PLUS: She was 11 with an eating disorder. Researchers develop device that diffuses potent disinfectants. Scientists solve 60 year old mystery of how thalidomide caused birth defects.
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In This Issue: 9 August 2018


In-Depth Articles
Video
Recommended Resource
In the News
LDL - The Lower The Better
By Dr Linda Calabresi
GP and Medical Editor

Low density lipoprotein cholesterol is the well-known culprit in terms of cardiovascular risk.

Courtesy of a large meta-analysis of statin trials done in 2010 (the Cholesterol Treatment Trialists Collaboration), we know that for people starting with higher LDL-C levels (approximately 3.4 mmol/L), they can lower their risk of having a major adverse vascular event by 22%, every time they lower their LDL-C level by 1mmol/L.

But what happens once your LDL level is lower? Can you continue to increase your protection by lowering your LDL levels further? Or does the beneficial effect plateau at a certain level? Or, worse still can very low LDL levels actually cause harm?

A new meta-analysis just published in JAMA Cardiology has gone some way in answering these questions.

Click here to continue reading.


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Typhoid In The Modern Era

The microbiology laboratory has made great strides in introducing clinically useful diagnostics over the past couple of decades, particularly in recent years with the development of molecular assays that ‘narrow the gap’ and provide early diagnoses.

While introducing new tests, it has also been important to evaluate and discard old tests that may not contribute greatly to patient outcomes. One such test that has come under the spotlight is the classic Widal agglutination test in the diagnosis of typhoid.

The Widal test, developed by George Fernand Widal in 1896, uses a suspension of killed Salmonella typhi as antigen to detect agglutinating antibodies to somatic O antigens and flagellar H antigens present in serum of typhoid patients. There are many reasons for its lack of clinical utility.

 Antibodies are not present in the acute illness and take time to develop.
Significant cross reactivity can occur with other infectious agents that mimic typhoid including malaria, dengue, endocarditis, tuberculosis and chronic liver disease.

Click here to continue reading.

 

COPD Updates: Pharmaceutical Benefits Advisory Committee Recommendations about Inhaled Medications
 
Download Healthed's monograph by Dr Philip Lee, BScMed MBBS (Hons) UNSW FRACP.

This article discusses the updated recommendations for use of inhaled medications in patients with chronic obstructive pulmonary disease, effective 1 August 2018.

Dr Philip Lee is a consultant in Respiratory and Sleep Medicine at St George Hospital. He has received local and international awards for his research work with continuing clinical and research interests in COPD, respiratory failure, non-invasive ventilation and sleep medicine. He is an expert advisor for Research Review Australia in COPD and has been an invited speaker at various local meetings. In 2016, Dr Lee received the St George Individual Volunteer Achievement Award for his outstanding contribution to the community.
Download the monograph!
Medications For Osteoarthritis

Interview with Prof. Arun Aggarwal (3 mins)

Alcohol Withdrawal At Home
For most GPs, patients wanting to kick their alcohol addiction get referred to specialised detox clinics or Drug and Alcohol Units. And while this practice is logical and safe, a recent study on a select group of addicted patients suggests there is another effective option. (1)

For some patients, a medically supervised alcohol withdrawal program at home is not only as safe as a clinic program but may also be more effective long-term, especially in those patients who did most of their excessive drinking in the home. Basically the thinking is if you can kick the habit in the environment that provides the greatest temptation, you’ve overcome the greatest hurdle.

Of course, you need to pick your patient. They have to be otherwise well and have someone there, with them all the time, willing to watch them and call for help if needs be.


In terms of pharmacotherapy, there is a resource, developed by SA Health that is particularly good. The guide to managing alcohol withdrawal in the home setting details the appropriate medications and dosages for patients in this situation. It also makes available a symptom chart that enables the carer to document the patient’s condition over time, allowing for accurate and appropriate monitoring and tailoring of treatment.

Alcohol withdrawal in the home setting is obviously not for everyone. But if a GP has a patient who is requesting this, and all the caveats are met, then this resource provides a very good framework for medically managing and monitoring the process.

 

Click here for more information.

In The News

I've never been to medical school, but after doing a lot of research on her symptoms, I finally diagnosed Norah, my tennis-playing, Minecraft-building, school-loving daughter with a non-body-image eating disorder that began just before her 11th birthday. Eating disorders have the highest mortality rate of any mental health condition, which is why every parent needs to know our story......Read More>>

Researchers develop device that diffuses potent disinfectants for airborne delivery

In a study published in the August issue of Applied Microbiology and Biotechnology, the team used the device to atomize disinfectants onto environmental surfaces contaminated with bacteria and showed that it effectively eliminated 100 percent of bacteria that commonly cause hospital-acquired infections. In addition, atomized bleach solution, ethanol and TEG completely eliminated highly multi-drug resistant strains of bacteria including K. pneumoniae......Read More>>


Scientists solve 60-year old mystery of how thalidomide caused birth defects

More than 60 years after the drug thalidomide caused birth defects in thousands of children whose mothers took the drug while pregnant, scientists at Dana-Farber Cancer Institute have solved a mystery that has lingered ever since the dangers of the drug first became apparent: how did the drug produce such severe fetal harm?....Read More>>

Notes and Resources from Seminars

The Annual Women's & Children's Health Update 2018
Healthed newsletters are for health professionals only

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