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In Depth Articles

Blood Pressure Targets – What Does the New Guideline Say and How Low Should You Go?

July 27, 2016

This week, the Heart Foundation launched new national guidelines on the management of high blood pressure (hypertension). There are several changes since the last edition, but the one making headlines is a lower blood-pressure target. Instead of aiming for a (systolic) target of 140 in most people with hypertension, 120 …

Teenage Pain Often Dismissed as ‘Growing Pains’, But it Can Impact Their Lives

Most of us know someone who has “a bad back”. Research tells us up to 70% of people will experience back pain at some stage during their lives. But what about when a child or teenager complains of musculoskeletal pain such as back or neck pain?
The most common type of …

Mal de Debarquement Syndrome

July 20, 2016

Mal de debarquement syndrome (MdDS) is uncommon and is a condition that is not well known to many doctors. It is becoming more frequently identified in patients due to increasing global travel.
MdDS is the inappropriate and persistent sensation of feeling unsteady, dizzy or rocking after passive travel (typically boat cruises, …

Antidepressants May Not Be as Effective as we Thought, and Shouldn’t Be the Only Treatment for Depression

July 14, 2016

The treatment of depression too often means treatment with antidepressants. Australia has one of the highest rates of antidepressant use in the world. This continues to increase despite mounting evidence they are not especially effective.
My colleague Andrew Chanen and I have just published an article that describes the apparent falling …

The Link Between Chronic Pain and Depression: Which Comes First?

July 06, 2016

It’s easy to imagine that people with persistent pain have cause to become depressed. After all, it’s a problem that affects every part of life, not just the bit that got injured.
But like so much to do with persistent pain, it becomes harder to unravel exactly what the relationship is …

Slowing of Kidney Disease in People with Diabetes with Empagliflozin

June 29, 2016

Kidney disease is a significant concern issue in the management of patients with type 2 diabetes, with 35% of patients eventually developing it and almost half of the renal-dialysis population now made up of those with diabetes.
Last year the EMPA-REG study showed that in high cardiovascular risk patients with diabetes, …

Macular Degeneration: Is the Antioxidant Advice Still the Same?

The Age-Related Eye Disease Study (AREDS) published in 2005 was pivotal in drawing attention to the association of vitamin and mineral supplementation and macular degeneration. But is the advice still the same eleven years later?
Eleven retinal specialty clinics enrolled 4,757 participants (aged 55 to 80 years) in the Age-Related Eye Disease …

Another New Diabetes Drug Shown to Reduce Cardiovascular Deaths

June 22, 2016

Following on from the recent EMPA-REG study showing a reduction in cardiovascular deaths in people with diabetes and high cardiovascular risk who were treated with empagliflozin (Jardiance), a new study has shown reduction in cardiovascular deaths in similar patients treated with liraglutide (Victoza).
Last week at the American Diabetes Association Annual …

Does Sex Addiction Exist?

The question today is – is sex addiction a distinct condition? Or is it an assortment of several other conditions, such as hypomania and mania, obsessive-compulsive disorder, a coping mechanism for stress, habit, maladaptive behaviours regarding interpersonal and relationship issues, an impulse control disorder, narcissistic ego gratification, hedonism, an excuse …

Fast Facts about Lichen Sclerosus et Atrophicus

June 15, 2016

This condition is 10x more common in women than men and occurs mostly in the older age groups, although approximately 10% of cases occur in children.1 The hallmark of lichen sclerosus et atrophicus is progressive thinning and loss of flexibility of the skin of the vulva, perineum and perianal area, …

Reduction in Cardiovascular Deaths with New Diabetes Agent

Approximately half of all deaths in people with type 2 diabetes are caused by heart disease, and the life expectancy of people with type 2 diabetes at high cardiovascular (CV) risk is reduced by approximately 12 years. Therefore, addressing the burden of CVD is fundamental to the management of diabetes. …

Should Metformin be used for Chemoprevention of Cancer?

June 08, 2016

Metformin is a biguanide that has been used for decades in the management of insulin resistance and diabetes. It decreases blood glucose levels by increasing glucose uptake in muscle and fat cells and supressing gluconeogenesis and glycogenolysis in the liver.1  Metformin does this by activation of AMP-activated protein kinase (AMPK) …