Primary Care Masterclass Podcast

In this General Practice Clinical session, we are joined by Dr. Sarah McMahon, a pediatric endocrinologist, to unpack the latest updates to the international guidelines for Turner syndrome care. Designed to serve as a comprehensive roadmap for clinicians, Dr. McMahon breaks down the extensive checklist of 47 health surveillance recommendations that span a patient's entire lifespan.

She discusses critical pediatric interventions, including the rationale for initiating growth hormone therapy as early as two years of age to prevent further growth failure. Dr. McMahon also explains the shift toward using transdermal estrogen starting between 11 and 12 years of age to...

In this General Practice podcast , we are joined by Professor Claus Gravholt, a leading international authority on Turner syndrome, to discuss critical new epidemiological and genomic findings.

This episode challenges the assumption that Turner syndrome is exclusively a pediatric diagnosis. Surprisingly, the median age of diagnosis is 15 years old, with many females diagnosed late in adulthood or not at all. Professor Gravholt highlights the "pre-diagnosis phenotype," revealing that patients often present to primary care with elevated endocrine conditions and cardiovascular medication use long before receiving a formal diagnosis.

We dive deep into the untangling of...

In this General Practice podcast, we welcome Professor Gerry Conway, a leading UK-based endocrinologist, to explore the long-term adult care of Turner syndrome. Moving beyond pediatric growth, Professor Conway dives into crucial updates on managing the "adult phenotype," specifically focusing on liver health, comorbidities, and hormone replacement therapy (HRT).

A major highlight of this episode is the call to rethink HRT protocols. Professor Conway argues against conservative pediatric guidelines, advocating for estrogen therapy to begin as early as 9 or 10 years old to mimic normal physiology, which ensures optimal brain, bone, and uterine development. He also challenges the...

In this episode, we bring you a recent Myhealth Academy webinar with Dr Alice Huang on Reproductive Genetic Carrier Screening and Genetic Testing: What Every GP Should Know. This session explores the evolving role of genetic screening in reproductive care, equipping GPs with the knowledge to navigate testing options, interpret results, and support patients through increasingly complex clinical decisions.

Description:

Reproductive genetic carrier screening (RGCS) is emerging as an essential element of preconception and fertility care within Australian general practice. It plays a vital role in providing individuals and couples with critical information about their...

Treating clinicians rely on pathology to help diagnose and stage their patient which fundamentally determines the treatment management plan. Therefore, it is incredibly important to get it right in the first place.

In this engaging podcast aimed at GPs, our multidisciplinary experts discuss:

In today's podcast, Associate Professor Martin MacDonald examines the interplay between Chronic Obstructive Pulmonary Disease (COPD) and cardiovascular disease, emphasizing the high rates of undiagnosed cardiovascular issues in COPD patients.

He highlights studies showing an increased risk of cardiovascular events regardless of traditional risk factors and urges clinicians to proactively assess cardiovascular health when managing COPD. MacDonald advocates for non-invasive diagnostic tools and a shift in treatment strategies that integrate cardiovascular care into COPD management.

This podcast was recorded live at the Monash Lung and Sleep Institute: COPD, Interstitial lung diseases, upper airway pathologies and...

Melanoma has many mimics, making detection a challenge. However, early detection and appropriate management of melanoma is crucial to ensuring a patient has the best chance of survival.

In this podcast from Melanoma Institute Australia, their multidisciplinary panel discuss:

In addition, the panel reviews a case study to put learnings into practice.

SPEAKERS

In today's podcast, the focus is on the integration of technology into diabetes management, particularly type 2 diabetes care.

Dr Rajini Jayaballa, an endocrinologist and clinical lead at Western Sydney Diabetes, opens the session by presenting compelling statistics about diabetes prevalence in Western Sydney, indicating a significant economic burden that necessitates innovative solutions for prevention, detection, and management of the condition. With the estimated cost of diabetes care near 17.6 billion dollars annually, the need for investment in effective management strategies is underscored.

The discussion then transitions to the transformative role of technology in diabetes care, emphasizing...

In this podcast, kidney specialist George Tsihlis discusses managing diabetic kidney disease, highlighting its rising prevalence in Australia.

1.3 million Australians were living with diabetes as of 2021, marking a three-fold increase since the start of the century.

Tsihlis underscores the gravity of diabetic nephropathy, noting that one in three individuals with diabetes will develop this condition, which is the leading cause of kidney failure in the region. He cites a significant increase in cardiovascular mortality among patients with diabetic nephropathy, with 31% mortality over ten years, compared to 11% for those without it.

