Lower back pain: what do the guidelines say?

The latest American College of Physicians guideline recommends the following non-invasive approach to the diagnosis and treatment of lower back pain (LBP).

The influence of metabolic factors on weight regain

While it is often assumed that patients who regain weight do so because of a lack of willpower, there are plenty of metabolic factors that compel the body to maintain weight and regain it once it has been lost.

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Folate: benefits beyond NTD prevention

The most well-known use of folic acid is its role in preventing neural tube defects (NTD) during pregnancy. But folate affects numerous bodily functions and is beneficial for much besides pregnancy.

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Reducing xerostomia to zero

Dry mouth is a common side effect of certain medications, radiotherapy for head and neck cancer and diseases including Sjogren’s syndrome and rheumatoid arthritis. Often overlooked, dry mouth must be treated to prevent comorbidities like caries and dysphagia.

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Ectoine: allergy’s alternative medication of choice?

Allergic rhinitis and conjunctivitis are among the most common conditions treated in general practice, yet growing numbers of patients are weary of traditional pharmacological therapies. Enter ectoine, a naturally produced treatment just as effective as pharmaceuticals.

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Xerosis: a focus on black skin

Doctors should provide evidence-based information about emollients for patients of African origin, since both hyperpigmentation and lichenification are different for black skin types than white or Asian skin types.

Strengthening bone health with magnesium and vitamin K

Osteoporosis is a common, aging-related disease, the prevalence of which has been increasing with the improvement of modern medicine and average life expectancy. Termed a “silent disease”, it often goes undetected until a patient suffers from a bone fracture.

Medical Chronicle April 2019 CPDs

Attached are both of the CPDs produced for the April 2019 issue of Medical Chronicle, accredited for 3 CPD points. Topics covered this month are xerosis considerations for black skin and magnesium/vitamin K for bone health.

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Much ado about urticaria

The World Allergy Organization and several European dermatology and immunology societies joined forces in 2016 to revise and update the diagnostic criteria and treatment of urticaria. The guideline was published last year.

Antibiotics vs antiseptics in wound healing

Iodophore-based formulations have remained popular after decades of use for antisepsis and wound healing. Recent data clearly supports its use in wound healing.

One size does not fit all ADHD patients

A common assumption is that ADHD is a modern occurrence. However, a case series of children presenting with the characteristic clinical features was published by the British paediatrician Sir George Still in The Lancet in 1902.

The pitfalls of long-term glucocorticoid therapy

We chat to Prof David Kendler, director of the Osteoporosis Programme at Providence Health Care in Vancouver (Canada) and Dr Sue Brown, council member of the National Osteoporosis Foundation of South Africa (NOFSA) about glucocorticoid-induced osteoporosis (GIOP).

Specialist Forum April 2019 CPDs

Attached are all three CPDs produced for the April 2019 issue of Specialist Forum, accredited for 3 points. Topics covered this month are stress management in IBS, glucocorticoid therapy and ADHD.

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Stress management in the IBS patient

IBS is reported more frequently in women than in men and those aged 30 to 49 years. On average, it takes four years for individuals with IBS to receive a definitive diagnosis.

New advances in head and neck squamous cell carcinoma

Lose teeth, oral abscesses and inexplicable ear ache might be signs and of head and neck squamous cell carcinoma (HNSCC), says radiation oncologist, Dr Robert de Müelenaere of De Müelenaere Oncology. HNSCC ranks sixth among the most common cancers worldwide with over 500 000 new cases reported each year.

How to take a sexual history

Some patients may not be comfortable talking about their sexual history, sex partners, or sexual practices, but detailed knowledge of these aspects of their lives is sometimes required, and doctors must know how to approach the subject.

Inflammation, immunity and infection in atherothrombosis

This is a new review topic addressing the overall concept of atherosclerosis and where we are at this moment in time in terms of pathogenetic concepts with an emphasis on inflammation and immunity.

Women’s acne battles

Patients diagnosed with acne vulgaris (AV) have a 63% increased risk of developing depression in the first year following diagnoses compared to their clear skinned counterparts, found a 2018 study published in the British Journal of Dermatology.

Updated atrial fibrillation guidelines

There is now a focused Update of the 2014 American Heart Association/American College of Cardiology/Heart Rhythm Society (AHA/ACC/HRS) Guideline for the Management of Patients with Atrial Fibrillation (AF).

Not all probiotics created equally

Irritable bowel syndrome (IBS) is a chronic disorder that is not only associated with physical symptoms such as diarrhoea, vomiting and abdominal pain, but also psychological conditions such as depression and anxiety.

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