on COPD populations.
Regular physical activity is one of the corenrstones of health, and active lifestyles are often promoted to optimise well-being and prevent disease. For significant health benefits, the World Health Organization (WHO) recommends that adults (aged 18-64 years) engage in at least 150-300 minutes of moderate-intensity aerobic physical activity, 75-150 minutes of vigorous-intensity aerobic physical activity, or an equivalent combination of these per week.
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AI in Healthcare Still Has Many Hurdles to Overcome
Artificial intelligence (AI) in healthcare is able to review and gather medical information quickly, screen for the risk of disease and suggest diagnoses, identify treatment options, provide second opinions, among
others. Despite enthusiasm, however, integration into clinical practice remains limited due to concerns about usability, ethical implications and physicians’ and patients’ acceptance.
Modern Medicine is now available for you to read. We have some great articles featured in this edition:
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.
Treating Seizure Clusters in the Outpatient Setting
Seizure clusters have been associated with a high rate of hospital admissions, and if left untreated, there is an increased risk of developing status epilepticus, seizure-related injuries, higher mortality rates and an
increased risk of postictal psychosis.
Midazolam nasal spray (MDZ-NS) is a portable and easy to use drug-device for the treatment of seizure clusters in the outpatient setting that does not require administration by a healthcare provider. It is also more socially acceptable than rectally administered therapies.
