Acute and Chronic Musculoskeletal Pain Pharmacological Management

Acute and Chronic Musculoskeletal Pain Pharmacological Management

Musculoskeletal pain is common and has significant consequences for affected patients and society as a whole. Musculoskeletal pain is not purely nociceptive; peripheral inflammation and central sensitisation processes, as well as neuropathic components, contribute. Management of patients with these conditions should be multimodal and multidisciplinary and follow principles of chronic disease management aiming for improved function. Nonopioid analgesics play an important role in the pharmacological management of patients. Opioids should be used with caution and only after careful consideration in patients with musculoskeletal pain. Adjuvants such as anticonvulsants and antidepressants may play a previously underestimated role in the management of patients with musculoskeletal pain.

Modern Medicine – Oct/Nov 2018

HPV DNA Screening Lengthens Testing Intervals

HPV DNA Screening Lengthens Testing Intervals

Cervical cancer, caused by persistent cervical infection by highrisk HPV and made worse by the HIV epidemic, remains an important cause of morbidity and mortality in South Africa. The SA HPV Advisory Board previously recommended HPV-based primary screening and now international support for this approach is also mounting in view of higher sensitivity. The main advantages for South Africa is the ability to safely increase screening interval and to test cervico-vaginal self-sampled specimens.

Modern Medicine – Oct/Nov 2018

Colon Cancer a Sobering Reality for Young Patients

Colon Cancer a Sobering Reality for Young Patients

The incidences of colon cancer in people younger than 50 is sharply increasing in recent years. The reason is unknown but lifestyle and diet most likely have a large part to play. Younger people are also being diagnosed with more aggressive forms of colon cancer. Since screening is not usually done in this age group, the cancer has often progressed to other parts of the patient’s body. Doctors need to play on the side of caution, take a younger patient’s complaints seriously, and screen for colon cancer.

Modern Medicine – Oct/Nov 2018

Nuclear Medicine, Molecular Imaging and Therapy

Nuclear Medicine, Molecular Imaging and Therapy

Nuclear Medicine, the most used form of molecular imaging, involves the injection of chemicals or pharmaceuticals labelled with radioactive tracers. These substances are subject to the same pharmacokinetic processes as other drugs but the molecular processes can however be imaged since the radioactive portion of each “radiopharmaceutical” emits an x-ray-like photon or “gamma-ray” detectable by either a gamma or PET camera depending on the type of radioactive decay process innate to that tracer when coupled to the pharmaceutical. In essence the imaging shows the physiological processes taking place in the body rather than merely looking at anatomy as is the case in conventional radiology.

Modern Medicine – Oct/Nov 2018

The Legal Liability of the Good Samaritan Doctor

The Legal Liability of the Good Samaritan Doctor

When the call: “Is there a doctor in the house?” goes out, does a doctor (or nurse or paramedic) who is enjoying a meal in a restaurant or who is travelling on a plane, have to step forward and do what he or she can? If he or she does not step forward, can they be held liable? If they do come forward and the treatment rendered is ineffective or complications arise, will liability be incurred? These are very real questions for the Good Samaritan doctor. They touch on legal and ethical issues potentially affecting all healthcare providers.

Modern Medicine – Oct/Nov 2018

Aug/Sept 2018 Edition

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

This month we have a jam packed edition for you. Our features this month include; General Practice, Gastroenterology, Pain, Probiotics 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.

Tapentadol, the Only MOR-NRI for Broad Spectrum Pain Relief

Tapentadol, the Only MOR-NRI for Broad Spectrum Pain Relief

Tapentadol is the first centrally acting analgesic that combines two mechanisms of action, mμ-opioid receptor agonism and noradrenaline reuptake inhibition (MOR–NRI), in a single molecule.1 The synergistic interactions between the two mechanisms provide inhibition of ascending pain signals through MOR agonism and enhancement of descending pain inhibition through NRI. The result is broad efficacy across nociceptive, neuropathic and mixed pain.

Modern Medicine – Aug/Sept 2018

Infection Control in a Globalised World: Challenges for General Practice

Infection Control in a Globalised World: Challenges for General Practice

The consistent use in the practice setting of standard precautions – work practices that achieve a basic level of infection control – protects both patients and staff. The use of appropriate precautions and a good medical handover help prevent dissemination of infection from patients into hospitals. It is important that a good history, including travel and previous healthcare exposure, is taken at every consultation. Knowledge and awareness is the key: in order to triage patients presenting to the general practice, it is imperative that GPs stay up to date with information regarding emerging infectious diseases and infections with multiresistant organisms. Environmental cleaning and good practice design help prevent infection transmission.

Modern Medicine – Aug/Sept 2018

The Gut Microbiome’s Role in MS

The Gut Microbiome’s Role in MS

Multiple sclerosis (MS) is a neurodegenerative autoimmune disorder of the CNS. Recent experimental and clinical evidence suggests the presence of microbial imbalances in the gut of MS sufferers. The gut microbiome is defined as the summation of all the microbial entities as well as their genes, proteins and metabolic products in a given space and time. Studies show the MS gut microbiome as having general alterations in specific taxa, some associated with the promotion of inflammatory cytokines and overall inflammation.

Modern Medicine – Aug/Sept 2018