28th September 2024, A/Prof Chee L Khoo
Patients are often given tacit recommendations about lifestyle changes for MAFLD because it’s “just a little fat in the liver”. For those of us who have that few patients with those liver as well as non-liver complications, we will remember how horrible these patients fare moving forward. Yet, we can’t refer all our patients with fatty liver to the hepatologist.…
28th September 2024, A/Prof Chee L Khoo
Diabetic retinopathy (DR) is the leading cause of new cases of blindness in patients with diabetes mellitus. In 2020, more than 103 million individuals with diabetes mellitus worldwide were affected by diabetic retinopathy and it is expected that this number will increase to 160 million by 2045 (1). We are all familiar with the association between poor glycaemic control and diabetic retinopathy development and progression.…
12th September 2024, A/Prof Chee L Khoo
We explored the four pillars of treatment for patients with heart failure with reduced ejection fraction (HFrEF) a few years ago now. In patients with heart failure with preserved ejection fraction (HFpEF) however, the options are quite limited. SGLT2 inhibitors is the only class of agents that has been shown to reduce major adverse cardiovascular events (MACE).…
12th September 2024, A/Prof Chee L Khoo
Inadequate protein intake in older adults may cause impairments of muscle mass and muscle function as well as impairment in immune function. Higher protein intake has been associated with increased muscle mass and strength, slower rate of bone loss, higher bone mineral density, lower risk of frailty, and improved cardiovascular function and recovery from illness (including wound healing) (1,2).…
8th September 2024, NIA Diagnostic Imaging
Computed tomography (CT) is widely recognised as the gold standard for detecting and diagnosing a broad range of pathologies due to its ability to provide detailed cross-sectional imaging. However, concerns about radiation exposure continue to be raised by both patients and clinicians. As a result, it is crucial to understand the impact of technological advancements in ensuring that radiation exposure is kept as low as reasonably achievable (ALARA) while still maintaining diagnostic accuracy.…
30th August 2024, A/Prof Chee L Khoo
Up until GLP1RAs +/- GIPs were shown to be efficacious in assisting patients lose weight and keeping the weight off, long term sustainable weight loss was practically unachievable. Not everyone wants to or is able to afford bariatric surgery to assist in weight loss. Even then, the weight loss is usually not sustainable. International guidelines (including Australian) include medical nutritional therapy in the management of obesity.…
24th August 2024, A/Prof Chee L Khoo
Last fortnight we looked at the effects of hypertriglyceridaemia (HTG) on atherosclerosis. We explored the source and metabolism of triglycerides (TG). We saw how important lipoprotein lipase was in regulating plasma TG. Triglyceride levels are closely related to plasma triglycerides rich lipoprotein (TRL) and TRL remnants. All three components penetrate through the endothelium into the subendothelial space where atherosclerotic inflammation occur.…
24th August 2024, A/Prof Chee L Khoo
Plasma glucose levels is such a simple test that we take for granted its reliability. The glucose level is absolutely critical in many of our clinical management. It governs whether we diagnose someone with diabetes or not and that have many regulatory implications. We have discussed the diagnosis and management of gestational diabetes mellitus (GDM) and how it affects maternal and offspring outcomes and future risks to both.…
11th August 2024, NIA Diagnostic Imaging
CT enterography (CTE) plays a vital role in the management of Crohn’s disease, a chronic inflammatory bowel disease (IBD). Crohn’s disease is the most common indication for a CTE, primarily used to determine diagnosis and complications (5) to guide effective treatment, and for monitoring disease progression and response to treatment.
WHAT IS CROHN’S DISEASE?…
11th August 2024, A/Prof Chee L Khoo
Treating the CV risk factors like hypertension, diabetes mellitus, hypercholesterolemia and smoking have led to significant reductions in cardiovascular disease and mortality. However, up to 25% of first-time patients with myocardial infarction are SMuRF-less. We explored the issue last fortnight. Essentially, SMuRF-less patients are patients who do not have the usual standard modifiable risk factors (SMuRF).…
High salt intake is said to independently contribute to high blood pressure and ultimately, increase cardiovascular disease (CVD). There are also many other diseases that are similarly associated with high salt intake. How robust is the evidence though? As we ponder about the associations, we may or may not push the message of salt reduction as strongly as we should.…
25th July 2024, A/Prof Chee L Khoo
The current gold standard for screening for gestational diabetes mellitus (GDM) for women with no risk factors for hyperglycaemia is an oral glucose tolerance test (OGTT) at 24-28 weeks’ gestation. Women with risk factors are recommended to have an OGTT in the first trimester. Unfortunately, many women are nauseous during the first trimester and performing an OGTT during that time can be very unpalatable.…