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In Depth Articles

Improving male fertility – a missed opportunity

October 02, 2019

Lack of knowledge and lack of opportunity are two key reasons why Australian GPs aren’t counselling men about how to improve their fertility.
According to a survey of over 300 practising GPs, the vast majority (90%) did not feel confident in their knowledge about modifiable risk factors that affect male fertility.
And …

Managing young people with ADHD – from personal experience

September 25, 2019

 
The usual medical focus in articles about ADHD is on how to support the family that is coping with a child with ADHD. Another common focus is about the misdiagnosis of ADHD, and how medication is overprescribed. This article is different. I want to emphasise, from personal experience, the importance …

Hyperkalaemia – harmless artefact or medical emergency?

September 24, 2019

Elevated potassium is one of the most vexing problems faced by a clinician because of the difficulty knowing whether an elevated level (for example, 7.5mmol/L) is a
harmless artefact or imminently lethal hyperkalaemia.
The clinical background is critical to interpretation.

Possible collection issues affecting serum potassium

Difficult collection

The two main ways a collection can cause elevated potassium are:

Prolonged tourniquet application with hand-clenching (‘making a fist’). Asking patients to clench their fist increases potassium by 2mmol/L, due …

Modern-day PSA screening

“The concept of age-related PSA levels is actually out of date” says Brisbane urologic oncologist Dr Ian Vela, at least when it comes to suspecting prostate cancer.
Whereas in the past clinicians would be reassured by levels that remained in the age-related reference range, these days it is considered more important …

Treating menopausal symptoms in 2019

September 18, 2019

Hormone replacement therapy has recently hit the headlines again and not in a good way. A research paper published in The Lancet reignited the controversy by again highlighting an association between hormone therapy and breast cancer.
While the experts have been quick in their response, pointing out the numerous limitations of …

Is vigorous exercise safe during the third trimester of pregnancy?

Expectant mothers receive an avalanche of information about potential risks to their baby. There’s a growing list of foods, toxins and environmental threats to avoid. It’s normal for this to lead to an increased level of anxiety.
As a result, some women believe it’s safer to avoid any risks in pregnancy, …

Do supplements help in mental illness?

Even primary school children know a good diet and proper nutrition is important if you want to be physically healthy.
Eat the wrong things or insufficient of the good things and chances are you’re destined to develop heart problems, diabetes or cancer.
But what about a person’s psychological health? How important is …

Correct inhaler technique

September 11, 2019

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.
Inhalers are such a fundamental component of asthma and COPD …

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 …

Optimising the value of PSA testing

September 04, 2019

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 …

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 …

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 …