Afleveringen
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Dr Natharnia Young is a leading urogynaecologist servicing South Eastern Melbourne’s suburbs and joins this conversation to discuss urinary incontinence in women, a condition associated with significant personal and social stigmatisation and affecting up to 1:2 women over the age of 70.
Rates of presentation by woman seeking management for stress incontinence and urge incontinence are low, perhaps on account of feelings of embarrassment and shame however there are many effective management strategies that Natharnia discusses in this very informative podcast episode. Please enjoy the conversation.
Useful references include:
Dr Natharnia Young – Australian Pelvic Floor Institute. [email protected] Urinary Incontinence – symptoms and causes – Mayo Clinic – www.mayoclinic.org Urinary Incontinence – Office on women’s health – www.womenshealth.gov Urinary Incontinence in Women – www.ncbi.nlm.nih.govTo be a guest on the show or provide some feedback, I’d love to hear from you: [email protected]
Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.
#urinaryincontinence #urogynaecologist #EverydayMedicine
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Dr Peter Brukner OAM is Professor of Sports Medicine at the Latrobe Sport and Exercise Medicine Research Centre and is one of Australia’s most respected and best-known specialist sports physicians with a wide breadth of knowledge of the subject. He has extensive experience, having enjoyed a stellar career with elite sports teams and Olympians over multiple decades in his professional capacity.
In this episode we discuss, several questions related to commonly used supplements taken by amateur and high-level athletes as well as delving into the darker realm of banned substances including anabolic steroids such as DHEA, testosterone and growth hormone. This is a tremendous conversation with master raconteur and communicator. Please enjoy the episode.
Useful references include:
- www.lowcarbdownunder.com.au
- peterbrukner.com
- youtube Professor Tim Noakes – “Medical aspects of the low carbohydrate lifestyle”
- ods.od.nih.gov – National Institutes of Health, Dietary Supplements for Exercise and Athletic Performance (the fact sheet for health professionals)
To be a guest on the show or provide some feedback, I’d love to hear from you: [email protected]
Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.
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Zijn er afleveringen die ontbreken?
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Dr Peter Brukner OAM is Professor of Sports Medicine at the Latrobe Sport and Exercise Medicine Research Centre at Latrobe University and is one of Australia’s most respected and best known specialist sports physicians. He has a deep breadth of knowledge and experience and was a founding partner at the Olympic Sports Medicine Centre in Melbourne as well as a sports physician to the Collingwood and Melbourne AFL clubs, Liverpool Football Club and has served as team doctor to the Australian cricket team, Socceroos and several Olympic teams. He has authored multiple best-selling books on sports medicine and more recently has become interested in the important relationship between lifestyle and health and after determining that he was pre-diabetic he embarked on a low carbohydrate ketogenic style diet. He has subsequently become a strong advocate of the low carbohydrate diet both in managing a healthy BMI and avoiding development of the metabolic syndrome and all its consequent health effects and authored the very popular and best-selling book A Fat Lot of Good. He energetically has also established the not for profit campaign Sugar By Half. He joins us today to discuss his experience and journey to a low carbohydrate diet and how such an approach may be highly beneficial to athletes of both amateur and elite persuasions. Please enjoy this podcast.
Useful references include:
- www.lowcarbdownunder.com.au
- peterbrukner.com
- youtube Professor Tim Noakes – “Medical aspects of the low carbohydrate lifestyle”
To be a guest on the show or provide some feedback, I’d love to hear from you: [email protected]
Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.
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The Peter Doherty Institute was the first Australian laboratory to establish a Covid 19 PCR test and diagnose the first SARS-Cov 2 infection on Australian shores, its research scientist is heavily involved in developing novel diagnostic tools applied across many areas of medical science and the institute plays a key leadership role in advising state and federal government on best medical practice. It’s no great surprise therefore that we have learned of their ground-breaking development of a new subunit Covid 19 vaccine utilising the receptor binding domain at the tip of the virus’s spike proteins. This is the region responsible for virus attachment and infection and for eliciting over 90% of neutralising antibodies following SARS Cov-2 infection. Parallel with the subunit vaccine development, another Melbourne group – the Monash Institute of Pharmaceutical Sciences has developed a similar vaccine but using mRNA technology copying the virus’s genetic sequence that codes for the receptor binding domain.
These vaccines enter the pantheon of other existing mRNA/viral vector/and subunit protein vaccines already available offering protection against Covid 19 but are different as they focus the immune response to the tip of the spike protein – the important receptor binding domain.
