In this podcast, Associate Professor Joanne Rimmer provides an in-depth analysis of the surgical management of chronic rhinosinusitis (CRS) with nasal polyps. She highlights the importance of structural nasal anatomy in patient assessments and discusses various types of rhinitis and sinusitis with an emphasis on evolving classifications. Professor Rimmer details common symptoms, surgical procedures such as septoplasty and inferior turbinoplasty, and the necessity for patient education regarding surgical outcomes. She introduces functional endoscopic sinus surgery (FESS) and shares case studies demonstrating the need for tailored approaches based on CRS subtypes. The episode also covers the role of biologics in CRS management while affirming the ongoing relevance of surgery for severe cases. Professor Rimmer concludes by addressing recurrence patterns of nasal polyps and the importance of an integrative approach for effective long-term treatment strategies.

This podcast was recorded live at the Monash Lung and Sleep Institute: COPD, Interstitial lung diseases, upper airway pathologies and occupational lung diseases State of the Art Symposium in Melbourne.

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Disclaimer: Content is for health professionals and general educational purposes only. It is not medical advice or a substitute for independent clinical judgement. Always consult current guidelines, product information and local protocols. Views expressed are those of the presenters and not necessarily ArmchairMedical. ArmchairMedical accepts no responsibility or liability for any loss or harm resulting from reliance on the information provided.

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In today's podcast, Victoria Silvestro and Dr Shannon Lin discuss sustainable diets and lifestyle modifications for patients using GLP-1 medications to achieve weight loss and improve diabetes outcomes. They highlight the critical link between obesity and diabetes and recommend an initial 10% weight loss target for health benefits.

The conversation covers the importance of lifestyle changes, including dietary strategies like Very Low-Calorie Diets and diabetes-specific nutrition formulas. A comparative analysis of various Very Low-Calorie Diets products and their effects on glycemic management is presented, emphasizing the role of monitoring and insulin adjustments.

The session further explores the tailored benefits of diabetes-specific nutrition formulas for individuals facing dietary challenges, reinforcing the significance of integrating both strategies into personalized diabetes care plans to promote lasting lifestyle changes.

This podcast was recorded live at the Western Sydney Diabetes Masterclass in Sydney.

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General Practitioners: Earn your full year's worth of CPD including Educational Activities, Reviewing Performance and Measuring Outcomes CPD Hours.

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Press play. You’re at the conference.

In this episode of ArmchairMedical Conference Podcasts, we bring Australia’s leading medical conference education straight to your headphones.

No travel.

No full days away from clinic.

No disruption to your life.

Each episode features real conference lectures, captured live and carefully curated into short, practical, evidence-based podcasts designed for busy general practitioners.

Whether you’re commuting, exercising, or moving through the gaps of your day, this is conference-quality learning that fits real GP life.

If you value staying at the leading edge of medicine, but don’t have the time to attend every conference, this is the smart way to do it.

🎧 Press play. You’re at the conference.

ArmchairMedical Conference Podcasts transform Australia’s best medical conferences into on-demand audio education for GPs. Learn from leading clinicians and experts, anytime and anywhere, in a format designed to work with - not against - your day.

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Disclaimer: Content is for health professionals and general educational purposes only. It is not medical advice or a substitute for independent clinical judgement. Always consult current guidelines, product information and local protocols. Views expressed are those of the presenters and not necessarily ArmchairMedical. ArmchairMedical accepts no responsibility or liability for any loss or harm resulting from reliance on the information provided.

Visit https://www.armchairmedical.tv/podcasts for more information.

This podcast by Associate Professor Yet Khor offers an update on interstitial pneumonia (IP) and interstitial lung disease (ILD), focusing on advancements in classification and diagnosis over the past two decades. Dr. Khor discusses the significance of recognizing both idiopathic and secondary causes, highlights key developments, such as the identification of idiopathic nonspecific interstitial pneumonia (NSIP), and advocates for improved diagnostic protocols, particularly concerning antigen-negative fibrotic hypersensitivity pneumonitis.