He covers the...

Are your osteoarthritis patients stuck in a cycle of ineffective pain management? Are we relying too much on MRIs and surgical referrals instead of treating the whole person?

Today, we are putting an end to the "wear and tear" myth and exploring exciting new and emerging therapies, from holistic core treatments to GLP-1 agonists that will empower your patients and revolutionize your primary care practice.

Joining us is Professor David Hunter. Professor Hunter is a rheumatologist clinician-researcher whose primary research focus is clinical and translational research in osteoarthritis. He is ranked as the leading expert...

Dr Kieran Kennedy explores adult ADHD diagnosis, highlighting DSM-5 criteria, effective assessment strategies, and distinguishing it from comorbid conditions, while addressing treatment and social norms' impact on symptoms.

He highlights the importance of understanding the foundational diagnostic criteria as laid out in the DSM-5, and addresses the nuances of adult presentations compared to children. Dr Kennedy emphasizes the role of thorough history-taking and open-ended questions in assessments, distinguishing ADHD from comorbid conditions such as anxiety and depression.

The discussion also covers effective assessment tools, treatment considerations, and the impact of social norms on symptom expression.<...

Diabetes medications - a discussion with Assoc Professor Samantha Hocking, Dr Jeremy Knott and Jaybee Serrano.

This podcast examines the use of GLP-1 receptor agonists and incretin-based therapies, focusing on their implications in cases such as pancreatitis, disordered eating, retinopathy, and surgical protocols.

Key points include the cautious use of GLP-1s in patients with a history of pancreatitis, the necessity for a multidisciplinary approach when treating patients with eating disorders, and monitoring eye health due to potential impacts on retinopathy.

Additionally, management during surgical procedures is discussed, emphasizing the importance of withholding...

This General Practice Clinical Sessions Podcast explores ischemic heart disease in women, the second leading cause of death among Australian females.

It highlights the Yentl syndrome, which leads to underdiagnosis due to the necessity of presenting with male-associated symptoms. The speaker discusses traditional and unique risk factors impacting women's health, including pregnancy complications and mental health issues.

Diagnostic challenges are addressed, particularly the limitations of angiography in recognizing microvascular complications, and the concept of ENOCA is introduced.

Case studies illustrate complex presentations. The podcast advocates for a comprehensive approach to diagnosis and management...

This General Practice Clinical Sessions Podcast with Prof Veronica Preda, explores Polycystic Ovary Syndrome (PCOS), highlighting its metabolic implications beyond reproductive issues and the role of general practitioners in women's health.

Key insights from Australian and international guidelines redefine PCOS as a multi-organ condition, necessitating updated diagnostic criteria.

The discussion covers various phenotypes, ethnic differences, and the influence of adiposity on metabolic health, as well as essential screening for cardiometabolic risks.

Psychosocial dimensions are addressed, advocating for a holistic approach that includes lifestyle modifications.

Treatment strategies combine pharmacological methods with diet...

This episode of General Practice Clinical Sessions explores the intricacies of chronic kidney disease (CKD) in women, highlighting disparities in diagnosis, treatment, and care compared to men. It addresses the underrepresentation of women in clinical trials and sociocultural factors affecting care, noting that women with CKD are less likely to be identified or treated adequately.

The discussion includes the impact of CKD on fertility and pregnancy, detailing risks related to renal function and management strategies for pregnant women. Menopausal considerations are also covered, emphasizing the earlier onset of menopause and associated cardiovascular risks.

The podcast...

In this General Practice Podcast, Dr Yu-Fang Wu, an endocrinologist at Macquarie University Hospital, provides a focused overview of menopause care for general practitioners. He highlights the significance of recognizing menopause as a critical phase in women's health and discusses common yet often overlooked symptoms. Using five hypothetical patient cases, Wu illustrates diverse menopause experiences and outlines key learning objectives, including symptom identification, assessment for menopausal hormone therapy (MHT), and referral guidelines.

The talk covers MHT indications, types, and associated risks, emphasizing the importance of personalized treatment plans. Wu concludes with tailored recommendations for managing specific patient...

This General Practice Podcast focuses on managing overweight women with oligomenorrhea seeking conception, highlighting the role of weight loss in fertility.

