Everyday Medicine with Dr Luke

In this podcast episode, we have a conversation with physiotherapist Ryan Johnson of R3 Physiotherapy in London who is passionate about gait correction and has written a book called The Way to Walk.  I looked forward to this conversation as Ryan’s strategies address some very major public health problems in our community with 20-37% of 45-year-olds and older estimated to be experiencing foot...

Prostate cancer is the second most commonly diagnosed cancer among men and the second most common cause of death from cancer in men, yet many prostate cancers are not fatal and some autopsy series have demonstrated up to 50% or more silent prostate cancers in men over the age of 70 years. At 50 years of age some studies suggest a 40% chance of harbouring a latent cancer, 16% chance of developing a...

Personalised medicine also known as precision medicine uses the knowledge of genetics to help predict disease development and to influence decisions about lifestyle choices and to tailor treatment to a particular individual’s tumour. The hope is that personalised medicine will allow more appropriate choices of targeted therapy and minimise side effects rather than choosing a “one size fits all” ap...

Cancer is responsible for over 40,000 deaths annually in Australia and has traditionally been managed by modalities including surgery, radiotherapy and chemotherapy. In 1992, Tasuku Honjo’s discovery of checkpoint proteins on tumour cells led to the birth of immunotherapy which has revolutionised the treatment of many cancers including bladder and kidney cancer, head and neck cancer, melanoma, non...

In this podcast episode we have a conversation with Mr Andrew Tang, Director of the Epworth Musculoskeletal Clinical Institute and an experienced orthopaedic surgeon operating at Epworth Richmond and St John of God Berwick since the early 1990’s. He has a particular interest in robotic knee surgery which allows improved accuracy with implant positioning and as the convenor of the Internal Orthopae...

As clinicians we are often faced with the dilemma of working up cystic structures in the pancreas. These may have been discovered incidentally but may also be clinically relevant and contributing to symptoms. In this podcast episode we are joined by Mithra Sritharan a hepatopancreaticobiliary and general surgeon with a particular interest in liver and pancreatic disease, but whose management skill...

Our approach to space-occupying lesions (SOL’s) in the liver is dependent on a firm knowledge of the potential pathology, the choice of imaging modality and the understanding of any background clinical liver disease in the index patient. We are joined today by expert hepatopancreaticobiliary and general surgeon Mr Mithra Sritharan, who carefully guides us through a logical approach to liver SOL’s...

In this episode, we talk with experienced general practitioner Dr Sally McDonald who has committed a large part of her time, energy and emotion providing palliative care for her local community. Palliative care is care focused on improving the quality of life for people and families with serious illnesses, directed at treating the symptoms of the patient, support for patient’s families and loved o...

Seizures may be defined as a transient disturbance of cerebral function due to abnormal paroxysmal neuronal discharge in the brain with epilepsy defined by any disorder characterised by recurrent (more than two) unprovoked seizures. It is estimated that 1-2% of the Australian population experience epileptic seizures in adult life and up to 4% of children experience epileptic seizures. With over 40...

Australia is in the dawn of its vaccination program against SARS-COV2, inoculations commenced this week among frontline health workers and aged care residents as well as our Prime Minister. By comparison, Israel’s vaccination rollout has been the fastest in the world, half the population has received one dose already and one third has received both inoculations. In a sense, Israel has become a rea...

It is estimated that more than 56,000 strokes will be experienced by Australians this year (new and recurrent) and that half of Australians are living with the effects of a stroke which remains the third leading cause of death in Australia and kills more women than breast cancer and more men than prostate cancer. As more than 80% of strokes may be prevented and four in 10 stroke survivors have a r...

It is estimated that 130,000 Australians have been diagnosed with insulin dependent diabetes mellitus with about seven new cases per day. Approximately 60% of the diagnoses are in children and young adults under the age of 25 years. As IDDM is an autoimmune disease resulting in the destruction of insulin producing cells, glycaemic control is obtained through the administration of insulin. There ha...

Endorectal ultrasonography combined with anorectal physiology allows the evaluation of the constituents of the wall of the anal canal and the scientific understanding of anorectal pathophysiology. It is very important to appreciate a patient’s anorectal dynamics before initiating an effective management strategy for what may be a wide variety of pelvic-anorectal disorders. In this episode we are j...