Both new Melbourne developed vaccines are entering phase 1 trials and results will be eagerly awaited.
Professor Dale Godfrey is a senior principal research fellow and immunology theme leader at the Doherty Institute and has played a major role in RBD subunit protein vaccine development.
Please join this conversation where Dale discusses the new vaccine development, their efficacy, and the phase 1 clinical trials evaluating the vaccines further.
References:
Professor Dale Godfrey: [email protected]
doherty.edu.au
Phone: 83449325 for further trial information or at [email protected]
To be a guest on the show or provide some feedback, I’d love to hear from you: [email protected]
Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.
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Delivering hard news to a patient or their relatives and admitting error can be one of the most difficult duties encountered by a doctor. Significant effort is now spent in teaching young training doctors techniques and strategies to avoid miscommunication and uncertainty in undertaking this complicated task whilst also remaining emotionally engaged and empathetic to their situation.
Rabow and McPhee have written eloquently on the subject of breaking difficult or bad news and have devised a mnemonic using the letters ABCDE as an excellent guide to this subject.
Accepting responsibility and apologising genuinely to a patient and their relatives for an error incurred during care requires courage and honesty and both Rabow and McPhee as well as the Harvard School of Public Health have written informatively on this subject.
In this episode we are joined by Dr Alan Saunder, Program Director of Surgery at Monash Health and both vascular and transplant surgeon with Dr Bill Shearer Consultant Anaesthetist and Executive Director of Quality Safety and Transformation at the Northern Hospital. We discuss these very important subjects with the honesty and wisdom of many years of advanced clinical practice. I believe you will find this conversation both helpful and engaging.
Useful references include:
- www.ncbi.nlm.nih.gov - Beyond Breaking Bad News: How to help patient who suffer
- www.aafp.org - Breaking Bad News – American Family Physician, G. VandeKieft.2001
- Harvard School of Public Health – www.hsph.harvard.edu
- Mistakes Were Made (But Not by Me) by Carol Tavris and Elliot Aronson, (Chapter 8)
To be a guest on the show or provide some feedback, I’d love to hear from you: [email protected]
Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.
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Chronic pain affects about 1 in 5 people in Australia and is a common reason for patients to see their doctor and to seek treatment. As patients seek ever increasingly strong pharmacological therapies they may become increasingly depressed, fatigued and dislocated from society.
In this episode we have a very interesting conversation with Dr Stephen Nutter, we follow Stephen’s journey from anaesthetist to pain management consultant at Metro Pain Clinic and discuss his approach to:
· Non-pharmacological
· Pharmacological
· Interventional approaches to chronic pain management
Stephen provides us with his personal approach to some common clinical pain syndromes, which we explore as a great introduction to this topic. I am delighted to share the conversation with you.
Useful references include:
www.painaustralia.org.au
www.apsoc.org.au
www.racgp.org.au
www.metropain.com.au
To be a guest on the show or provide some feedback, I’d love to hear from you: [email protected]
Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.
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Genetic testing for cancer is important for a small number of families at increased risk due to the inheritance of genetic mutations. Most commonly this involves the inheritance of breast cancer genes such as the BRCA 1 and 2 or colorectal cancer genes such as the Lynch syndrome genes. Although these only represent a small percentage of total cancers reported there is significant public interest in these syndromes.
We have a further discussion with Dr Lucy Gately from the Cabrini Family Cancer Clinic in this episode in regard to the BRCA 1 and 2 genes on chromosome 17 inherited by 1:400 women and men, and the Lynch syndrome genes which are accounted for by five mutations inherited by about 1:280 people. The Lynch syndrome is believed to affect about 80,000 Australians of whom perhaps only 5% know they have inherited this mutation. Whilst the BRCA 1 and 2 genes are associated with both breast and ovarian cancer in women, BRCA 2 inheritance may also imply an increased incidence of prostate cancer and breast cancer in men. Lynch mutations have been associated with up to 12 different forms of cancer although colorectal cancer and endometrial cancer are most highly represented by these mutations.
It is a great pleasure to discuss this fascinating subject in more detail with Dr Lucy Gately whose expertise on this complex subject is generously shared.
