June/July 2018 Edition

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

This month we have a jam packed edition for you. Our features this month include; Ethics, Gastroenterology, Back Pain, UTIs 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.

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With Back Pain, Also Consider Incontinence and Breathing Disorders

With Back Pain, Also Consider Incontinence and Breathing Disorders

The prevalence of low back pain (LBP) as well as bladder and bowel dysfunction in adult populations are well documented. LBP is the 5th most common reason for doctor visits in the US, with an annual point prevalence of approximately 25%. Bladder and bowel dysfunction may be more prevalent than LBP in some populations yet, due to the stigmatising nature of these symptoms, providers may be unaware that their patients are struggling with these conditions.

Modern Medicine – June/July 2018

Echinacea Reduces Rhinovirus Infection Rate

Echinacea Reduces Rhinovirus Infection Rate

Upper respiratory tract infection (URTI) commonly occurs in both children and adults and is a major cause of mild morbidity. It has a high cost to society, being responsible for absenteeism from school and work and unnecessary medical care and is occasionally associated with serious sequelae. URTIs are usually caused by several families of virus. Of these, rhinoviruses and coronaviruses are responsible for approximately 50-70% of all colds.

Modern Medicine – June/July 2018

Relevance of IgE Levels to Allergy Testing

Relevance of IgE Levels to Allergy Testing

Traditionally, the concept of allergy implied an abnormal response to an otherwise benign agent with an easily identifiable relationship between exposure and disease. However, there are syndromes in which the relationship between exposure to the relevant allergen and the “allergic” disease is not clear. In these cases the presence of specific IgE antibodies can play an important role in identifying the relevant allergen and provide a guide to therapy. Good examples include chronic asthma and exposure to perennial indoor allergens and asthma related to fungal infection.

Modern Medicine – June/July 2018

Cranberry Stops E.coli Adhesion, Preventing UTIs

Cranberry Stops E.coli Adhesion, Preventing UTIs

Each year, urinary tract infections (UTIs) account for >11 million doctor visits in the USA and 2 million doctor visits in France and 3.5 million antimicrobial prescriptions.1,2 Escherichia coli, the major pathogen involved in these infections, has developed new mechanisms of resistance against ß-lactams and fluoroquinolones which are commonly used to treat UTIs. The effectiveness of cranberry proanthocyanidins and cranberry beverages against antibiotic-resistant E. coli has been described in a number of studies.

Modern Medicine – June/July 2018

Antimicrobial Stewardship for GPs

Antimicrobial Stewardship for GPs

There is a strong link between antibiotic consumption and the rate of antibiotic resistance. The vast majority of antibiotics are prescribed by general practitioners (GPs). The GAPS study evaluated an integrated, mu l t i faceted evidence-based package of interventions implemented over a six month period.

Modern Medicine – June/July 2018

Female Urinary Incontinence Effective management in primary care

Female Urinary Incontinence Effective management in primary care

Female urinary incontinence is a common and distressing problem. Overactive bladder and stress urinary incontinence are the two common types of urinary incontinence in women. Most women with urinary incontinence can be managed effectively in primary care. Women with refractory incontinence and those with more complex presentations and associated problems should be referred for specialist management. Conservative management of overactive bladder involves pelvic floor muscle training, bladder retraining and fluid management. Antimuscarinic medication is the mainstay of drug therapy for overactive bladder. Stress urinary incontinence should be treated initially with pelvic floor muscle training.

Modern Medicine – June/July 2018

Practical Approach to Initiating SGLT2 Inhibitors in Type 2 Diabetes

Practical Approach to Initiating SGLT2 Inhibitors in Type 2 Diabetes

Sodium-glucose co-transporter 2 (SGLT2) inhibitors are an attractive novel therapeutic option for the treatment of type 2 diabetes. They block the reabsorption of filtered glucose in kidneys, mainly in proximal renal tubules, resulting in increased urinary glucose excretion and correction of the diabetesrelated hyperglycemia. Beyond improving glucose control, SGLT2 inhibitors offer potential benefits by reducing body weight and blood pressure. On the basis of the efficacy demonstrated in clinical trials, SGLT2 inhibitors are recommended as second- or third-line agents for the management of patients with type 2 diabetes.

Modern Medicine – June/July 2018

Adult Antiretroviral Therapy Guidelines

Adult Antiretroviral Therapy Guidelines

The HIV guidelines by Meintjies et al. (2017) are an update to those published in the Southern African Journal of HIV Medicine in 2014 and an update to guidelines regarding when to initiate antiretroviral therapy (2015). Since the release of the previous guidelines, the scale-up of antiretroviral therapy (ART) in southern Africa has continued. New antiretroviral drugs have become available with improved efficacy, safety and robustness.

Modern Medicine – June/July 2018

When Drug Reps’ Gifts Bias Prescribing Patterns …

When Drug Reps’ Gifts Bias Prescribing Patterns …

Communications and interactions between pharmaceutical companies and doctors regarding drug promotion and marketing have lately been the focus of ethical interest. These interactions are pervasive and can be influential and beneficial for the patient, but they may also have some undesirable consequences. Concerns are whether drug promotion is inducing doctors to prescribe specific drugs and if promotion leads to inappropriate clinical use of some drugs.

Modern Medicine – June/July 2018