It evaluates GLP-1 receptor agonists and their implications for contraception, while discussing ovulation induction with clomiphene versus letrozole. Hormone replacement therapy (HRT) is addressed, along with complications of obesity, cardiovascular health, and innovative approaches for managing estrogen deficiency post-hysterectomy.

The session emphasizes personalized care strategies and the importance of patient engagement in addressing anxieties around treatment options.

This episode was recorded live at the launch of the Heart, Endocrine and Renal (HER...

This podcast featuring Professor Xiaoqi Feng and Professor Thomas Astell Burt,explores the significant impact of nature on health through the concept of nature prescription, focusing on the need for urban environments that integrate green spaces to enhance public health.

Extensive research has consistently shown that access to green space is vital for health, particularly in combating chronic diseases like obesity and diabetes. The discussion transitions into the epidemiological evidence that reveals the need for a minimum of 30% tree canopy coverage in urban areas to support public health outcomes, including reduced risks of various health conditions.

This episode, featuring Dr. Julie Wehbe based on material by Professor Richard Newton, explores the pathophysiology of ADHD and its significant overlap with other psychiatric pathologies, particularly eating disorders.

The etiology of ADHD is described through a "gene-environment interaction" model. While genetics play a massive role—with heritability estimated at 70-80%—environmental factors such as maternal stress, toxin exposure, and childhood instability are crucial contributors. The presentation emphasizes that ADHD rarely appears in isolation, frequently co-occurring with conditions like autism spectrum disorder (ASD), mood disorders, substance use, and obesity.

A core theme is the neurobiological conn...

In this General Practice podcast, Dr Will Errington discusses the inadequacies in current diagnosis and management practices for ADHD and ED, emphasizing the significance of proper screening, referencing key tools and methodologies that can facilitate accurate evaluations.

The variability in resources and access across different states underline the challenges practitioners face in delivering consistent care. The podcast touches on the historical context of ADHD as a diagnosis and how societal perceptions have changed over time, which impacts both recognition and treatment.

A detailed examination of clinical practices reveals the logistical difficulties practitioners encounter, such as...

Hosted by: Dr. Kate Wylie (Doctors for the Environment Australia)

Episode Summary

In this episode of the General Practice Webinar Catchup Podcast, we dive into the intersection of finance and planetary health. Originally hosted by Doctors for the Environment Australia (https://www.dea.org.au/), this session explores how medical professionals and the general public, can use their money as a tool for good.

Dr. Kate Wylie is joined by experts in financial planning, climate analytics, and shareholder activism to discuss how to harness the power of money to drive climate solutions. The...

In today's podcast, Prof Param Nair focuses on advancements in imaging techniques, particularly functional MRI, and their applications in the assessment of lower airway diseases. He introduces the concept of functional imaging, emphasizing its growing importance in clinical and research settings. The conversation highlights the integration of comprehensive imaging programs within clinical care, illustrating the transformative potential of combining research with practical applications.

Prof Param Nair, explains the advantages of using hyperpolarized gases, such as xenon, in MRI to visualize airflow and lung functionality, underscoring the limitations of traditional imaging techniques that often focus on structural rather...

Diabetes and Frailty Professor Richard Lindley, Anandhi Murugesan and Tim Bailey-Coles

This session explores the complexity of managing diabetes in older adults, a demographic where medical success has led to "life extension" with disability rather than a compression of morbidity. Professor Richard Lindley argues that because frailty dominates modern medicine, clinicians must measure it, recommending the Clinical Frailty Scale (CFS) as a quick, essential tool for the electronic medical record. He presents retrospective analyses of major trials, revealing that while intensive blood pressure and glucose lowering can be harmful or attenuated in the frail (as seen in...

In this podcast, Associate Professor Joanne Rimmer provides an in-depth analysis of the surgical management of chronic rhinosinusitis (CRS) with nasal polyps. She highlights the importance of structural nasal anatomy in patient assessments and discusses various types of rhinitis and sinusitis with an emphasis on evolving classifications. Professor Rimmer details common symptoms, surgical procedures such as septoplasty and inferior turbinoplasty, and the necessity for patient education regarding surgical outcomes. She introduces functional endoscopic sinus surgery (FESS) and shares case studies demonstrating the need for tailored approaches based on CRS subtypes. The episode also covers the role of biologics in...

In today's podcast, Victoria Silvestro and Dr Shannon Lin discuss sustainable diets and lifestyle modifications for patients using GLP-1 medications to achieve weight loss and improve diabetes outcomes. They highlight the critical link between obesity and diabetes and recommend an initial 10% weight loss target for health benefits.