Useful references include:
- www.cabrinicancerclinic - BRCA gene mutations
- Genetic Testing Fact Sheet – www.cancer.gov
- Genetics: Breast Cancer Risk Factors – breastcancer.org
- BRCA 1 and BRCA 2 associated hereditary breast and ovarian cancer – www.ncbi.nlm.nih.gov
- Lynch syndrome – www.cancer.net
- What is Lynch syndrome – Lynch syndrome Australia – lynchsyndrome.org.au
- Understanding genetic tests for Lynch syndrome – Centre for genetics – www.genetics.edu.au
To be a guest on the show or provide some feedback, I’d love to hear from you: [email protected]
Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.
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In the context of family cancer screening, genetic testing looks for specific inherited changes or variants in a person’s genes which may predispose them to an increased risk of developing a neoplasm. Harmful variants in some genes are known to be associated with an increased risk of developing specific cancers such as mutations to the BRCA 1 and 2 genes associated with breast and ovarian cancer and the Lynch genes associated with colorectal and endometrial cancer.
Alterations in tumour suppressor genes (loss of function) and proto-oncogenes (gains of function) are fundamental to our understanding of the science associated with family cancer syndromes and can be tested in the setting of family cancer screening clinics. The subsequent very important genetic counselling for patients and relatives who may have inherited such mutations involves discussing the risk of inherited cancer, individual risk screening and cancer risk reduction strategies.
In this episode, we are joined by Dr Lucy Gately and Lynne McKay from the Cabrini Family Cancer Clinic who have been instrumental in delivering one of Australia’s premier family cancer screening services and genetic counselling services to our community. Please welcome them to this conversation.
Useful references include:
- Family Cancer Clinic for Risk Assessment Advice and Testing – www.cabrini.com.au
- Family Cancer Centres – www.cancer.vic.org.au
- Genetic Testing for Cancer Risk – www.cancer.net
- Family Cancer Syndromes – American Cancer Society – www.cancer.org
- Cancer Genes – pubmed.ncbi.nlm.nih.gov
To be a guest on the show or provide some feedback, I’d love to hear from you: [email protected]
Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.
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The ketogenic diet has recently become popular as an effective dietary approach to weight loss. The diet restricts carbohydrates to just 5-10% of total calories and relies on caloric intake from fats (55-60%) and proteins (30-35%) forcing metabolism to shift from gluconeogenesis to ketogenesis with the production of acetoacetate, beta-hydroxybutyrate and acetone – ketone bodies – as the usable energy source. People adopting this diet report a significant reduction in hunger, increase in energy, clarity of thought and reduction in chronic inflammatory conditions. Some are concerned the diet is difficult to maintain long term and may be risky in patients that are diabetic and in those with chronic kidney disease.
In this podcast episode, we delve deep into the roots of the ketogenic diet and its benefits with Dr Rodney Taylor an expert educator and host of the increasingly popular and very well supported Low Carb Down Under science education program. Rod has been instrumental in bringing some of the world’s experts on metabolism and dietetics to conferences he hosts in Australia and his youtube channel Low Carb Down Under has over 325,000 subscribers. I was very privileged to catch up with Rod in this interview and welcome you to the conversation.
Useful references include:
- Dr Rod Tayler – lowcarbdownunder.com.au
- A Ketogenic Diet for Beginners: The #1 Keto Guide – www.dietdoctor.com
- Should you try the keto diet? Harvard Health – www.health.harvard.edu
- Ketogenic Diet – StatPearls – www.ncbi.nlm.nih.gov
To be a guest on the show or provide some feedback, I’d love to hear from you: [email protected]
Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.
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Before proceeding, we apologise for the audio quality in this week's episode. Unfortunately, we experienced some technical difficulties and we will endeavour to resolve these problems in future episodes of Everyday Medicine.
It is estimated that up to 80% of the population will experience back pain sometime in their lives with presentations from adolescent age to the elderly. Back pain is the third most common reason for visits to a medical practitioner and in many instances treatment strategies have already been sought elsewhere from chiropractors, physiotherapist myotherapists, personal trainers and osteopaths.
