January 7th, 2022, Dr Chee L Khoo
There is a trend across the medical specialties to make their guidelines a live document as emerging data comes thick and fast these days. 12 months is a long time for once a year updates. But when you have guidelines or protocols that are updated on a daily basis, it could mean that either there are really, really lots of data coming through or those guidelines are not based on scientific data.…
25th December, 2021, Spectrum Medical Imaging
As CT procedure volume grows – reaching an all-time high ahead of the COVID-19 pandemic – so too does the need to optimise CT protocols and expand patient positioning options to help expedite exams and accommodate more patients. The actual scan itself only takes a few minutes and the remainder of the time is dedicated to patient prep – including positioning the patient and identifying the correct protocols and settings, plus image reconstruction and report time.…
25th October 2021, Spectrum Medical Imaging
One of the very few beneficial things over the lockdown period is the easier availability of radiological services. Most radiological practices have reported reduction in throughput during the recent outbreaks. As we emerge from the lockdown, referrals for medical imaging are increasing and with the increase, an increasing wait time for services is happening.…
9th April 2021, Dr Chee L Khoo
We are all aware of the treatment inertia in the management of patients with diabetes. In patients with heart failure, several drug classes have demonstrated significant but independent survival benefit. Quadruple therapy with an angiotensin receptor–neprilsyin inhibitor (ARNI), evidence-based β-blocker, mineralo-corticoid receptor antagonist (MRA) and sodium glucose cotransporter 2 inhibitor (SGLT2i) can cumulatively reduce the risk of death by 73% over 2 years (1).…
29th January 2021, Spectrum Interventional Radiology
Benign Prostate Hypertrophy (BPH) is a prevalent condition in males that results in Lower Urinary Tract Symptoms (LUTS). BPH is present in 50% of males at 50yrs of age and increases to 90% of males at 90 years of age. Apart from trans-urethral resection of prostate (TURP) and dutasteride/tamsulosine, there is another longstanding and tested option.…
14th December 2020, Dr Chee L Khoo
We explored the Covid-19 vaccine candidates in the last issue. You would have read that the Pfizer vaccine has been approved and has been rolled out in UK and US. I have yet to come across the full disclosure of the trial anywhere. The Oxford/AstraZeneca trial has been published in full and it is worthwhile dissecting the study and ponder the implications as other vaccines are being rolled out internationally and will hit Australian shores in early 2021.…
13th December 2020, Dr Chee Khoo
First, we have twice daily then once daily GLP1 injections. This was followed by weekly GLP1 injectables. The same is occurring with the insulins. Once daily insulins have been around for a few years and is well established as basal insulins in patients with type 1 and type 2 diabetes. We now have a weekly insulin coming onto the market.…
8th August 2020, Dr Chee L Khoo
Two years is an awfully long time in diabetes management updates. Well, that’s exactly how long it has been since the last RACGP diabetes management guidelines was last updated. There have been a deluge of data pouring in to help guide us in our management of patients with type 2 diabetes. The “handbook” is actually looking more like an encyclopaedia now with 198 pages of information.…
8th July 2020, Spectrum Radiology
Adjunct screening with dynamic contrast-enhanced (DCE)-MRI was first recommended for women at high (>20%) lifetime risk of breast cancer, facilitating earlier cancer detection and reducing interval cancers. Even in women at average risk of breast cancer, there is evidence that they might also benefit from screening MRI.
Apart from the cost of MRI equipment, other costs include the relatively long acquisition, limiting high-volume patient throughput and interpretation times involved in a full diagnostic protocol.…
We all know how restricted the criteria for swabbing patients for Covid-19. You may consider perhaps, a chest rays may help. Although there are lots of studies describing the “classic” ground glass appearance on CXR or Chest CT, Unfortunately, in practical terms, they are not useful. It may actually endanger your radiology colleagues and their staff unless we work as a team during this difficult period.…
I don’t know about you but I am always unsure what to do with thyroid nodules. Thyroid nodules are common, very common. So, I am frequently unsure! We either refer too many thyroid patients unnecessarily or order too many ultrasound or other thyroid scans. Finally, someone has come up with a guide to assist us GPs navigate this difficult but common condition.…
10th February 2020, Dr Chee L Khoo
Diabetes can either be the sole perpetrator of the heart failure or be an accomplice to other cardiac disease such as coronary artery disease or myocarditis. Diabetic cardiomyopathy can manifest itself either as a restrictive cardiomyopathy with heart failure with preserved ejection fraction (HFpEF) or as a dilated cardiomyopathy with heart failure wth reduced ejection fraction (HFrEF).…