In a significant part of her discussion, Dr. Khor introduces the concept of disease behavior classification, which provides insights into patient prognosis and treatment goals. The lecture emphasizes the recognition of mixed presentations in patients, where they may exhibit features of multiple patterns rather than fitting neatly into a single classification. This highlights the complication of diagnosing ILD.

The podcast transitions into an exploration of recent findings related to the complications of diagnosing antigen-negative fibrotic hypersensitivity pneumonitis (HP), where a subset of patients exhibit progressive lung function decline despite the absence of identifiable antigens. Dr. Khor raises important considerations regarding the implications of these cases and the clinical challenges they pose, thus advocating for a re-evaluation of current diagnostic protocols and potential reclassification to spur further investigation in this area.

This podcast was recorded live at the Monash Lung and Sleep Institute: COPD, Interstitial lung diseases, upper airway pathologies and occupational lung diseases State of the Art Symposium in Melbourne.

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Access thousands of additional conference podcasts and 'full video' podcasts including synchronised PowerPoint slides at https://www.armchairmedical.tv/podcasts

Disclaimer: Content is for health professionals and general educational purposes only. It is not medical advice or a substitute for independent clinical judgement. Always consult current guidelines, product information and local protocols. Views expressed are those of the presenters and not necessarily ArmchairMedical. ArmchairMedical accepts no responsibility or liability for any loss or harm resulting from reliance on the information provided.

Visit https://www.armchairmedical.tv/podcasts for more information.

Panel Discussion Dr Antony Kodsi, Prof Sam Adie, Dr Razvan Stoita

The podcast opens with a discussion around the decision-making process regarding prosthesis options in surgical orthopedics. One participant clarifies that while the fund doesn't dictate the type of implants used by surgeons, it does influence rehabilitation protocols, emphasizing a model where patients are encouraged to return home shortly after surgery. The conversation highlights that surgeons retain the autonomy to select implants based on individual patient needs, with one panelist explaining their personal disinterest in managed care because it challenges the equitable provision of patient care.

As the discussion transitions, a specific case is presented, who is described as a patient suffering from chronic pain post-repeated hip replacements. The experts address the complexities associated with distinguishing pain sources in patients who have undergone multiple revisions. They stress the importance of understanding multifactorial pain—where surgery is not necessarily a panacea for all patient issues. The panel agrees on the necessity for thorough diagnostic assessments and emphasizes the importance of patient involvement in their recovery. Treatment strategies discussed include targeted medication regimens, potential use of procedures like fascia iliaca blocks, and considering non-surgical contributions to pain, such as sensitization or issues related to surrounding joints.

The conversation evolves to include specific inquiries about lidocaine use in post-operative settings, where it is noted that its utility is often limited to intraoperative scenarios, particularly involving nerve structures. Michael, another participant, stresses the need for accurate diagnosis before considering further surgical interventions for painful joint replacements, reiterating that understanding the root cause of pain is critical.

Questions arise about the appropriateness of second opinions. The surgeons generally favor patients returning to their original surgeon unless there's a clear mechanical issue needing reevaluation. They advocate for continued patient support, focusing on reassurance and recovery guidance, indicating that unnecessary second opinions could lead to further anxiety rather than providing solutions.

The discussion then touches on the challenges of managing postoperative opioid prescriptions. The panel acknowledges common practices whereby patients leave hospitals on opioids, leading to a concerted effort in primary care to manage tapering and long-term use. They suggest that an effective pathway would involve early screening and referrals to pain specialists when red flags are present.

Next, the complex issue of medicinal cannabis is broached. Participants outline the current lack of robust evidence supporting its use in pain management, particularly emphasizing the need for more definitive research in the orthopedic space. While acknowledging its potential, they express skepticism about its efficacy and the risks involved.