Radiological interrogation is often required to assist formulation of an appropriate treatment strategy and in this episode we discuss a radiological perspective of this problem with radiologist Dr Max Kupershmidt who has specialised in procedural radiology and musculoskeletal imaging.Max completed radiology training at the Alfred Hospital in 2006 and worked there as an interventional radiology fellow before undertaking an Abdominal Imaging Fellowship in Toronto in 2008 . Max has been engaged in private radiology for the last 11 years and was a founding executive and treasurer of ARGANZ as well as running and organising many successful conferences and seminars. In this podcast we also discuss with Max the issue of radiation exposure in radiology noting that the average person may receive the equivalent of 3 mSv of radiation per year and that a plain chest x-ray delivers an equivalent of 7 days of background radiation and standard mammography about 7 weeks of equivalent background radiation. CT exposure with a modern scanner delivers approximately 2.6 years radiation, PET scans about 8 years equivalent exposure and MRI none. It is estimated that the additive lifetime risk from a CT scan from fatal and nonfatal malignancy is about 1 in 1100 (equivalent to the risk of drowning). As medical practitioners we all need to be aware of the exposure risk when ordering investigations particularly in our younger patients where the lifetime risk is very real. Please join this conversation with Max.
References:
Dr Max Kupershmidt: LinkedIn
www.cancer.org Understanding Radiation Risk from Imaging Tests
www.radiologyinfo.org Radiation Dose in Xray and CT Exams
www.racgp.org.au Radiation Safety
To be a guest on the show or provide some feedback, I’d love to hear from you: [email protected]
Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.
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Diabetic foot is the name given to the condition commonly experienced by people with diabetic peripheral neuropathy and results in an insensitive and often deformed foot. Found in both type I and type II diabetic patients (of which there are 1.8 million living in Australia-one new diagnosis is made every 5 minutes), even minor trauma in the diabetic foot may lead to the development of an ulcer. The combination of impaired vascular supply from micro and macro vascular disease and neuropathy presents real challenges for healing. Consequently, diabetic foot ulcer is a major event in 85% of subsequent amputations and is the cause of 20% of hospital admissions related to diabetes. Ten to 15% of diabetic foot ulcers fail to heal and of these, 25% lead to an amputation. In one study up to 50% of diabetic patients undergoing amputation were dead within 2 years. Failure to be seen and managed by medical attendants more than 6 weeks after developing an ulcer in a diabetic foot vastly increases the amputation risk however just one year after appropriate vascular surgical management, between 70 and 90% of limbs will be saved from amputation. Furthermore, one year after vascular intervention up to 60% of diabetic foot ulcers are healed, highlighting the importance of vascular surgical expertise early in the management of the diabetic foot.
In this episode we are joined by expert vascular surgeon Mr Ming Yii who is the director of vascular and transplant surgery at Monash Health and adjunct Senior lecturer with Monash University. Ming is part of the Monash transplant team in kidney and pancreas transplantation and brings a wealth of knowledge and experience as well as an effusive personality to accompany his skills. In this episode he discusses his approach to this major problem and the multidisciplinary strategy for management that is needed.
References:
mingyiivascular.com.au
www.webmd.com
www.bmj.com Diabetic foot. SC Mishra 2017
www1.racgp.org.au.diabetic foot ulcer
To be a guest on the show or provide some feedback, I’d love to hear from you: [email protected]
Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.
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It is common in clinical practice to identify patients with impaired renal function as determined by diminished glomerular filtration rate and elevated creatinine. The decision to undertake thorough work-up and investigation of such patients or to observe and monitor, removing any potential offending nephrotoxic agent, is a clinical problem we address in this podcast with expert nephrologist Dr Tony Amin, who considers:
· Acute kidney injury
· Chronic kidney injury
· Appropriate management and work up
· Intravenous contrast nephrotoxicity
This is a complex subject with multiple considerations which Tony outlines with great clarity.
Useful references include:
- Dr Tony Amin – www.healthshare.com.au
- Okusa MD et al. Reading between the Guidelines – The KDIGO practice guideline on acute kidney injury in the individual patient. Kidney Int. 2014 January; 85(1):39-48
- Farrington K et al. Clinical Practice Guideline on management of older patients with chronic kidney disease stage 3b or higher: a summary document from the European Renal Best Transplant Group. Nephrology Dial Transplant. 2017 Jan 1:32(1):916
To be a guest on the show or provide some feedback, I’d love to hear from you: [email protected]
Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.
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Sodium is a major extracellular cation. Normal sodium concentrations range between 135 and 145 mmol/L. Alterations in sodium concentration, particularly hyponatraemia is the most common electrolyte disorder doctor’s encounter in clinical practice. Up to 20% of people admitted to hospital have hyponatraemia and it is estimated that 1.7% of population also have hyponatraemia.
