New Imaging Modalities in Coronary Artery Disease

New Imaging Modalities in Coronary Artery Disease – MM1605

Cardiac imaging remains one of the most powerful tools in the diagnosis and management of coronary artery disease with a growing focus on characterising coronary lesions beyond angiographic features. Novel imaging modalities are expected to enhance diagnosis and treatment of coronary atherosclerosis.

Coronary computed tomographic angiography is a noninvasive imaging technique traditionally used to identify anatomically significant coronary lesions and coronary anatomy before surgical intervention. Optical coherence tomography has provided a deeper understanding of plaque morphology, progression of atherosclerosis and post-stenting outcomes. Advances in catheter-based intracoronary imaging techniques now offer unprecedented views of coronary anatomy and pathology.

Modern Medicine – May 2016

May 31, 2016 by Cardiology Radiology

Pelvic Organ Prolapse: What Choice Do I Have?

Pelvic Organ Prolapse: What Choice Do I Have? – MM1605

Pelvic organ prolapse is a common, distressing and disabling condition encountering increasing incidences with advancing age, menopause and parity. It is the downward descent of female pelvic organs, including the bladder, uterus or post-hysterectomy vaginal cuff and the small or large bowel, resulting in protrusion of the vagina, uterus, or both.

Prolapse development is multifactorial, with vaginal delivery, hysterectomy, chronic straining, normal ageing and abnormalities of connective tissue or connective-tissue repair predisposing some women to disruption, stretching, or dysfunction of the levator ani complex, connective-tissue attachments of the vagina, or both, resulting in prolapse. Many women with pelvic organ prolapse are asymptomatic and do not need treatment. When prolapse is symptomatic, options include observation, pessary use and surgery.

Modern Medicine – May 2016

May 31, 2016 by Gynaecology Urology Womans Health

Diuretic Resistance, a Factor in Chronic Kidney Disease

Diuretic Resistance, a Factor in Chronic Kidney Disease – MM1605

Diuretics exert their effects via the kidney, relying on secretion, and to a minor degree on glomerular filtration, to achieve therapeutic concentrations in the tubule. Diabetes and atherosclerosis can both cause glomerular damage and glomerulosclerosis, affecting glomerular filtration rate (GFR), while the Renin-Angiotensin system activation and inflammation common to both conditions also contributes to a reduced response.

Modern Medicine – May 2016

May 31, 2016 by Cardiology

April edition – ready to read

The April edition of Modern Medicine is online for you to read.

Our Ethics writer, Prof Keith Bolton puts forward an article on the purely human topic of altruism and how it relates to the practice of organ donation. A thought-provoking piece, indeed.

This issue holds a number of articles, covering everything from hypothyroidism during pregnancy, to headaches, allergies and the oral contraceptive pill.

Modern Medicine, the journal that’s with you wherever you go.

April 21, 2016 by Uncategorized

Managing Hypothyroidism in Pregnancy Reduces Adverse Mother and Child Outcomes

Managing Hypothyroidism in Pregnancy Reduces Adverse Mother and Child Outcomes – MM1604

Thyroid hormones play a critical role in neurodevelopment both during pregnancy and postpartum. Before 16 weeks of pregnancy, when the foetus is totally dependent on maternal thyroid function for brain development, maternal thyroid sufficiency plays a vital role.

Modern Medicine – April 2016

April 21, 2016 by Hypothyroidism Pregnancy

Combined OCPs Choosing the right one for your patient

Combined OCPs Choosing the right one for your patient – MM1604

With so many combined oral contraceptive pills available, each patient must be assessed individually to choose the right one. Noncontraceptive effects and side effect profiles must be considered when making this choice.
The progestogen component is responsible for the primary contraceptive effect in a contraceptive preparation, while the oestrogen component of the combined oral contraceptive pill (COCP) is associated with the more serious side effects of venous thromboembolism and cardiovascular and cerebrovascular events; however, it is responsible for the noncontraceptive benefits of the COCP, such as improvements in acne, hirsutism and cycle control. The qualities of a COCP are governed by the dose of the compounds it contains and the interactions between them.
When starting a COCP, a woman should generally be commenced on a preparation containing either levonorgestrel or norethisterone; however, if the initial choice does not suit the patient or noncontraceptive benefits drive the decision, a preparation containing one of the newer progestogens could be considered. Monitoring for minor and major risk factors should occur every six months.

Modern Medicine – April 2016

April 21, 2016 by Contraception

Absolute Fracture Risk What does it mean for your patient?

Absolute Fracture Risk What does it mean for your patient? – MM1604

Fracture prevention is the main goal of treatment for osteoporosis. Absolute fracture risk calculators have been developed that aim to better quantify fracture risk and may help to guide treatment decisions in certain situations. It may also help to clarify situations of low absolute fracture risk where treatment is not indicated.
Absolute fracture risk calculators incorporate clinical risk factors as well as bone mineral density into risk estimations. Commonly used fracture risk calculators are the WHO Fracture Risk Assessment Tool (FRAX) and the Garvan Fracture Risk Calculator (GFRC).

Modern Medicine – April 2016

April 21, 2016 by Fracture Osteoporosis

Study Reveals Positive IgE Level Association with Respiratory Allergen-related Symptoms

Study Reveals Positive IgE Level Association with Respiratory Allergen-related Symptoms – MM1604

Commonly, the relation between IgE sensitization and allergic respiratory symptoms has been evaluated by dichotomizing specific IgE levels. In the study, Olivieri et al (2016)1 evaluated the association between specific IgE levels and risk of symptoms on allergen-related exposure, with special reference to allergen-related asthma-rhinitis comorbidity.
A clear positive association was observed between specific IgE levels to cat/grass/mite and the risk of symptoms on each allergen-related exposure. This trend was particularly pronounced when considering the coexistence of asthmalike and oculonasal symptoms.

Modern Medicine – April 2016

April 21, 2016 by Allergies

Investigation of Patients Presenting with Headache

Investigation of Patients Presenting with Headache – MM1604

Authoritative advice is presented by the authors on the investigation of a common clinical problem, especially commissioned for family doctors and written by members of the Royal Australasian College of Physicians.
Headache in the primary care setting most often has a benign cause, usually a primary headache disorder. A systematic approach to headache diagnosis, including careful history taking and physical examination to screen for red flag features, will identify those patients who require further investigation, without putting those who clearly have a primary headache disorder through unnecessary tests.
Neuroimaging may identify incidental unrelated neurological abnormalities that can heighten patient anxiety and lead to practical and ethical dilemmas regarding management.

Modern Medicine – April 2016

April 21, 2016 by Headache Pain
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