Disrupted Sleep Precedes Alzheimer Onset
Disturbances in the sleepâwake 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 sleepâwake and circadian disruption often occur early in the course of
the disease and may even precede the development of cognitive symptoms.
Modern Medicine â August 2017
The Bidirectional Nature of Sleep Problems and Psychopathology
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 âat-riskâ individuals.
Modern Medicine â August 2017
Drug Adherence Impacts Multiple Sclerosis Outcomes
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.
Modern Medicine â August 2017
Mild COPD: Initial Steps Common questions asked by primary care practitioners
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.
Modern Medicine â August 2017
Vaginal Atrophyâs Impact on Womenâs Sexuality
Results from the original CLOSER (CLarifying vaginal atrophyâs impact
On SEx and Relationships) survey conducted in Europe and North
America, highlighted the negative physical and emotional impact of
vaginal atrophy on womenâs 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.
Modern Medicine â August 2017
Combating Oestrogen Deficiency in Vulvovaginal Atrophy
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.
Modern Medicine â August 2017
When Is It Time To Hang Up The Stethoscope or Scalpel?
When are doctors too old to practise medicine? In 1905, at the age of 55 years, Sir William Osler publicly
spoke of the âcomparative uselessnessâ 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.
Modern Medicine â August 2017
Using Positive Incentives to Promote Vitality
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.
Modern Medicine â August 2017
We welcome you to come and read through our latest, July, edition of Modern Medicine.
This month we have a jam packed edition for you. Our features this month include; Cardiology, Nutrition, Pulmonology 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 thatâs with you wherever you go.
Gut Health Starts Even Before Birth
The human intestinal tract harbours a diverse and complex microbial community which plays a central role in
human health, with an estimated range of 1000 bacterial species and 100-fold more genes than those found in
the human genome. This community impacts host metabolism, physiology, nutrition and immune function. It
is now apparent that the gut microbiome co-evolves with humans and that changes to this population can have
major consequences, both beneficial and harmful, for human health.
Modern Medicine â July 2017
