Therapeutic Drug Monitoring Increasing IBD Treatment Efficacy

Therapeutic Drug Monitoring Increasing IBD Treatment Efficacy

Infliximab, adalimumab and other tumour necrosis factor inhibitors have revolutionised the treatment of several immune mediated inflammatory diseases. Still, many patients do not respond sufficiently to therapy or lose efficacy over time. Therapeutic drug monitoring (TDM), an individualised treatment strategy based on systematic assessments of serum drug concentrations, has been proposed as a clinical tool to optimise efficacy of
treatment.

Modern Medicine – Issue 4 2020

August 14, 2020 by Diagnostics

More Than Just Reflux: The Era of Eosinophilic Oesophagitis

More Than Just Reflux: The Era of Eosinophilic Oesophagitis

Eosinophilicoesophagit is (EoE) is a unique form of nonimmunoglobulin E (IgE) mediated food allergy. Adults with EoE typically present with food bolus impaction and/or dysphagia to solid foods. Children can have a more varied presentation, such as heartburn, failure to thrive, persistent vomiting or chronic abdominal pain. Allergy tests are not useful. First-line management options include proton pump inhibitors (PPIs), topical corticosteroids or dietary management. Response to PPIs and resolution of eosinophilia will occur in many patients with EoE.

Modern Medicine – Issue 4 2020

August 14, 2020 by Gastroenterology

Fenofibrate and Cardiovascular Outcomes in Statin Users with Metabolic Syndrome

Fenofibrate and Cardiovascular Outcomes in Statin Users with Metabolic Syndrome

A propensity matched cohort study, by Kim et al. (2019), investigated fenofibrate as an add-on to statin treatment to reduce persistent cardiovascular risk in adults with metabolic syndrome in real-world settings. Results showed a significantly lower risk of major cardiovascular events compared with statin treatment alone.

Modern Medicine – Issue 4 2020

August 14, 2020 by Cardiology

Atrial Fibrillation Management The central role of the GP

Atrial Fibrillation Management The central role of the GP

Opportunistic screening for atrial fibrillation (AF) is recommended for all patients aged over 65 years, and choosing between a rate and rhythm control strategy is important. Beta-blockers or nondihydropyridine calcium
channel antagonists are the first choice for rate control.
Flecainide is preferable for the pharmacologic rhythm control. The sexless CHA2DS2-VA assessment is recommended to assess stroke risk. Integrated care to support comprehensive treatment and address the specific needs of people with AF is required, and GPs are central to its effective delivery.

Modern Medicine – Issue 4 2020

August 14, 2020 by Anticoagulants Atrial Fibrillation Cardiology

Hypertension, Drugs and COVID-19 Risk

Hypertension, Drugs and COVID-19 Risk

Arterial hypertension is the leading cause of death in the world and is frequently accompanied by other comorbidities such as diabetes, obesity, chronic kidney disease and established cardiovascular disease of different types. Patients suffering from infection by SARS-CoV-2 frequently present with arterial hypertension and these accompanying comorbidities. Concern has been expressed that medical therapy for cardiovascular disease might specifically contribute to the severity of illness in patients with COVID-19.

Modern Medicine – Issue 4 2020

August 14, 2020 by Cardiology COVID

Nanocrystalline Silver Dressings Support Antimicrobial Stewardship

Nanocrystalline Silver Dressings Support Antimicrobial Stewardship

Antimicrobial resistance is an ever-increasing global concern, with the era of untreatable infection becoming a reality. Wound care is no exception, with increasing issues of antibiotic-resistant infections across different wound types and care settings. There is an urgent need for novel anti-biofilm strategies and novel antimicrobial agents and, in this scenario, silver nanotechnology has received tremendous attention in recent years in therapeutically enhanced healthcare.

Modern Medicine – Issue 4 2020

August 14, 2020 by Antibiotics Woundcare

Aripiprazole for the Treatment of Adult Bipolar Disorder

Aripiprazole for the Treatment of Adult Bipolar Disorder

Bipolar disorder is characterised by exacerbations of opposite mood polarity, ranging from manic to major depressive episodes. Treatment of all phases of this disorder is primarily with mood stabilisers. Aripiprazole is a novel antipsychotic initially approved for the treatment of schizophrenia but soon found to be effective in bipolar disorder. This drug is well studied, as randomised controlled trials have been conducted in various phases of bipolar disorders. Aripiprazole exhibits the pharmacodynamic properties of partial agonism, functional selectivity and serotonin-dopamine activity modulation.

Modern Medicine – Issue 4 2020

August 14, 2020 by Bi-Polar CNS

Managing Asthma and COVID-19 Risk

Managing Asthma and COVID-19 Risk

In the face of unchartered territory and unprecedented times, there remains uncharted much to be learned about the impact of asthma on the course of SARS-CoV-2 virus infection. Although adult data suggest that asthma is a risk factor for COVID-19 morbidity and mortality, such a risk in children is unclear. Differentiating COVID- 19 from worsening asthma, or an asthma exacerbation, is challenging. There is broad consensus that asthma exacerbations should be treated aggressively and in keeping with current guideline recommendations.

Modern Medicine – Issue 4 2020

August 14, 2020 by Asthma COVID Pulmonology
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