The conversation covers the importance of lifestyle changes, including dietary strategies like Very Low-Calorie Diets and diabetes-specific nutrition formulas. A comparative analysis of various Very Low-Calorie Diets products and their effects on glycemic management is presented, emphasizing the role of monitoring and insulin adjustments.

The session further explores...

This podcast by Associate Professor Yet Khor offers an update on interstitial pneumonia (IP) and interstitial lung disease (ILD), focusing on advancements in classification and diagnosis over the past two decades. Dr. Khor discusses the significance of recognizing both idiopathic and secondary causes, highlights key developments, such as the identification of idiopathic nonspecific interstitial pneumonia (NSIP), and advocates for improved diagnostic protocols, particularly concerning antigen-negative fibrotic hypersensitivity pneumonitis.

In a significant part of her discussion, Dr. Khor introduces the concept of disease behavior classification, which provides insights into patient prognosis and treatment goals. The lecture emphasizes the...

Panel Discussion Dr Antony Kodsi, Prof Sam Adie, Dr Razvan Stoita

The podcast opens with a discussion around the decision-making process regarding prosthesis options in surgical orthopedics. One participant clarifies that while the fund doesn't dictate the type of implants used by surgeons, it does influence rehabilitation protocols, emphasizing a model where patients are encouraged to return home shortly after surgery. The conversation highlights that surgeons retain the autonomy to select implants based on individual patient needs, with one panelist explaining their personal disinterest in managed care because it challenges the equitable provision of patient care.

Delivering a net-zero health system with Professor Nick Watts, Director, Centre for Sustainable Medicine, University of Singapore.

In this podcast from the Alfred Emergency Academic Centre's Collaboration & Leadership for Sustainable Healthcare Symposium, Professor Nick Watts, the Director of the Center for Sustainable Medicine at the National University of Singapore, presents an insightful and impassioned discussion on the intersection of healthcare and climate change. With a rich background as the first Chief Sustainability Officer for the NHS and as co-founder of multiple health alliances focused on climate, Watts draws on his extensive experience to explore the evolution of...

In this podcast, Dr. Kodsi, an adult medicine physician with expertise in palliative and pain medicine, addresses the challenging topic of chronic post-surgical pain management. He begins with an illustrative case of a 62-year-old retired teacher named Margaret who, despite a successful mastectomy and a cancer-free diagnosis, continues to experience significant pain affecting her quality of life. Dr. Kodsi emphasizes that chronic post-surgical pain is a prevalent issue, impacting approximately half of patients undergoing high-risk procedures, such as mastectomies. He highlights the importance of recognizing and addressing these pain issues as they often manifest in a general practice setting...

Hip Assessing hip pain in primary care Professor Sam Adie

In this podcast, Professor Sam Addy, an orthopedic and trauma surgery specialist at the University of New South Wales, provides a comprehensive overview of hip pain, particularly focusing on its assessment within primary care settings. With a solid foundation in orthopedic surgery and extensive research experience, Professor Addy outlines the epidemiology, causes, and management strategies for hip pain, setting the stage for a nuanced understanding of this common ailment.

The lecture begins with an exploration of the epidemiological factors influencing hip pain, particularly in older...

Hip Osteoarthritis and surgical interventions Dr Razvan Stoita

In this podcast, Dr Razvan Stoita, a highly skilled orthopedic surgeon specialized in hip and knee surgeries, delivers an extensive lecture on the treatment of hip osteoarthritis. He emphasizes the importance of distinguishing between non-operative and surgical management of the condition, clarifying that while non-replacement options were already addressed by a colleague, his focus will primarily be on hip replacement techniques and their applications in various patient scenarios.

Starting with a review of non-operative treatments, Dr Stoita contrasts recommendations from the College of General Practitioners with those...

Supporting geriatric patients through orthopaedic surgery with Dr Nargis Shaheen

This podcast focuses on the complexities of managing surgical patients in the elderly demographic, emphasizing the critical nature of preoperative assessments and the need for tailored approaches to care. The speaker highlights the increasing prevalence of elderly patients undergoing surgery and the associated heightened risks, including complications such as organ dysfunction, cognitive decline, and functional impairment. Given these factors, it is imperative to adopt a well-rounded approach that encompasses thorough risk-benefit analyses and shared decision-making between healthcare providers and patients.

A significant portion of the...

