Pulmonary Arterial Hypertension New treatments and the prospect of cure

Pulmonary Arterial Hypertension New treatments and the prospect of cure

Pulmonary arterial hypertension (PAH) is a life-threatening disease of the small pulmonary arteries that progresses
to right heart failure and death if untreated. Early diagnosis and timely initiation of therapy is crucial to good
outcomes. PAH must be considered in any patient with unexplained breathlessness. Unexplained breathlessness
should be viewed just as seriously as chest pain. Definitive diagnosis requires right heart catheterisation.
Annual screening for PAH should be undertaken in high risk patient groups, such as those with systemic sclerosis
or past repair of a septal defect. Many efficacious drug therapies are available and combination therapy is now
the evidence-based standard of care.

Modern Medicine – March 2018

Defining Anti-VEGF Therapy Response in n-AMD

Defining Anti-VEGF Therapy Response in n-AMD

The introduction of anti-vascular endothelial growth factor (anti-VEGF) has significantly reduced visual loss due to
neovascular age-related macular degeneration (n-AMD). However there are significant inter-individual differences
in response to an anti-VEGF agent due to a variety of factors including patient’s age, lesion characteristics,
lesion duration, baseline visual acuity (VA) and the presence of particular genotype risk alleles.

Modern Medicine – March 2018

February 2018 Edition

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

This month we have a jam packed edition for you. Our features this month include; Diabetes, Gastroenterology, Immunisation, Ethics 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.

Type 2 Diabetes: Tailoring a treatment approach

Type 2 Diabetes: Tailoring a treatment approach

Early and optimal glycaemic control in patients with type 2 diabetes is imperative for reducing microvascular
and potentially macrovascular complications. Glycated haemoglobin remains the key focus of glycaemic
management although targets should be individualised based on age, comorbidities and life expectancy.
Treatment choice should be guided by patient comorbidities, adverse effect profile, acceptability of the
method of administration and cost. Metformin remains first-line treatment unless contraindicated. Insulin may
be considered at any stage, particularly where control is poor. Patients with pre-existing cardiovascular disease
can be safely managed with new agents, including some DPP4-inhibitors, GLP-1 receptor agonists and SGLT-2
inhibitors and some therapies may offer cardiovascular mortality benefit.

Modern Medicine – February 2018

Immunisation: It’s Not Just For Kids

Immunisation: It’s Not Just For Kids

Adults may require vaccines for multiple reasons, including incomplete childhood schedules, waning
immunity, medical and lifestyle risk factors, occupationrelated risks, travel and migration. The majority of
undervaccinated people are adults. Vaccines are one of the key components to healthy ageing, given the high
burden of vaccine-preventable diseases in the older population. More vaccines are becoming available and
are recommended for the adult population, including zoster vaccine for adults aged 70 to 79 years. Barriers
to the delivery of adult vaccinations include cost, lack of documentation of doses previously received and
public misconceptions about the need for vaccination in adulthood.

Modern Medicine – February 2018

Managing Common Luminal GI Disorders During Pregnancy

Managing Common Luminal GI Disorders During Pregnancy

Gastrointestinal symptoms are common in pregnancy and can result in significant morbidity. Some conditions
may occur for the first time during pregnancy or may be exacerbated by pregnancy. A careful history and
physical examination are essential for diagnosis. Nausea and gastro-oesophageal reflux may respond to lifestyle
and dietary modification, although medications are often required. When indicated, medications should be
used judiciously with knowledge of the potential risks to the fetus. Active coeliac disease and inflammatory
bowel disease (IBD) have potential adverse effects on pregnancy outcomes. Recurrent miscarriages may be a
clue to undiagnosed coeliac disease.

Modern Medicine – February 2018

Can Too Much Medicine be a Bad Thing?

Can Too Much Medicine be a Bad Thing?

Ineffective and harmful medical practices have always been
present, but the scale and institutionalisation of overdiagnosis
and overtreatment have expanded exponentially in the last few
decades.
The concept of ‘ too much medicine’ reflects a growing
concern in the medical community regarding the over- testing,
overdiagnosis and overtreatment of various pathologies. In the
past few decades, the number of people diagnosed with diseases
or risk factors like high blood pressure, cancer and asthma
have dramatically increased, and hence the number of people being
treated for these problems has also increased.

Modern Medicine – February 2018

2018 Medical Conference Planner

Modern Medicine is proud to present our 2018 Medical Conference Planner in line with our mission to add value for our readers.

The Planner is designed to be a one-stop tool for Doctors, and people in the healthcare industry, to use while they plan the events they’d like to attend in the coming year.

With an exhaustively researched list of almost 100 medical conferences that are due to take place over the coming year, the Planner is a tool you can’t afford to be without.

Modern Medicine magazine will include more information and updates on current events, on a monthly basis.

If you have any further events that you’d like to see included in future lists, please don’t hesitate to contact us with details.

January 2018 Edition

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

This month we have a jam packed edition for you. Our features this month include; Diabetes, Cardiology, Addiction and Rehab 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.

Elevated Serum Ferritin Identifying Iron Overload

Elevated Serum Ferritin Identifying Iron Overload

Ferritin, an iron storage protein, is critical to iron haemostasis. Alterations in ferritin level are seen commonly
in clinical practice, often reflecting perturbations in iron homeostasis or metabolism. Ferritin is an acute-phase
reactant that can become elevated in several conditions related to inflammation or infections. Hyperferritinaemia
is seen in patients who misuse alcohol and patients with fatty liver disease. Raised ferritin levels are also caused
by overexpression of tissue ferritin in a number of cancers. The most common iron overload condition is hereditary
haemochromatosis. Haemophagocytic syndrome is a heterogeneous group of disorders with a final common
pathway consisting of hyperferritinaemia, pancytopenia, splenomegaly and multiple organ failure.

Modern Medicine – January 2018