A case study of a patient with bilateral knee replacements facing postoperative pain issues brings forth a discussion on chronic pain after surgery, where the challenges of knee interventions contrast with other joint surgeries. Noting a significant percentage of unhappy knee replacement patients, the participants stress that chronic pain management requires a multidisciplinary approach, incorporating psychological support and the continuous reassessment of the surgical intervention's outcomes.

Towards the end of the interview, they discuss initiatives aimed at establishing a more structured model of care to address the needs of patients suffering from chronic postoperative pain. This highlights the necessity for collaborative efforts among surgeons, primary care physicians, and allied health professionals in creating comprehensive care plans.

The...

Delivering a net-zero health system with Professor Nick Watts, Director, Centre for Sustainable Medicine, University of Singapore.

In this podcast from the Alfred Emergency Academic Centre's Collaboration & Leadership for Sustainable Healthcare Symposium, Professor Nick Watts, the Director of the Center for Sustainable Medicine at the National University of Singapore, presents an insightful and impassioned discussion on the intersection of healthcare and climate change. With a rich background as the first Chief Sustainability Officer for the NHS and as co-founder of multiple health alliances focused on climate, Watts draws on his extensive experience to explore the evolution of the healthcare sector's engagement with environmental sustainability.

Watts begins by setting the stage for a critical moment regarding climate policy in the UK, highlighting a recent announcement by the Conservative Party that threatens to repeal the UK Climate Change Act if reelected. This raises fundamental questions about political engagement and the continuing commitment to climate action across party lines, a historical norm that seems to be eroding. He reflects on how political leaders from various parties have previously championed climate action and illustrates the potential ramifications of such a shift in the political landscape, emphasizing the urgency for healthcare professionals to respond to these developments.

Tracing the evolution of climate and health discourse back to the late 1980s and early 1990s, Watts notes the initial phase characterized by advocacy from passionate clinicians and organizations dedicated to raising awareness. He recalls significant milestones, such as the establishment of health chapters within global climate change frameworks and the emergence of new institutions focused on environmental health. Notably, he credits the shift towards data-driven dialogues that provided empirical evidence of the health impacts of climate change, facilitating broader acceptance and integration of these issues into mainstream medical practice.

As the narrative progresses, Watts outlines a critical transition in the healthcare sector, particularly from advocacy to practical delivery of sustainable practices, highlighting the role of healthcare systems in reducing carbon emissions. He paints a vivid picture of a transformation where hospitals and healthcare providers across the globe are adopting net-zero commitments, emphasizing the healthcare sector's economic weight and influence. The lecture transitions into celebrating the collaborative efforts that have emerged, as health systems now share a common goal and are recognized as capable agents of change toward climate action.

Watts also discusses the need for evolution in skills among healthcare professionals to maintain momentum amid growing challenges, such as increasingly mean political climates. He argues for better education in carbon literacy and a push for rigorous evaluations of healthcare interventions aimed at sustainability. This emphasis on evidence-based practices ties back to the necessity for the sector to be equipped with the right metrics and evaluations to push back against any skepticism regarding the healthcare community’s climate action.

The importance of collaboration is underscored throughout Watts' talk, highlighting collective strength as pivotal in navigating present and future challenges posed by climate change. He shares poignant examples of healthcare workers supporting one another through tough times, stressing the value of camaraderie and shared purpose in the sustainability journey. This aspect of community building emerges as a vital theme, reinforcing the notion that collective efforts can lead to significant advancements in sustainable healthcare practices.

In conclusion, Watts reiterates the immense potential found within smaller yet passionate communities within Australia, inspiring a sense of...

In this podcast, Dr. Kodsi, an adult medicine physician with expertise in palliative and pain medicine, addresses the challenging topic of chronic post-surgical pain management. He begins with an illustrative case of a 62-year-old retired teacher named Margaret who, despite a successful mastectomy and a cancer-free diagnosis, continues to experience significant pain affecting her quality of life. Dr. Kodsi emphasizes that chronic post-surgical pain is a prevalent issue, impacting approximately half of patients undergoing high-risk procedures, such as mastectomies. He highlights the importance of recognizing and addressing these pain issues as they often manifest in a general practice setting rather than in surgical or hospital environments.

