EARLY BREAST CANCER DETECTION – NO COMPROMISE WITH 3D MAMMOGRAPHY

13rd September 2022, NIA Diagnostic Imaging

Mammography remains the gold standard imaging technique in early-stage breast cancer diagnosis. It forms part of the triple test approach to the investigation of new breast symptoms. (Cancer Australia 2021). In the past, there used to be limitations with conventional mammography’s sensitivity and specificity in detecting abnormalities in young female breasts due to the patients’ mostly dense breast tissues.…

To aspirin or not to aspirin for primary CVD prevention

9th September 2022, Dr Chee L Khoo

Aspirin

While aspirin does provide a modest benefit in reducing nonfatal MI and nonfatal stroke events, low dose aspirin has little or no effect on cardiovascular disease mortality or all-cause mortality in patients who have not had cardiovascular disease (1). In 2016, the US Preventive Services Task Force (USPSTF) concluded that the beneficial effect of aspirin for the primary prevention of CVD was modest and occurred at doses of 100 mg or less per day (2).…

SGLT2i and cardiorenal benefits – more than you think

CKD

29th August 2022, Dr Chee L Khoo

By now, you would be very familiar with the additional cardiorenal benefits when you use an SGLT2 inhibitor (SGLT2i) in the management of hyperglycaemia in patients with type 2 diabetes (T2D). You would also know that the benefits are enjoyed by patients whether they have diabetes or not. DAPA-CKD published in September 2020 during the pandemic.…

Lipoprotein (a) – should we routinely measure in everyone?

28th August 2022, Dr Chee L Khoo

Atherosclerosis

We know that low density lipoprotein cholesterol (LDL-C) is a risk factor for atherosclerotic cardiovascular disease (ASCVD). We also know that reducing LDL-C levels can significantly reduce those risks irrespective of whether they have established cardiovascular disease or not (1). That means reducing LDL-C works in secondary as well as primary prevention. However, even when LDL-C is well-controlled in statin-treated ASCVD patients, there is still a residual risk of cardiovascular disease.…

Recommended physical activity – how much or how often is beneficial?

14th August 2022, Dr Chee L Khoo

We all know that regular physical activities is associated with lower ill-health and mortality and better quality of life. International guidelines suggest adults perform from 150 to 300 minutes per week (min/wk) of moderate-intensity aerobic physical activity, 75 to 150 min/wk of vigorous-intensity aerobic physical activity, or an equivalent combination of both intensities (1).…

Type 3c Diabetes – diabetes of exocrine pancreas

12th August 2022, Dr Chee L Khoo

We used to think of the islets of Langerhans as tenants in the exocrine pancreas boarding house. Like two separate cell types living under the same roof – one endocrine and the other exocrine. Both cell types happen to be involved in the business of nutrient digestion but they perform totally separate functions. Patients with diabetes are more likely to get pancreatic cancers and pancreatic exocrine insufficiency.…

Diabetes Tech & Talk 2022

8th August 2022

Tech & Talk 2022

It’s that time of the year again. It’s Diabetes Tech & Talk 2022. it is that time of the year where we get to interact and intermingle with colleagues – GPs, endocrinologists, diabetes educators and researchers.

We are exploring Innovation and Integration in Diabetes Clinical Care, Self-management and Prevention this year. We are extremely privileged that this year’s key note speaker is Professor Dianna Magliano.…

Post Covid-19 pneumonitis

30th July 2022, Spectrum Medical Imaging

Up to 31%-69% of COVID-19 survivors will experience long COVID symptoms after initial recovery from SARS-CoV-2 infection [1, 2]. While the initial symptoms of long COVID symptoms include fatigue (29%), muscle pain, palpitations, cognitive impairment (28%), dyspnea (21%), anxiety (27%), chest pain, and arthralgia (18%) [3], in patients experiencing long covid symptoms, fatigue is most prevalent (51%), followed by dyspnoea (35%), arthralgia (25%) and concentration difficulties (25%).…

Medial meniscal tears – surgery or physio or both?

30th July 2022, Dr Chee L Khoo

medial meniscal tear

I recently came across a trial comparing arthroscopic partial meniscectomy (APM) with physiotherapy (PT) in the management of medial meniscal tears in older patients. Older patients here mean patients that are older than 45 years who are supposed to have degenerated menisci. Now, meniscal tears (usually medial but sometimes can be lateral meniscal tear) in younger patients often require surgical intervention but in older patients, surgery is not necessarily better than conservative physiotherapy.…

SURMOUNT-1: Tirzepatide for obesity management

29th July 2022, Dr Chee L Khoo

12 months ago, at GPVoice, we announced the arrival of drug LY3298176, which now has a name, tirzepatide, as the first in its class of “twincretins” in the management of type 2 diabetes. We briefly explored the 4 Phase 3 trials looking at the efficacy and safety of trizepatide in comparison with placebo, semaglutide, insulin degludec and insulin glargine.…

PCSK9 inhibitors in dyslipidaemia – where is the evidence?

13th July 2022, Dr Chee L Khoo

Meta-analysis

In the last issue of GPVoice, we looked at the up-to-date guidelines in the management of dyslipidaemia in primary and secondary prevention. We looked at how complex those guidelines are. We also touched on the fact not all the evidence behind the guidelines is Level A evidence. The PCSK9 inhibitors, in particular, are a relatively new class of lipid lowering agents and the data is still coming in.…