Modern Medicine

Gastroenteropancreatic Neuroendocrine Neoplasms ESMO Clinical Practice Guideline summary

Neuroendocrine neoplasms (NEN s) arise from the diffuse neuroendocrine cell system and may occur at many different disease sites. Most frequently, these neoplasms occur in the digestive system, followed by the lung. The term NEN encompasses well-differentiated neuroendocrine tumours (NE Ts) and poorly differentiated neuroendocrine carcinomas (NECs). NECs represent only 10%–20% of all NEN s. The main focus of these guidelines is on sporadic small intestinal (SI)- NENs and pancreatic NENs (Pan-NENs) since these are the most prevalent NEN s at advanced disease stages. This is a shortened version of the original article.

Modern Medicine – Issue 5 2021

Low-dose Aspirin Reduces Pre-existing Vascular Disease

Aspirin reduces cardiovascular morbidity and mortality in patients with pre-existing vascular disease and is therefore widely prescribed for secondary prevention of cardiovascular events.

Modern Medicine – Issue 5 2021

ESC 2021 Heart Failure Guideline Update

The European Society of Cardiology recently released their 2021 updated guidelines for the diagnosis and treatment of acute and chronic heart failure. This article looks at the treatment of heart failure with reduced ejection fraction (HFrEF). The diagnosis of HFrEF requires the presence of symptoms and/or signs of heart failure (HF) and a reduced ejection fraction (LVEF ≤ 40%). Pharmacotherapy is the cornerstone of treatment for HFrEF and should be implemented before considering device therapy, and alongside non-pharmacological interventions.

Modern Medicine – Issue 5 2021

Fenofibrate is an Effective Tool in Dyslipidaemia

Increased risk of cardiovascular disease in type 2 diabetes is attributable in part to the high prevalence of associated risk factors including hypertension and diabetic dyslipidaemia, the latter characterised by elevated plasma triglyceride levels and low plasma levels of high-density lipoprotein cholesterol (HDL-C). Fibrates are used in patients with dyslipidaemia and high cardiovascular risk, where the greatest benefits of fenofibrate are seen among those with marked hypertriglyceridemia.

Modern Medicine – Issue 5 2021

Identifying Atrial Fibrillation Events Following Cryptogenic Stroke

In 20–40% of ischaemic strokes, a definitive cause is not identified, despite extensive evaluation1; this condition has been defined as ‘cryptogenic stroke.’ Atrial fibrillation (AF) is a well-known cause of ischaemic stroke and about 15% of strokes are attributable to a documented AF. Many strategies have been explored to improve detection of AF, ranging from in-hospital monitoring, serial electrocardiography and Holter monitoring and the use of external events (or loop recorders) or insertable cardiac monitors (ICM).

Modern Medicine – Issue 5 2021

Running a Profitable Healthcare
Practice

Running a Profitable Healthcare Practice

With excellent patient outcomes and a solid reputation, Michael’s healthcare practice seemed to be thriving. As his practice grew, so did the time spent on managing the accompanying admin. He was spending so much energy on these functions that he couldn’t focus on improving treatment service for his patients.

Modern Medicine – Issue 5 2021

Post-COVID Stress Disorder and Substance Abuse

The first three waves of COVID have seen the escalation to catastrophic proportions of post-traumatic stress disorder. As a result of the high levels of COVID-related trauma, many people have turned to alcohol and drug use, to cope with the ‘new normal’.

Modern Medicine – Issue 5 2021

Finding Relief for Vertigo Symptoms in Ménière’s Disease

Ménière’s disease (MD) is an idiopathic disorder characterised by recurrent episodes of vertigo, unilateral sensorineural hearing loss, tinnitus and aural fullness. The development of endolymphatic hydrops – an increased fluid within the inner ear organ – is observed (or presumed) in all individuals with MD. Vertigo symptoms can be managed through a combination of dietary salt restriction, stress reduction and medical therapy (betahistine, diuretics, or both).

Modern Medicine – Issue 5 2021

Increased Empathy Means Better Care

Empathy plays a critical interpersonal and societal role, enabling sharing of experiences, needs and desires between individuals and providing an emotional bridge that promotes prosocial behaviour. This capacity requires an exquisite interplay of neural networks and enables us to perceive the emotions of others, resonate with them emotionally and cognitively, to take in the perspective of others, and to distinguish between our own and others’ emotions.

Modern Medicine – Issue 5 2021

Enhancing Immune Response to Cutaneous Malignancies with Imiquimod

Imiquimod is a synthetic imidazoquinolone amine, which has potent immune response modifier activity when used topically. This characteristic property of imiquimod has led to its use in a number of applications in dermatology, particularly in cutaneous malignancies, where it has been found to be effective and safe. Currently it is used to treat actinic keratosis (AK), basal cell carcinoma (BCC) and external genital warts.

Modern Medicine – Issue 5 2021