Heart Failure – are biomarkers useful?

12th July 2023, Dr Chee L Khoo

The WHO define biological markers or biomarkers as “any substance, structure or process that can be measured in the body or its products and influence or predict the incidence of outcome or disease”. In heart failure, many biomarkers have been studied but B-type natriuretic peptide (BNP) and N-terminal pro–B-type natriuretic peptide (NT-proBNP) come close to the characteristics of “ideal” heart failure (HF) biomarkers.…

Finerenone is finally here – do you remember what it is for?

12th July 2023, Dr Chee L Khoo

DKD

It’s almost a year since we foreshadowed the arrival of finerenone and it’s finally on the PBS, albeit with the usual and expected very restricted criteria. We discussed finerenone’s impressive cardiovascular and renal outcomes in patients with heart failure and chronic kidney disease. We further discussed why finerenone is a better mineralo-corticosteroid receptor antagonist (MRA) than what we have at the moment, spironolactone and eplenerone.…

Obstetric Imaging – what scans/tests can you order?

29th June 2023, Spectrum Medical Imaging

At Spectrum Medical Imaging, we are pleased to offer your patients a wide range of obstetric imaging options throughout all stages of their pregnancy. We are committed to providing you with high quality services at affordable prices. All of our sonographers who perform Nuchal Translucency scans are certified by the Fetal Medicine Foundation and all of our reporting Radiologists have a special interest in obstetric ultrasound.…

Hypertrophic cardiomyopathy – do the old sporting restrictions still apply?

25th June 2023, Dr Chee L Khoo

Sudden cardiac death

Consensus cardiology recommendations previously supported the ’blanket’ disqualification of athletes with hypertrophic cardiomyopathy (HCM) from competitive sport. Clinically, it is almost impossible to exclude HCM from physical examination. Thus, sudden cardiac death (SCD) is always on our minds when we are asked to sign off on a clearance to participate in sporting activities.…

Familial hypercholesterolaemia – lessons from the Dutch FH Screening Project

25th June 2023, Dr Chee L Khoo

FH

A few weeks ago we explored familial hypercholesterolaemia (FH) primarily in adults. The issues we touched on were how not so rare FH really is and further, how aggressive we should target the LDL-Cholesterol (LDL-C). As we know, commencing lipid lowering agents is only the first step. The next step is to agree on what the LDL-C target should be in this patient based on the cardiovascular risk of the patient.…

Pelvic organ prolapse – diagnosis with translabial ultrasound

11th June 2023, NIA Diagnostic Imaging

translabial US

The incidence of pelvic organ prolapse is highly associated with increased age and vaginal childbirth (Weintraub et al., 2020). Majority of patients who present with POP may not report any symptoms. Patients who do present with symptoms, however, often describe a sense of feeling of a bulge protruding through the vaginal opening. In younger women, vaginal laxity is more commonly noticed and related to sexual dysfunction (Peter Dietz, 2015).…

Weekly insulin injection is here – are they any good?

11th June 2023, Dr Chee L Khoo

Weekly?

First, we have short acting GLP1-RA (exenatide) which requires twice a day injections. Then, we have once daily GLP1-RA injections (e.g. Exenatide ER, liraglutide, lixisenatide) which makes it more convenient for most patients. Of course, once daily injection is still too many. Once a week would be better, wouldn’t it? Of course, we now have weekly dulaglutide and semaglutide and patients love them.…

Diets for T2D – what should you tell your patient?

which diet?

10th June 2023, Dr Chee L Khoo

It’s all very confusing, isn’t it? Low fat, low carbohydrate, Mediterranean diet, Paleo diet, Nordic diet or DASH diet. There are many other diets which we haven’t even heard of. Are they any good? Do they cause harm? How can we advise our patients if we don’t know what those diets are?…

Knee MRI – the best investigation to elucidate the diagnosis

30th May, 2023, Spectrum Medical Imaging

Knee injuries are one of the most common injuries we see in general practice. We always start with history to determine the mechanism of injury. Examination is not always straight forward especially, if there is severe pain and restriction of movement. MRI is an excellent tool for demonstrating injuries of the internal soft tissue structures in the joints.…

Hypertriglyceridaemia – why is it not sexy to talk about it?

28th May 2023, Dr Chee L Khoo

Hypertriglyceridaemia has always played second fiddle to hypercholesterolaemia for a long time. Studies after studies have demonstrated the cardiovascular benefits of cholesterol lowering therapy. You might know that most of these clinical trials excluded patients with hypertriglyceridaemia. Does that mean that hypertriglyceridaemia doesn’t matter? We know hypertriglyceridaemia inflict oxidative damage to vital metabolic systems and organs.…

Danuglipron – the new, small kid on the GLP1-RA block

27th May 2023, Dr Chee L Khoo

small molecule agonist

The first GLP1- RA, exenatide was first isolated by John Eng in 1992 while working at the Veterans Administration Medical Center in the Bronx, New York.[1] It was made by Amylin Pharmaceuticals and commercialised by AstraZeneca. Exenatide was approved by the FDA on April 28, 2005, for people whose diabetes is not well controlled on other oral medications.…

CT Colonography vs Colonoscopy

NIA Diagnostic Imaging, 14th May 2023

Colorectal cancer (also known as bowel cancer) is the third most prevalent type of newly diagnosed cancer and the second deadliest type of cancer in Australia. CRC generally arises from the inner lining of the colon and is often characterised by polyps, which, if left undetected, can transform into aggressive malignancies. Despite the fact that optic colonoscopy is the golden standard for the detection of colorectal cancer, CT colonography (CTC) is regarded as a non-inferior alternative.…