SMuRF-less myocardial infarctions – what are they?

12th July 2024, A/Prof Chee L Khoo

Myocardial Infarction

We are always on the look out for the traditional cardiovascular risk factors – hypertension, diabetes, lipids and smoking to reduce the risk of adverse cardiovascular events. These are termed standard modifiable cardiovascular risk factors (SMuRFs). Unfortunately, there are a significant number of patients that present with acute coronary syndrome (ACS) who has none of the SMuRFs.…

Management of fatty liver disease – what works?

30th June 2024, A/Prof Chee L Khoo

MASLD

Just in case you are not aware, there will be a tsunami of patients with metabolic dysfunction associate fatty liver disease (MAFLD) or metabolic dysfunction associated steatotic liver disease (MASLD) coming to you over the next few years. Part of the reason is to do with the better recognition of the condition and we are now detecting them more with biomarkers, imaging and a high index of suspicion.…

The deadly exacerbations of COPD

30th June 2024, A/Prof Chee L Khoo

CVD in COPD

We are all aware of the exacerbations in patients with chronic obstructive pulmonary disease (COPD) especially when they are discharged from hospital back to primary care. We tend to forget that each time a patient with COPD have flare up or chest infection, that represent an exacerbation of COPD. Now, you may think it’s just a matter of semantics and coding but it’s more than that.…

Childhood dyslipidaemia – what happens to these kids?

30th June 2024, A/Prof Chee L Khoo

childhood dyslipidaemia

We advocate applying protective sunscreens for little babies onwards because most of the sun damage starts from young and often, we fight a losing battle trying to rescue severe sun damaged skin in later life. It wouldn’t be any different in dyslipidaemia in children and adults. When you think about it, it really doesn’t matter what age you are.…

DEXA – The key to diagnosing osteoporosis

6th June 2024, NIA Diagnostic Imaging

DEXA (Dual-Energy X-ray Absorptiometry), is a non-invasive, quick and simple medical imaging modality used to measure bone mineral density (BMD). It is highly effective in diagnosing osteoporosis or osteopenia, hence enabling managing clinicians to assess the extent of bone loss for their patients. It is considered the “gold standard” by the World Health Organisation (WHO) and is the most accurate and inexpensive test to diagnose osteoporosis.…

Coronary CT Angiogram – should we be ordering more?

10th June 2024, A/Prof Chee L Khoo

coronary CT angiogram

Identification of individuals at high risk of atherosclerotic cardiovascular events is actually quite challenging in practice. There are many predictive algorithms which try to assess the cardiovascular risk of an individual. These scoring systems are based on the traditional risk factors that we all know well – lipids, smoking, hypertension, diabetes, family history of atherosclerotic cardiovascular disease (ASCVD), age and gender but unfortunately, we still don’t fully understand an individual’s susceptibility to the atherogenic vulnerability.…

Muscle loss with weight loss – is there a drug for it?

10th June 2024, A/Prof Chee L Khoo

muscle weakness

There will always be a certain degree of fat free mass (i.e. muscle) loss with any weight loss. While the makers of the GLP1/GIP agonists will tell you that overall, there is more fat loss than muscle loss, it is still a concern for the long term health of patients who lose muscles which may not be restored.…

Breast Imaging at Spectrum Medical Imaging

31st May 2024, Spectrum Medical Imaging

When you have to further investigate any breast conditions including breast lesions, the imaging modalities can be many. You want to refer a patient to a radiology service which can offer a whole array of imaging modalities. Spectrum Medical Imaging is the first practice for breast screening in NSW to offer personalised risk assessment and screening recommendations.…

Testosterone replacement – is it cardio safe?

31st May 2024, A/Prof Chee L Khoo

Testosterone Replacement

It’s coming to almost 10 years now when suddenly, we were not able to prescribe testosterone replacement therapy (TRT) to men with hypogonadism or low testosterone levels under the PBS. This came on the back of a decision by the US FDA in March 2015 to restrict the prescription of TRT (1).…

The 4th Pillar in treatment of CKD

31st May 2024, A/Prof Chee L Khoo

CKD

Renin-angiotensin system (RAS) inhibitors and SGLT2 inhibitors have been the cornerstone treatment of chronic kidney disease (CKD) for many years now. They have been shown to protect kidneys and at the same time reduce adverse cardiovascular outcomes. Finerenone was recently shown to do the same. These three agents are now the guideline-directed three pillars in the treatment of CKD.…

Paediatric ultrasound – developmental hip dysplasia

12th May 2024, NIA Diagnostic Imaging

Developmental dysplasia of the hip (DDH) stands out as one of the most prevalent musculoskeletal disorders manifesting in neonates and infants (Charlton et al., 2017). Owing to the dynamic potential for hip remodelling, hip dysplasia at birth may either resolve spontaneously or progress as the child grows (Loh & Wollett, 2021). DDH encompasses a spectrum of hip conditions, including abnormal acetabular development and hip dislocation causing disruption to the typical alignment of the femoral head and acetabulum as a stable ball-and-socket joint (Landes, 2011).…

Colchicine to reduce CVD – is it prime time yet?

12th May 2024, A/Prof Chee L Khoo

ASCVD

We are used to using colchicine for acute treatment of gout but colchicine has also proven itself a key pharmacotherapy in the treatment of cardiovascular conditions such as pericardial disease (1), post-operative atrial fibrillation (2) and coronary artery disease (3). Colchicine disrupts the inflammatory response in acute gout but the inflammatory pathways that colchicine acts on are also found in other inflammatory diseases including coronary artery disease.…