In the last issue of GPVoice we read about the what sub-type of spinal stenosis might benefit from glucocorticoid injections. Apart from spinal stenosis, there are many other joints, bursa or soft tissue that may benefit from glucocorticoid injections. It can sometimes be confusing as to what joints or soft tissue may be amenable to injections and what modality of imaging may assist the injections.…
Author: adminwp
INTERIM OPIOID TREATMENT ACCREDITATION COURSE
March 15, 2018
Dr Jenny James
General Practice Drug and Alcohol Advice and Support Service
The Opioid Treatment Accreditation Course is currently being restructured by the University of Sydney, Discipline of Addiction Medicine. The new format training is expected to commence by 1 June 2018.
As a measure to manage the waiting list for accreditation training, an interim course is being be offered.…
VLCD may cause initial reduction in cardiac function
March 2018, Dr Chee L Khoo
Several meta-analyses of randomised clinical trials showed that ketogenic diets induce a long-term significant improvement in body weight, diastolic blood pressure, triglycerides and HDL-cholesterol, when compared to low fat diets. However, rapid weight loss may cause a transient rise in plasma triglycerides which can contribute to impairment in cardiac function in the short term.
The heart has a very high energy demand, which is met almost entirely by the mitochondrial oxidation of fatty acids and carbohydrates.…
Glucocorticoid injection for spinal stenosis – who might benefit?
March 2018, Dr Chee L Khoo
Sometimes conclusions from a landmark scientific trial may be different from what we see in our own practice. The LESS trial (2014) found that epidural injection of glucocorticoids plus lignocaine offered minimal or no short-term (6 weeks) benefit as compared with epidural injection of lignocaine alone in the treatment of lumbar spinal stenosis (LSS). Yet, we all have some patients that have responded well to spinal injections.…
D-dimer – how to use it correctly in general practice
March 2018, Dr Chee L Khoo
We all know a bit about d-dimer. We all know that it can be a useful marker for the diagnosis of venous thromboembolism (VTE). It can be used to guide the optimal duration of anti-coagulation in VTE. It is also useful in assessing the risk of recurrence in patients who already had a VTE event especially in patients with cancer.…
How to get lounge access when flying economy
March 2018, Dr Chee L Khoo
If you earn more than $76,000 per annum and you would like lounge access when flying economy overseas on the cheap, read on. I don’t know about you but I can only afford economy class when flying overseas. I can’t really justify spending 4 times the economy fare to be pampered. Really, I just need lounge access.…
Congenital Hip Dysplasia – how useful is the “click”?
February 2018, Dr Chee L Khoo
Congenital hip dysplasia (CDH) is a common fear when we examine newborns. A clicky hip is a common reason for further investigations. CDH is actually not very common but how often does a clicky hip lead to a diagnosis of CDH? In other words, how useful is the “click”?
A 20-year prospective, longitudinal, observational study was undertaken to assess the relationship between the presence of a neonatal clicky hip and pathological CDH.…
To err is human… actually, it’s now manslaughter!
February 2018, Dr Chee L Khoo
I am sure you have read about Dr Bawa-Garba who was “thrown under the bus” by the system for her treatment of a 6 year old child with Down’s syndrome who died of sepsis while being treated in hospital. . There have been many discussions in UK and internationally about the ramifications of the court and tribunal’s decisions but what can GPs in Australia learn from this case?…
CancerSEEK test – not another screening test for cancer
February 2018, Dr Chee L Khoo
“Doc, is there a test for cancer?” I’m sure you have many a patient asking for a blood test to screen for cancer. Some of you may be tempted to order a CEA or a CA-125 without being familiar with their sensitivities and specificities (that’s another story on another day). An international group of researchers recently described a blood test, called CancerSEEK which purportedly can detect eight common cancers.…
Dasiglucagon – the new glucagon
February 2018, Dr Chee L Khoo
Hypoglycaemia is one of the most common endocrine emergencies and the most feared complication of having diabetes. Treatment of severe hypoglycaemia in patients who are unable to take oral treatment is limited to either glucagon or glucose injections both of which requires some experience in playing with syringes and bottles. Dasiglucagon, a novel soluble glucagon analog, is a ready to use rescue pen developed for treatment of severe hypoglycaemia.…
GP Drug & Alcohol Advice & Support Service
We all have patients troubled by alcohol or drugs. We are either approached by the patient or more often than not, family members who are lost in the maze of services out there. Despite being a GP in the area for more than 25 years, I still don’t know what is out there, who needs what, let alone who or where to get help for these patients.…
Non-invasive prenatal testing – what GPs need to know
February 2018, Dr Chee L Khoo
You would have no doubt come across a few patients enquiring about non-invasive prenatal testing. Obviously, this come on top of the “optional” nuchal translucency (NT) with or without maternal serum analysis which has been around for some years. What does non-invasive prenatal tests (NIPT) exclude and what does it not exclude?
So, what does NIPT test for?…