General Practice Clinical Sessions 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...

Bone Health in Diabetes Dr Angela Sheu

In this episode, Dr Angela Sheu, a staff specialist endocrinologist, explores bone health in type 2 diabetes, discussing the increased risk of skeletal fragility and fractures. She highlights the elevated fracture risk and mortality rates post-fracture among diabetic individuals, as well as the complexities surrounding vertebral fractures. Sheu reviews clinical predictors of fractures linked to diabetes, including metabolic characteristics and duration of the condition. She emphasizes the limitations of traditional fracture risk assessment methods and introduces advanced imaging techniques, such as HRPQCT and the Trabecular Bone Score, to better evaluate bone...

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.

From titration and tolerance to nutrition and sustainable care featuring Dr. Angela Kwong

Bio: Dr. Angela Kwong is a Sydney-based GP and the RACGP NSW State Lead for Obesity Management, advocating for an integrated, multidisciplinary approach to metabolic and weight-related care. She has extensive experience supporting patients using GLP-1 receptor agonists and contributes to national discussions on safe, evidence-based obesity management in primary care.

Angela regularly presents at national conferences on obesity, digital health and collaborative models of care. In this webinar, she will share practical strategies to help GPs navigate medication titration, side-effect management...

Balancing chronic kidney disease and diabetes Michele Ryan.

In this episode, Michelle Ryan explores dietary management for individuals with chronic kidney disease (CKD) and diabetes, highlighting the unique challenges of carbohydrate and protein intake.

She discusses KDOKI recommendations for protein consumption, the benefits of a plant-based diet, and updated guidelines favoring a Mediterranean approach.

Practical meal planning strategies are provided, including optimal food proportions and potassium level management.

Ryan dispels myths about carbohydrates in diabetic diets and emphasizes the risks of food additives. The lecture concludes with actionable strategies for effectively...

Troubleshooting Pumps and CGM Tingting Xu.

In this episode, TingTing Xu discusses troubleshooting techniques for insulin pumps and continuous glucose monitors (CGMs). She details the critical functions and components of these devices, emphasizing their role in glycemic control for diabetes management. The session covers the two delivery methods of insulin pumps—bolus and basal—and compares various CGMs and pumps available in Australia. Xu addresses potential risks associated with device malfunctions and provides a structured approach for healthcare providers to manage common issues. A case study illustrates effective troubleshooting in an emergency scenario, highlighting the importance of prop...

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...

Pre conception Care and Post Partum Follow up in General Practitioners - How are we going Dr Mani Manoharan.

This podcast emphasizes the critical importance of preconception care and postpartum follow-up within Australia's healthcare system. It highlights that nearly half of pregnancies are unplanned, making preconception health crucial for positive lifelong outcomes in children. The speaker discusses systemic evidence showing how preconception care contributes to improved maternal and fetal health by encouraging healthier behaviors, reducing risks of congenital anomalies, and managing conditions like diabetes effectively. Obesity's impact on pregnancy is also addressed, alongside the necessity for continuous...

Pre existing diabetes in pregnancy and post partum Dr Natassia Rodrigo.

The podcast examines the management of pre-existing diabetes during pregnancy and the postpartum period, focusing on implications for maternal and fetal health. It outlines different types of pre-existing diabetes, highlights the increasing prevalence linked to factors like obesity and age, and discusses vulnerabilities in specific ethnic groups that experience poorer outcomes. Key risks associated with maternal hyperglycemia and the importance of optimizing glycemic control before and during pregnancy are emphasized, including recommended strategies such as self-monitoring and multidisciplinary care. The complexities of managing weight gain and...

Pre pregnancy and Pregnancy Management of Women who have Undergone Bariatric Surgery Dr Gilly Rosic

In this episode, Dr Gilly Rosic, a dietician at the Family Metabolic Health Service, provides a thorough overview of preconception and pregnancy care for women with a history of bariatric surgery. The discussion emphasizes the role of the OPAL Clinic in supporting women with obesity to enhance pregnancy outcomes. She addresses the rising rates of obesity among Australian women and its effects on reproductive health, including fertility challenges and pregnancy complications. The lecture highlights the link between bariatric surgery and improved fertility...