Robotic assisted surgery allows doctors to perform complex procedures with more precision, flexibility and control than is possible with conventional techniques.  Now used in many forms of surgery including cardiac, prostatic and orthopaedic, in this episode we are joined by the dynamic and highly skilled Mr T C Nguyen who discusses – · The application of robotic surgery to colorectal patholo...

Wednesday 19th June 2019 was a historic day for Victoria after parliament introduced voluntary assisted dying legislation to the community for patients facing imminent death as a result of incurable disease, with that ruling a patient’s decision to end his or her life voluntarily became a possibility. The legislation is complicated and coupled with many safeguards. VAD has understandably been deba...

Medical cannabinoids are derived from the cannabis sativa plant. There are 144 known cannabinoids, THC is perhaps the best known for its psycho-active effects, however cannabidiol (CBD) is now being recognised for its many medical applications. To discuss the role of cannabidiol in medicine we are joined by Dr Sud Agarwal, anaesthetist and CEO of one of Australia’s most interesting and emerging bi...

In 2019 experienced anaesthetist Dr Tom Edgley was left to defend his two properties in the rural and bushy enclave of Tonimbuk from the disastrous fires claiming over 26 properties in the region. Not only did Tom survive protecting his properties from the fire, but he also lent a major hand to his neighbours and was involved in the emotional rehabilitation of his community. He cited his attendanc...

In this episode we have a conversation about Type 2 diabetes, a condition that affects at least 1.2 million Australians (5% of Australians) and for which there are a complex number of pharmacologic treatment strategies available. We are joined by experienced and very popular Endocrinologist Dr Chin Tan who discusses – · Oral hypoglycaemic agents that are available to us in Australia · How to combi...

The transfer of stool from a healthy donor into the gastrointestinal tract of a recipient (FMT) at first consideration does not seem like a reasonable or scientific approach to the treatment of gastrointestinal diseases. Historically however, it has been used by communities for over 3,000 years, gaining credibility in 1958 after a paper by Eisemen in Denver who described treating pseudomembranous...

DARCY HOLT - BIOLOGICS AND SMALL MOLECULES FOR INFLAMMATORY BOWEL DISEASE Biologic agents (produced in living organisms or containing components of living organisms) coupled with a variety of new small molecules (acting in novel ways to influence the human immune system) have dramatically improved medical management of inflammatory bowel disease. In this podcast episode, we are joined by Dr Darcy...

Inflammatory Bowel Disease (IBD) affects approximately 85,000 Australians and 5 million people worldwide and includes Crohn’s disease and ulcerative colitis. These conditions may have a major impact on patient’s quality of life. To discuss both ulcerative colitis and Crohn’s disease in more detail we are joined by Dr Catherine Sorrell, a very experienced and popular gastroenterologist who takes us...

Australia has led the world in pain management, interventional techniques and pain research including in the management of severe and debilitating axial and musculoskeletal pain via spinal cord and DRG stimulation as well as in several evolving techniques for the management of visceral pain.   Recently potential breakthroughs have been emerging in the application of spinal cord stimulation to...

In this episode I have a conversation with Dr Puneet Mahindra on the subject of Barrett’s oesophagus. Puneet not only discusses the origins of this condition, named after Australian born thoracic surgeon Mr Norman Barrett, but also discusses – · Its relationship to chronic reflux disease · Adenocarcinoma risk · Surveillance guidelines · Appropriate medical management Puneet makes the point that Ba...

In this episode I interview experienced gastroenterologist Dr Puneet Mahindra on the common clinical problem of gastro-oesophageal reflux disease. Puneet details – · Risk factors · Complications · Approaches to management He provides personal tips drawn from experience and the literature outlining an approach that should be helpful to everyone practicing clinical medicine. Puneet also walks us thr...

It is estimated that at least 300,000 Australians have chronic heart failure imposing a significant impact on the quality of life and mortality. In this podcast episode, we are joined by an experienced interventional cardiologist, Dr James Sapontis, as we explore heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF). James carefully dissect...