It was enlightening to review this subject with Dr Tony Amin, nephrologist and public educator who discusses:
· The importance of assessment of serum and urine osmolality in conjunction with serum sodium and urinary sodium
· Assessment of patient’s volume status (hyper/hypovolemic)
· A variety of different clinical examples in respect to this subject
Please join me in this very engaging conversation with Tony whose expertise is evident from our discussions.
Useful references include:
- Dr Tony Amin – www.healthshare.com.au
- UpToDate
- HenryDa.In the clinic: Hypernatremia. Annals of Internal Medicine.2a15 August 4; 163(3);ITC1-19
To be a guest on the show or provide some feedback, I’d love to hear from you: [email protected]
Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.
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The consequences of dementia with short term memory loss, visuospatial dysfunction, executive dysfunction, apathy, word-finding difficulty and apraxia is devastating both to the patient and family. It is estimated that 1% of Australians aged 65 years have dementia and that almost half of our population over 85 years have dementia to varying degrees. Alzheimer’s (60% of cases), vascular dementia (15% of cases), Lewy body and frontotemporal (each 5% of cases) and other forms of dementia secondary to alcohol, trauma and neurodegenerative disorders reflect the main forms of dementia seen in our society.
In this podcast we engage expert neurologist and cognitive specialist Dr Helene Roberts to discuss:
· Forms of dementia
· Appropriate investigation
· Management strategies
Helene guides us gently through this difficult and devastating clinical problem. Please join me in conversation with her.
Useful references include:
- www.dementia.org.au
- www.nia.nih.gov
- www.nhs.uk
- Dr Helene Roberts – www.healthshare.com.au
To be a guest on the show or provide some feedback, I’d love to hear from you: [email protected]
Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.
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Each year in Australia, over 125,000 of our more elderly population are admitted to hospital consequent to a fall. About a third of people over the age of 65 years fall each year and this figure rises exponentially with age. In up to 10% of falls, serious injuries such as fractures (a third of which are hip), soft tissue injuries and direct brain injuries arise. Falls and injuries from falls have serious implications and consequences.
In this podcast episode we are joined by geriatrician Dr Kim Tew who discusses:
· The complex relationship between balance, ambulation, cognitive function, neuromuscular function and cardiovascular function
· Appropriate management of an elderly patient following a fall
· The importance of early referral to a falls clinic or geriatrician with a view to careful work up, the deprescribing of medication, engagement of physiotherapy and occupational therapy.
Please join me in this interesting episode with Kim.
Useful references include:
- www.aihw.gov.au
- www.anzfallsprevention.org
- www.monash.edu – Fall-related injury profile for Victorians aged 65 – Monash University
To be a guest on the show or provide some feedback, I’d love to hear from you: [email protected]
Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.
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Couples are said to be infertile if pregnancy does not result after a year of carefully timed sexual activity without the use of contraceptives and is estimated to affect up to one in six Australian couples. It is also estimated that male partners contribute approximately 40% to cases of infertility, the same percentage as women. In a third of couples, a combination of male and female factors both need consideration. Today, women in Australia are 31 years of age before their first child is born compared to a generation ago where women on average were 24 years of age, this change in timing of first pregnancy and lifestyle may also be contributing to the difficulty some couples have starting their families.
In this conversation, we are joined by Dr Peter Yong, a specialist obstetrician and gynaecologist who works with Monash IVF and has a special interest in infertility and assisted conception. Peter trained in the United Kingdom and was awarded the gold medal in the membership examination at the Royal College of Obstetricians and Gynaecologists as well as being the recipient of the RCOG Young Obstetrician and Gynaecologist award. He also won a travel award to visit the Leuven Institute of Fertility and Embryology in Belgium. It was a privilege to have him on a conversation today to discuss:
· Incidence of infertility amongst couples
· Factors to consider
· Appropriate examination and workup
· Subsequent management strategies
Please join me in this very interesting conversation with Dr Yong.
Useful references include:
- www.sjog.org.au
- monashivf.com
- www.aafb.org
- www.ncbi.nlm.nih.gov
- www.nichd.nih.gov
- www.nhs.uk
- emedicine.medscape.com
To be a guest on the show or provide some feedback, I’d love to hear from you: [email protected]
Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.
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Altered uterine bleeding is estimated to affect 10-30% of women in midlife and constitutes about a third of outpatient gynaecological reviews. There are many aetiologies to consider including leiomyomas (fibroids), endometrial pathologies, polyps, malignancy, platelet dysfunction and coagulopathies.
