Colorectal cancer (CRC) is the third most common cancer and cause of cancer-related death worldwide. Although
the majority of individuals who develop CRC have sporadic disease, up to 20% may have a genetic predisposition.2
Survival is strongly related to the stage of the disease at diagnosis. Randomised controlled trials have shown that
screening programmes using faecal occult blood and endoscopic screening reduce mortality from CRC by early
cancer detection as well as detecting advanced adenomas which are likely to develop into cancers.
Hidradenitis suppurativa (HS) is a debilitating chronic skin disease characterised by inflammatory nodules, abscesses, sinus tracts, comedones
and fibrotic scarring. HS lesions are most common in the axillae but can occur in any intertriginous area. The cause of HS is not completely understood and
is likely to be multifactorial; contributing factors may include obesity, smoking, hormonal fluctuation, inflammation and genetics.
The main clinical features supporting an HS diagnosis are a history of recurrent, painful or suppurating lesions (typically deep-seated inflammatory
nodules) in intertriginous areas, with a chronic or relapsing course. There is no single efficacious therapy for HS and a combination of lifestyle modifications,
medical and laser or surgical interventions are often required. Referral to a dermatologist is recommended for patients with moderate to severe HS.
Disturbances in the sleep–wake cycle and circadian rhythms are common symptoms of Alzheimer Disease
(AD), and they have generally been considered as late consequences of the neurodegenerative processes.
Recent evidence demonstrates that sleep–wake and circadian disruption often occur early in the course of
the disease and may even precede the development of cognitive symptoms.
Most patients with psychiatric disorders experience sleep disturbance. Patients with comorbid sleep
problems have greater symptomatology and poorer treatment outcomes. Obstructive sleep apnoea (OSA)
and insomnia are associated with higher rates of depression and anxiety than community prevalence
rates. There is evidence indicating a bidirectional relation between sleep disorders and mental health.
Treatment of sleep problems may have additional benefits on mental health for patients with comorbid
psychiatric illness and may prevent the onset of psychiatric conditions in ‘at-risk’ individuals.
In the past two decades, several disease-modifying therapies
(DMTs) have become available for the treatment of relapsing-onset
multiple sclerosis (MS). While all DMTs reduce disease activity
to some extent, the efficacy rates vary.However, the success of
any pharmacological management for MS relies on the adherence
and persistence to the prescribed therapy; even the most potent DMT
will have little benefit if the drug is not taken, or not taken correctly.
COPD is a clinical diagnosis confirmed by spirometric evidence of airflow limitation that is not fully reversible. Early detection of COPD allows early
intervention. Treatment of COPD is based on severity of symptoms, airflow obstruction and presence or absence of exacerbations. All smokers
should be assisted to quit smoking. All patients with COPD should be vaccinated against influenza. First-line pharmacotherapy for recently
diagnosed mild COPD is a short-acting bronchodilator on an as-needed basis. If symptoms persist or worsen, a long-acting bronchodilator may be
added as maintenance therapy. Long-acting bronchodilators have been shown to improve symptoms, help extend exercise tolerance and prevent
exacerbations.
Results from the original CLOSER (CLarifying vaginal atrophy’s impact
On SEx and Relationships) survey conducted in Europe and North
America, highlighted the negative physical and emotional impact of
vaginal atrophy on women’s self-esteem and relationships. Due to a
lack of information about the sexual welfare of postmenopausal women
in South Africa, the South African CLOSER study was conducted.
Vulvovaginal atrophy and dryness are common symptoms of the
decline in endogenous production of oestrogen at menopause and
often result in dyspareunia. The main goals of treatment for vaginal
atrophy are to improve symptoms and to restore vaginal and vulvar
anatomic changes. Treatment choices for postmenopausal
dyspareunia resulting from vulvovaginal atrophy will depend on
the underlying aetiology and might include individualised treatment.
When are doctors too old to practise medicine? In 1905, at the age of 55 years, Sir William Osler publicly
spoke of the “comparative uselessness” of men older than 40 years of age. He contended that men should
retire after age 60 and jokingly suggested that at 60 years of age, men be allowed a year of contemplation
before being offered a peaceful departure by chloroform. These comments provoked a storm of
controversy, but Osler maintained his stance that men of intellect should retire at 60 years of age. While
his beliefs might have been influenced by social and cultural factors of the time, the controversy of agerelated
forced retirement continues in professions such as medicine, in which public safety could be at risk.
Non-communicable chronic diseases (NCDs) such as diabetes, cardiovascular
diseases, dyslipidaemias and certain cancers pose one of the greatest health
and economic challenges of the 21st century.
