7th October 2019. Dr Chee L Khoo
GPs are the experts in the practice of the art of medicine. There is a lot of subtle negotiation, bargaining and a touch of scare tactics that goes on when we consult with a patient with a chronic and complex disease. Patients with type 2 diabetes (T2D) comes as complex as you can get.…
6th October 2019. Dr Chee L Khoo
Traditionally, warfarin was the main anticoagulant for stroke prevention in patients with atrial fibrillation and in patients with significant valvular disease. The newer direct oral anti-coagulants (DOACs) are now the main anti-coagulants used instead of warfarin. However, a common limiting factor in the use of the DOACs is renal impairment. We still have come back to good old warfarin in patients whose eGFR is near 30 mL/min/1.73 m2.…
6th October 2019. Dr Chee L Khoo
Last month we looked at the state of play with screening for the deadly disease, pancreatic ductal adenocarcinoma (PDAC). We saw how it may not be useful to screen the general population with the technology that we have but there are select higher risk groups where screening may be useful. Long standing type 2 diabetes (T2DM) is a modest risk factor for PDAC.…
28th September 2019. Dr Chee L Khoo
I have known Greg for about 30 years. He is now 63 years old and has amongst many medical conditions, type 2 diabetes (T2D). He is a working class telephony technician. I have seen him and his children grown up. They are now adult kids but Greg, like the usual middle aged Australian, has gradually grown fatter and less healthy over the years.…
26th September 2019. Spectrum Medical Imaging
Breast cancer is the most common cancer affecting women. In 2019, it is estimated that 19,535 Australians will be diagnosed with breast cancer. However it is important to remember that most women survive breast cancer. Diagnosis of breast cancer patients in early stages is one of important aspects of breast cancer treatment. Among of many diagnostic platforms, imaging techniques are main diagnostic approaches which could provide valuable data on patients with breast cancer.…
26th September 2019. Dr Chee L Khoo
We put patients at high risk of cardiovascular events on statins as primary prevention. We sometimes put patients with high risk of cerebrovascular disease on aspirin to prevent strokes. What about patients who are at high risk of breast cancer? Now, these are not patients who already had breast cancer. We are talking about patients who have not had cancer but are at higher than average risk of developing breast cancer.…
26th September 2019. Dr Chee L Khoo
Everyone seems to be worried about coeliac disease (CD) these days. Everyone else is on a gluten free diet anyway. The naturopaths are also homing in on this bandwagon. How accurate are those blood tests? Or to be specific, what is the specificity and sensitivity of the serological screening tests? Why do we still need a duodenal biopsy?…
14th September 2019. Dr Chee L Khoo
We all have patients similar to this presenting to the practice not that infrequently. This is a real case that I came across just recently. Joanne was referred to the practice by a friend of a friend. She had just been discharged from the local hospital after three weeks following amputation of the lateral two toes of her right foot.…
13th September, 2019. Dr Chee L Khoo
Checkpoint molecules are key regulators of the immune system. These checkpoint molecules are expressed by T cells and are essential for maintenance of immunological tolerance by preventing the unimpeded activation of T cells. Tumour cells capitalise on these checkpoint molecules to protect themselves from attacks by the immune system. Checkpoint therapy block inhibitory checkpoints, restoring immune system function.…
10th September 2019. Dr Chee L Khoo
Have you noticed that most patients with type 1 diabetes (T1D) are not only small and petite but are often devoid of muscles when diagnosed. Insulin is a growth factor and without endogenous insulin, muscle growth is often stymied. We can’t push insulin therapy too hard because it will result in hypoglycaemia. Patients with T1D generally have normal lipids (especially triglycerides) and don’t have elements of metabolic syndrome.…
10th September, 2019. Dr Chee L Khoo
Let’s face it. We all dread the diagnosis of pancreatic cancer in any of our patients. There aren’t too many red flags that we can rely on to warn us that something is not right with this deep seated abdominal organ. Many of the symptoms are either subtle or non-specific like nausea, intermittent epigastric pain, nausea, weight loss, loss of appetite or back pain.…
I
t’s here again. The DOMTRU GP Diabetes Injectable Workshop Masterclass will be held at Mercure Hotel, Liverpool on Sunday 10th November with a totally new agenda. Over the last 12 months we have presented numerous articles detailing the multiple trials and guidelines surrounding the usage of the new GLP1-Ras and insulins. There are now 5 different GLP1-Ras in Australia all with their different pharmacokinetics, cardiovascular outcome data and PBS listings.…