Modern Medicine

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

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?

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

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.

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

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

Secondary Prevention After Acute Coronary Syndromes

Although survival after acute coronary syndrome (ACS) has improved, ACS is still associated with significant
morbidity and mortality. Secondary prevention is crucial to minimising the risk of future cardiovascular events
after ACS. Secondary prevention measures extend beyond pharmacological therapy alone and patients may benefit
from the input of a multidisciplinary team. Support of a GP is crucial to achieving long-term success in
secondary prevention therapy.

Modern Medicine – January 2018

Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia

One in five men over the age of 35 years is bothered by lower urinary
tract symptoms (LUTS). The most common cause of LUTS is benign
prostatic hyperplasia (BPH). There are certain ‘red flag’ clinical features
for which early urological referral is recommended. There are many
options for medical therapy of men with LUTS and the choice of
drug should be individualised after a thorough assessment has been
conducted. Although transurethral resection of the prostate (TURP)
remains the gold standard for surgical treatment of men with
BPH, newer minimally invasive procedures are available with fewer
side effects.

Modern Medicine – January 2018

Managing Diabetes by Targeting the Kidneys

Sodium-glucose cotransporter-2 inhibitors (SGLT2 inhibitors) are a new class of once-daily oral
antihyperglycaemic agents that target the kidneys. As they act independently of insulin, SGLT2 inhibitors have
been found to be effective throughout the type 2 diabetes mellitus spectrum. Standard treatment for diabetes
carries the risk of hypoglycaemia with the management of obesity and hypertension adding to the challenge. SGLT2
inhibitors offer a favourable weight profile and low risk of hypoglycaemia.

Modern Medicine – January 2018

The Four Pillars of Successful Addiction Treatment

The four pillars of addiction treatment are as follows:
• A structured treatment programme
• Medication-assisted treatment
• Family involvement and integration
• Recovery network and 12 step support
Observation and experience has proven that these principles are paramount in
successful long-term addiction treatment. Each pillar is important by itself, but for
the recovering addict or alcoholic a firm recovery needs to incorporate all four
pillars. What exactly are these pillars consisted of? More importantly, how do
quality treatment centres like Tranquility Home Rehabilitation Clinic provide clients
with these tools?

Modern Medicine – January 2018