Oct/Nov 2018 Edition

We welcome you to come and read through our latest, Oct/Nov, edition of Modern Medicine.

This month we have a jam packed edition for you. Our features this month include; Oncology, Colon Cancer, Pain and many more.

We encourage all of our readers to complete the CPD questionnaire for this edition, this can be done on the answer-form included in the magazine, or on our website CPD system.

Modern Medicine, the journal that’s with you wherever you go.

Asthma, COPD and When They Coexist

Asthma, COPD and When They Coexist

Asthma and chronic pulmonary obstructive disease (COPD) are umbrella terms that describe disorders of the airways with diverse inflammatory pathways and pathophysiology. Recent advances in the understanding of the immunopathology of asthma have led to the emergence of biological agents that more precisely target disease pathways but will require a more precise understanding of those dysfunctional pathways. There are areas where the pathology and expression of airways disease in asthma and COPD overlap. The overlap between asthma and COPD presents important challenges in diagnosis as well as management.

Modern Medicine – Oct/Nov 2018

Challenges in the Treatment of Age-related Macular Degeneration

Challenges in the Treatment of Age-related Macular Degeneration

Age-related macular degeneration (AMD) is the fourth biggest cause of visual impairment. Early diagnosis and treatment with intravitreal injections of anti-VEGF drugs saves sight. The burden of such treatments may be challenging to patients and carers and may reduce adherence to therapy. Investigations of alternative therapeutic targets and modalities are providing promising results. New drugs are being developed that require fewer treatments, thereby improving treatment efficacy and reducing disease burden.

Modern Medicine – Oct/Nov 2018

Consider Etoricoxib in the Management of Arthritis

Consider Etoricoxib in the Management of Arthritis

Osteoarthritis (OA) and rheumatoid arthritis (RA) are common diseases worldwide, as well as leading causes of morbidity and disability that threaten human health.1,2 The primary objectives of treatment for patients with OA or RA are to control pain, improve function and reduce disability.3 Of all the strategies available for the treatment of OA and RA, nonsteroidal anti-inflammatory drugs (NSAIDs) are often prescribed to relieve pain and inflammation.

Modern Medicine – Oct/Nov 2018

Acute and Chronic Musculoskeletal Pain Pharmacological Management

Acute and Chronic Musculoskeletal Pain Pharmacological Management

Musculoskeletal pain is common and has significant consequences for affected patients and society as a whole. Musculoskeletal pain is not purely nociceptive; peripheral inflammation and central sensitisation processes, as well as neuropathic components, contribute. Management of patients with these conditions should be multimodal and multidisciplinary and follow principles of chronic disease management aiming for improved function. Nonopioid analgesics play an important role in the pharmacological management of patients. Opioids should be used with caution and only after careful consideration in patients with musculoskeletal pain. Adjuvants such as anticonvulsants and antidepressants may play a previously underestimated role in the management of patients with musculoskeletal pain.

Modern Medicine – Oct/Nov 2018

HPV DNA Screening Lengthens Testing Intervals

HPV DNA Screening Lengthens Testing Intervals

Cervical cancer, caused by persistent cervical infection by highrisk HPV and made worse by the HIV epidemic, remains an important cause of morbidity and mortality in South Africa. The SA HPV Advisory Board previously recommended HPV-based primary screening and now international support for this approach is also mounting in view of higher sensitivity. The main advantages for South Africa is the ability to safely increase screening interval and to test cervico-vaginal self-sampled specimens.

Modern Medicine – Oct/Nov 2018

Colon Cancer a Sobering Reality for Young Patients

Colon Cancer a Sobering Reality for Young Patients

The incidences of colon cancer in people younger than 50 is sharply increasing in recent years. The reason is unknown but lifestyle and diet most likely have a large part to play. Younger people are also being diagnosed with more aggressive forms of colon cancer. Since screening is not usually done in this age group, the cancer has often progressed to other parts of the patient’s body. Doctors need to play on the side of caution, take a younger patient’s complaints seriously, and screen for colon cancer.

Modern Medicine – Oct/Nov 2018

Nuclear Medicine, Molecular Imaging and Therapy

Nuclear Medicine, Molecular Imaging and Therapy

Nuclear Medicine, the most used form of molecular imaging, involves the injection of chemicals or pharmaceuticals labelled with radioactive tracers. These substances are subject to the same pharmacokinetic processes as other drugs but the molecular processes can however be imaged since the radioactive portion of each “radiopharmaceutical” emits an x-ray-like photon or “gamma-ray” detectable by either a gamma or PET camera depending on the type of radioactive decay process innate to that tracer when coupled to the pharmaceutical. In essence the imaging shows the physiological processes taking place in the body rather than merely looking at anatomy as is the case in conventional radiology.

Modern Medicine – Oct/Nov 2018

The Legal Liability of the Good Samaritan Doctor

The Legal Liability of the Good Samaritan Doctor

When the call: “Is there a doctor in the house?” goes out, does a doctor (or nurse or paramedic) who is enjoying a meal in a restaurant or who is travelling on a plane, have to step forward and do what he or she can? If he or she does not step forward, can they be held liable? If they do come forward and the treatment rendered is ineffective or complications arise, will liability be incurred? These are very real questions for the Good Samaritan doctor. They touch on legal and ethical issues potentially affecting all healthcare providers.

Modern Medicine – Oct/Nov 2018