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Read the latest articles relevant to your clinical practice, including exclusive insights from Healthed surveys and polls.

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Dr Linda Calabresi
  • Clinical Articles

Correct inhaler technique

Recognise this scenario? You prescribe an inhaler for the patient. You educate the patient on why they need the inhaler. You draw diagrams. You demonstrate the technique on the placebo inhaler. You write the script. And then… you cross your fingers.

By Dr Linda Calabresi
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Dr Linda Calabresi
  • Clinical Articles

Laser ablation works best for varicose veins

Endovenous laser ablation has been rated as the most successful and cost-effective treatment for varicose veins over surgery and sclerotherapy, according to recent research. In a UK randomised controlled trial involving almost 800 patients, researchers analysed quality of life questionnaires completed by trial participants five years after having their varicose veins treated via one of these methods. “This large, multicentre trial … showed that in all three groups, quality of life five years after treatment was improved from baseline,” the study authors wrote in The New England Journal of Medicine.

By Dr Linda Calabresi
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Dr Linda Calabresi
  • Clinical Articles

Optimising the value of PSA testing

Screening for prostate cancer with PSA testing has always been a bit controversial. Initially the high rate of false positives, especially in younger men, had most GPs questioning whether overall, we were doing more harm than good. But it would seem we’ve come a long way since those early days. Not only do we understand a lot more about the PSA test itself, but also, we now are better able to determine what an elevated PSA signifies in a particular patient through tools such as imaging, before subjecting the man to a series of invasive procedures.

By Dr Linda Calabresi
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Prof Martha Hickey
  • Clinical Articles

The latest on menopausal hormone therapy and breast cancer

Menopause is a normal life stage for women at around 51 years. Most women don’t need treatment for their symptoms, but around 13% of Australian women aged 50-69 take menopausal hormone therapy (sometimes called “hormone replacement therapy”). This medication contains hormones that are normally low or absent after menopause, and reduces symptoms such as hot flushes and night sweats, which can be troublesome and persistent for some women. But growing evidence over recent years has pointed to an increased risk of breast cancer associated with menopausal hormone therapy. This has already led some women to stop or avoid the treatment.

By Prof Martha Hickey, Prof Mark Jenkins
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Dr Linda Calabresi
  • Clinical Articles

Paracetamol – the hidden harm

While the ‘opioid epidemic’ might be grabbing all the headlines at the moment, Australian toxicologists are reminding us that paracetamol is the most common drug used in overdoses in this country. What’s more the numbers of both paracetamol-related hospital admissions and liver injury have been increasing over the past decade at a rate that far exceeds the rate of population increase. According to a retrospective study recently published in The Medical Journal of Australia, there has been an average 3.8% annual increase in the number of paracetamol-related hospital admissions since 2007, and a mean 7.7% annual increase in paracetamol-related liver injury cases, whereas the population has been increasing at a rate of only 1.6% annually.

By Dr Linda Calabresi
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Dr Linda Calabresi
  • Clinical Articles

Pre-live vaccine checklist

Any doctor who has done the online yellow fever vaccination training module on the ACRRM website will be aware of this resource. It’s a straight-forward, one-page pdf that presents a set of questions you need to ask the patient to see whether there are any contraindications to them receiving the yellow fever vaccination or indeed any live vaccine. The checklist has been derived from information in the Australian Immunisation Handbook, and it is both succinct and comprehensive.

By Dr Linda Calabresi
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Dr Linda Calabresi
  • Clinical Articles

Live longer – eat less meat

Want your best chance for living a long, healthy life? Have a diet that is high in plant protein, say Japanese researchers. That’s the suggestion following their prospective study of over 70,000 adults, recently published in JAMA Internal Medicine. According to their findings, a higher intake of plant protein was associated with lower total mortality, specifically mortality related to cardiovascular disease. In fact, those people whose diet was proportionally in the highest bracket for plant protein were up to 41% less likely to die from a heart attack or stroke.

By Dr Linda Calabresi
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Dr Lawrie Bott
  • Clinical Articles

Understanding glomerular filtration rate

Glomerular filtration rate (GFR) is the best single measure of kidney function. A subnormal GFR is an important early indicator of possible chronic kidney disease. However, it also does not identify the cause. It is also not a ‘catch all’, for example, in early diabetes mellitus, GFR will typically be normal or even increased, due to ‘hyperfiltration’. Optimal detection and risk stratification of early kidney disease also requires measurement of urine albumin, rather than just eGFR.

By Dr Lawrie Bott
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Dr Vivienne Miller
  • Clinical Articles

Assessing stroke risk – easier than saying “CHA2DS2-VA Score”!

General Practitioner Dr Vivienne Miller takes a look at what’s changed in the recently updated CHA2DS2-VASC Score for the determination of stroke risk factors from atrial fibrillation. The CHA2DS2-VA Score was updated from the CHA2DS2-VASC Score last year to exclude female sex (represented by Sc) in the determination of stroke risk factors from atrial fibrillation. The two scores are identical, apart from the exclusion of female sex, which is no longer considered an outright risk factor in stroke from atrial fibrillation, but more of a ‘risk modifier’ of this complication.1General Practitioner Dr Vivienne Miller takes a look at what’s changed in the recently updated CHA2DS2-VASC Score for the determination of stroke risk factors from atrial fibrillation. The CHA2DS2-VA Score was updated from the CHA2DS2-VASC Score last year to exclude female sex (represented by Sc) in the determination of stroke risk factors from atrial fibrillation. The two scores are identical, apart from the exclusion of female sex, which is no longer considered an outright risk factor in stroke from atrial fibrillation, but more of a ‘risk modifier’ of this complication.

By Dr Vivienne Miller
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Brian Brooks
  • Clinical Articles

Concussion in kids: Insomnia treatment linked to faster recovery

Active kids sustain injuries. It is estimated that every year more than 100,000 Canadian children and adolescents get a concussion while participating in normal childhood activities, like sports and play. Most kids return to school and activities within about one month of the injury, but sometimes they need specialized concussion treatment and rehabilitation. Our recent study, published in the Journal of Head Trauma Rehabilitation, found that psychotherapy can improve adolescents’ insomnia after concussion and that it also improves overall post-concussion recovery.

By Brian Brooks, Lianne Tomfohr-Madsen
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Dr Linda Calabresi
  • Clinical Articles

Subclinical hypothyroidism in pregnancy, is it a real risk?

In the ‘largest analysis to date’, researchers have determined that subclinical hypothyroidism is associated with preterm birth but have stopped short of recommending screening. It is well-known that overt thyroid disease in pregnancy is linked with preterm birth, as defined as delivery before 37 weeks. But whether milder forms of thyroid disease make a difference has been controversial.

By Dr Linda Calabresi
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Dr Linda Calabresi
  • Clinical Articles

Sprained ankle physiotherapy

It’s that time of year. Cold weather. Footy season. Finals approaching. Muscles pulled. Ankles twisted…. Of course, the elite sportspeople will have their support team to strap, massage, rehabilitate and retrain the injured joint or muscle – coaxing it back to good health. But for your average ill-fated weekend exerciser with a sprained ankle, they will present in general practice (generally on a Monday) wanting advice on how to expedite their recovery inexpensively and in a manner that doesn’t risk further injury.

By Dr Linda Calabresi

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