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...

Contraception and Pregnancy Planning in Diabetes Assoc Professor Emily Hibbert.

Assoc Professor Emily Hibbert's podcast explores the intersection of diabetes management and pregnancy planning for women with diabetes mellitus. It emphasizes the rising risks during pregnancy and the importance of effective preconception care. Hibbert highlights the poorer outcomes for pregnant women with diabetes and the critical need for glucose control. The lecture advocates for comprehensive care, including safe contraceptive use and education, identifying long-acting reversible contraceptives as ideal. Case studies demonstrate the benefits of targeted education, concluding with a call for improved collaboration in women's health care.<...

Fertility and type 2 diabetes Inoka Perera.

Registered dietitian Inoka discusses the critical link between type 2 diabetes and fertility, emphasizing the need for a comprehensive approach that includes both partners. Through a case study, she illustrates how undiagnosed male diabetes can affect sperm quality and highlights the physiological impacts of diabetes on reproductive health. The episode covers the importance of preconception health, monitoring clinical markers, and addressing nutritional deficiencies, while also advocating for glycemic control and individualized supplementation to optimize fertility outcomes. Inoka concludes with a call for proactive diabetes management and a multidisciplinary care approach.

...

Overview, Screening and Diagnosis Professor David Simmons.

This podcast provides an overview of gestational diabetes mellitus (GDM), distinguishing it from pre-gestational diabetes and emphasizing early screening due to the presence of elevated glucose levels prior to conception. Statistically, around 50,000 pregnancies in Australia are affected each year. The speaker highlights increased risks associated with early-onset GDM and the need for timely intervention, citing studies that show improved outcomes when GDM is managed early.

The discussion advocates for updated diagnostic criteria, including ethnic considerations in screening. The lecture concludes by calling for a shift in viewing GDM...

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...

Operationalising the DAP+ Model of Care Alicia Southwell.

Alicia Southall's podcast covered the Diabetes Alliance Program Plus model of care, which has evolved since 2014. Key enhancements from a recent philanthropy grant include engaging 60 new GP practices, expanding specialist diabetes care via the Medibus in rural areas, and implementing virtual case conferences. Southall detailed the referral triage process, onboarding for new practices, and evaluation methods using Patient Reported Outcome Measures. The Medibus offers innovative diabetes care in remote locations, and lifestyle wellbeing modules developed with the University of Newcastle support patient self-management. Overall, the lecture emphasized collaboration for...

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...

From Delivery to Data Results from the DAP+ for Patients and Providers Professor Alexis Hure.

The Western Sydney Masterclass led by Professor Alexis Hure centers on the Diabetes Alliance Program Plus, a model aimed at enhancing diabetes management. The lecture outlines the program's core components, including joint case conferencing and data-driven quality improvement initiatives. With over 200 general practices involved, the initiative has facilitated over 7,000 patient care conferences and educated more than 3,000 healthcare practitioners through diabetes masterclasses.

Data collection strategies and economic evaluations are discussed, emphasizing the importance of clinical data and qualitative insights for improved...

Integrated Diabetes Care Through Diabetes Alliance Program+ (DAP+) A Win Win Model for Patients and Providers Professor Shamasunder Acharya.

In this podcast, Dr. Shamasunder Acharya, an endocrinologist, explores the Integrated Diabetes Care model within the Diabetes Alliance Program Plus, focusing on enhancing diabetes management for patients and supporting healthcare providers. The discussion acknowledges the challenges faced by Indigenous populations and presents alarming diabetes statistics in Australia, including the impact of clinical inertia on timely treatments. Dr. Acharya highlights regional disparities in diabetes care and outlines the Diabetes Alliance Program's evolution, key components, and innovative outreach strategies, such...

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.