In this conversation, we are joined by expert obstetrician and gynaecologist Dr Peter Yong who completed his undergraduate medical training in Singapore before undertaking postgraduate training in obstetrics and gynaecology in Scotland. He has a special interest in infertility and assisted conception and was awarded the gold medal in the membership examination at the Royal College of Obstetricians and Gynaecologists as well as being a recipient of the RCOG Young Obstetrician and Gynaecologist award. Peter also won a travel award to visit the Leuven Institute of Fertility and Embryology in Belgium. He works both in private practice and at Monash IVF and joins us in this discussion to consider:
· Causes of altered uterine bleeding
· Appropriate investigations and work-up
· Management strategies
Please join me in this very interesting conversation with Dr Yong.
Useful references include:
- www.sjog.org.au
- monashivf.com
- www.aafb.org
- www.ncbi.nlm.nih.gov
To be a guest on the show or provide some feedback, I’d love to hear from you: [email protected]
Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.
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The detection of colorectal polyps is of critical importance in the prevention of colorectal cancer. Studies have demonstrated that colorectal cancer arises from colorectal polyps in more than 95% of cases. Fortunately most polyps do not become malignant (less than 1%) and it is known that less than 5% of all colonic adenomas harbour malignancy. The National Bowel Cancer Screening Program has been a government initiative to assist in the detection of early cancers and malignant polyps through the detection of occult haemoglobin in stool and some larger clinical trials have demonstrated the benefits of screening population this way. Once a malignant polyp is determined colonoscopically a fresh set of questions arises in regards to best management practice.
To discuss this topic of malignant polyps in more detail we are joined by expert colorectal surgeon Hanumant Chouhan, who covers:
· Detection of malignant polyps
· Surgical decisions to progress to resection vs relying on endoscopic removal
· Transanal total mesorectal excision (TaTME)
I am most grateful for his expert review of this subject. Please join me for this interesting conversation.
Useful references are:
- www.sjog.org.au
- www.ncbi.nlm.nih.gov
- www.surgery.wisc.edu
To be a guest on the show or provide some feedback, I’d love to hear from you: [email protected]
Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.
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Rectal bleeding is a very important clue to the possibility of serious internal colonic pathology. Whilst our approach to work up of patients with rectal bleeding is determined by the description of blood, the age of the patient and background history, it is extremely important not to overlook rectal bleeding as a possible early sign of a malignant polyp, premalignant polyp, colorectal malignancy or inflammatory bowel disease.
To discuss this subject in more depth we are joined by the very well-trained colorectal surgeon Hanumant Chouhan who discusses:
· Approach to rectal bleeding guided by patients’ age and family history
· Increased risk of colorectal malignancy in young patients
· Appropriate investigations and workup
Hanumant provides an excellent synopsis of this subject in conversation. Please join us on this episode.
Useful references are:
- www.sjog.org.au
- my.clevelandclinic.org
- www.mayoclinic.org
- www.asge.org
To be a guest on the show or provide some feedback, I’d love to hear from you: [email protected]
Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.
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Metabolic bone disease is common, it is estimated that about 4.75 million Australians have either osteopenia or osteoporosis. Osteoporosis affects up to 23% of women and 6% of men over the age of 50 with a markedly increased risk of minimal trauma fractures including hip fracture with increased morbidity and mortality. Osteoporosis is characterised by microscopic architectural deterioration of bone structure, loss of bone mass and a change in bone metabolism and can be confirmed by dual-energy x-ray absorptiometry (DEXA scan). Until recently 70-85% of patients presenting with a minimal trauma fracture have tended to be both under investigated for osteopenia and osteoporosis, nor appropriately managed to prevent a further fracture. Metabolic bone disease is a silent epidemic.
We are joined today by Dr Ie-Wen Sim who is an endocrinologist and andrologist with special interests including clinical andrology, reproductive endocrinology and metabolic bone disease. He is a graduate of the University of Melbourne with first class honours and the recipient of the NHMRC post graduate scholarship for osteoporosis research. In this conversation Ie-Wen covers:
· Incidence and aetiology of metabolic bone disease
· Comorbidities and risk factors including medications
· Diagnosis
· Medical interventions including use of anabolic and antiresorptive therapies
I hope you enjoy this fascinating conversation with Ie-Wen.
Useful references include:
- www.epworth.org.au
- www.osteoporosis.org.au
- www.aihw.gov.au
To be a guest on the show or provide some feedback, I’d love to hear from you: [email protected]
Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.
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