Knee Osteoarthritis and Surgical Interventions with Dr Jonathan Negus

This podcast explores the various facets of knee surgery, including robotic techniques, prehabilitation, and rehabilitation strategies. Dr Jonathan Negus shares insights drawn from nearly two decades of practice as well as emerging technologies that promise to improve patient outcomes. A key aim of the lecture is to clarify the surgical role in treating knee issues, particularly osteoarthritis, which is commonly accompanied by various degrees of degeneration in knee tissues.

In discussing patient demographics, the lecture notes a trend toward younger patients with knee arthritis, often resulting...

Comorbidities, obesity, diabetes and age why they matter for hip and knee joints Dr Bernard Zicat

This podcast centers on the complex interplay between obesity and diabetes as comorbidities in the field of orthopedics, specifically focusing on their impact on surgical outcomes in hip and knee arthroplasty. Dr Bernard Zicat, with extensive experience in implant design since 1994, reflects on the evolving perceptions of these conditions in the surgical realm.

The discussion begins with an overview of diabetes, acknowledged as a significant concern due to its historical links to wound healing and infection risks in surgical...

Session 2 Panel Discussion Dr Nargis Shaheen, Dr Jonathan Negus, Dr Bernard Zicat

The discussion focuses on the management of Prolia, an injectable osteoporosis medication, particularly in the context of total shoulder arthroplasty and its timing relative to surgical procedures. The discussion begins by highlighting the importance of educating general practitioners (GPs) regarding the administration and timing of Prolia in relation to arthroplasty surgeries, emphasizing a one to three-month window post-injection for optimal outcomes. The panelists agree on the critical nature of timing, noting that delaying the next dose of Prolia could lead to adverse effects such as...

Lower limb Sports injuries in patients who are ‘young at heart’ Dr Michael Dan

In this podcast, Michael Dan, an Australian-trained lower limb orthopedic surgeon with specialized training in knee procedures, discusses the management of lower limb sports injuries, particularly as they relate to patients who remain active despite aging. His focus is primarily on the intersection of arthritis and meniscal injuries in the knee, drawing on both his professional expertise and personal experiences, particularly as a participant in athletic events like the City to Surf.

Dan begins by acknowledging the disparities in outcomes following knee...

Degenerative rotator cuff disease vs osteoarthritis Associate Professor Sumit Raniga

This podcast features Dr. Sumit Raniga, an academic orthopedic surgeon specializing in the intricacies of shoulder and elbow reconstruction and joint replacement. With a robust background in molecular medicine and biomechanics, Dr. Raniga leads the upper limb surgery and therapy team at Macquarie University and directs the Macquarie University Translational Orthopedic Research Program. His presentation focuses on a significant comparison between degenerative rotator cuff disease and osteoarthritis, delving into the underlying mechanisms, patient management, and predictive anatomical factors involved in these distinct conditions.

Dr. Raniga...

The discussion focuses on the complexities surrounding shoulder surgery, particularly the use of reverse total shoulder arthroplasties (RTSA) for cases involving rotator cuff tears and related arthropathy. The speaker, Simit, explains that while reverse shoulder replacements are becoming prevalent, the indications for them are more nuanced than simply addressing rotator cuff damages. There is a noted increase in RTSA cases due to previous neglect in managing patients with full thickness rotator cuff tears that have advanced to massive tears and eventual rotator cuff tear arthropathy. The speakers emphasize the importance of early intervention, suggesting that careful management of these...

Panel Discussion Dr Alice Powell, Prof James Burrell, Ms Madelaine Rañola, RN

In this podcast, we delve into the financial implications and logistical challenges associated with new dementia therapies, particularly focusing on treatments such as dananimab and lacanemab. We discuss the estimated cost of these therapies, which can exceed $77,000 over an 18-month treatment period, and the potential out-of-pocket expenses associated with necessary scans and clinical assessments. The lecture emphasizes the high costs of both FDA-approved medications and the required diagnostic imaging, which could price many patients out of receiving these promising therapies. The discussion acknowledges the b...

Ms Madelaine Rañola, RN

The podcast presents an insightful exploration of the support needs for individuals and families coping with dementia and Parkinson's disease, led by clinical nurse consultant Madeleine Rañola. With her extensive background in neuroscience, nursing, and clinical research, she provides a comprehensive overview of the unique challenges faced by patients diagnosed with these neurodegenerative diseases, emphasizing the importance of individualized care and support systems.

Rañola begins by outlining the various dimensions of care required for patients suffering from dementia, highlighting the myriad types of dementia and the necessity for pat...