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.…
28th August 2019, Dr Chee L Khoo
Now, most of us travel overseas a lot. We have already seen how to get lounge access in a previous article. It would be nice if you could also use your frequent flyer points during peak season and fly for free as well. What if you don’t have enough points? Well, what if I can get you more points for free so that you can use those points to fly for free.…
23rd August 2019, Dr Chee L Khoo
Remember we used to have lipid targets for patients with diabetes and patients with cardiovascular disease. Life was simple then. Just follow those numbers. Then the 2013 ACC/AHA guidelines told us to throw away those targets and put everyone with cardiovascular (CV) risk above a certain figure on maximally tolerated statins. It’s kind of set and forget strategy.…
13th August 2019, Dr Chee L Khoo
Although persons 75 years or older account for 6% of the population, they account for more than 65%of all deaths due to cardiovascular disease (CVD) (1). We know from numerous trials that intensive treatment to reduce lipid levels reduces CV events in patients after they have an ACS (2). What about elderly patients (>75 years old)?…