Considerations when Prescribing Topical Corticosteroids
Topical corticosteroids are one of the oldest and most useful treatments for dermatologic conditions. There are many topical steroids available, and they differ in potency and formulation. Successful treatment depends on an
accurate diagnosis and consideration of the steroid’s delivery vehicle, potency, frequency of application, duration of treatment, and side effects.
Modern Medicine – Issue 4 2020
Timely Diagnosis of Pancreatic Exocrine Insufficiency is Key
Pancreatic exocrine insufficiency (PEI) may be caused by pancreatic disorders, including chronic pancreatitis (CP), cystic fibrosis (CF), pancreatic resection and pancreatic cancer. PEI may also result from extra-pancreatic conditions, including coeliac disease, Zollinger-Ellison syndrome and gastric surgery.
Modern Medicine – Issue 4 2020
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
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
Colorectal Cancer on the Rise in Young Adults
Cancers of the colon and rectum have been declining in older adults in recent decades and have always been considered rare in young people. But scientists and doctors are reporting a sharp rise in colorectal cancers in adults as young as their 20s and 30s, an ominous trend.
Modern Medicine – Issue 4 2020
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
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
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
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
Moisture Management is Essential for Wound Healing
Moist wound environments enhance wound healing and promote new tissue growth. In contrast, excess or insufficient moisture impairs the healing process and causes breakdown of the wound bed and surrounding
skin.
Modern Medicine – Issue 4 2020