Dr. Kodsi sheds light on his journey as a pain specialist, underlining the crucial role that general practitioners play in managing chronic pain. He insists on early collaboration between general practitioners, anesthetists, and pain specialists to prevent pain from becoming a long-term burden. Recognizing that the road to recovery can be disrupted by chronic pain, he introduces various interventions and strategies aimed at reducing the incidence of chronic pain in surgical patients.

A key focus of the lecture is the discussion of the factors that contribute to chronic post-surgical pain. Dr. Kodsi explains biological and psychological factors, emphasizing the role of demographic variables such as age and pre-existing psychological issues, including catastrophic beliefs about pain. Preoperative opioid use also emerges as a significant negative factor, complicating recovery and raising the risk of chronic pain outcomes. He encourages healthcare professionals to implement multimodal pain management strategies, focusing on preemptive analgesia to potentially mitigate hypersensitivity and its consequences.

As the lecture progresses, Dr. Kodsi reviews historical studies, including seminal surveys identifying the high prevalence of phantom limb pain and chronic pain following surgical interventions. He discusses the evolution of understanding chronic post-surgical pain and the classification criteria established over the years, highlighting the need for further understanding of pain mechanisms such as central sensitization and neuroplastic changes.

Delving into practical interventions, Dr. Kodsi outlines the objectives and mechanisms of various pain management strategies, including the use of diagnostic nerve blocks and the role of regional anesthesia. He emphasizes the concept of preventive analgesia, advocating for the administration of analgesics before surgical procedures to minimize the likelihood of developing chronic pain. The discussion includes a review of different analgesic agents and techniques, such as the use of gabapentinoids and corticosteroids, while addressing their respective risks and benefits during the preoperative and postoperative periods.

Moreover, he discusses the importance of assessing patients for neuropathic pain and the significance of opioid stewardship in managing postoperative pain. Dr. Kodsi highlights the necessity of transitioning patients off opioids whenever feasible and exploring alternative medications that could lower the chances of developing chronic post-surgical pain. He underscores the combination of pharmacological and non-pharmacological approaches as crucial to fostering better recovery outcomes for patients.

Chronic post surgical pain management Dr Anthony Kodsi

In conclusion, Dr. Kodsi emphasizes that effective management of chronic post-surgical pain begins with a recognition of the various risk factors involved, prompt preoperative planning, and collaborative pain management strategies. He calls upon general practitioners to actively participate in the prevention of chronic pain by understanding these dynamics and implementing immediate, evidence-based solutions to improve patient...

Hip Assessing hip pain in primary care Professor Sam Adie

In this podcast, Professor Sam Addy, an orthopedic and trauma surgery specialist at the University of New South Wales, provides a comprehensive overview of hip pain, particularly focusing on its assessment within primary care settings. With a solid foundation in orthopedic surgery and extensive research experience, Professor Addy outlines the epidemiology, causes, and management strategies for hip pain, setting the stage for a nuanced understanding of this common ailment.

The lecture begins with an exploration of the epidemiological factors influencing hip pain, particularly in older populations. Drawing on data from the Australian Joint Replacement Registry, Professor Addy highlights that the incidence of hip replacements primarily occurs in individuals aged between 55 and 75, predominantly due to osteoarthritis. This age-related trend underscores the importance of recognizing not only age as a risk factor but also the interplay of genetics, lifestyle choices, and previous injuries that can predispose individuals to hip disorders. Professor Addy points out other less common causes such as inflammatory arthritis and avascular necrosis, emphasizing the need for a broad differential diagnosis.

Moving forward, Professor Addy discusses the critical symptoms and signs associated with hip issues, including pain and functional limitations. He details how the pain often radiates from the hip joint to surrounding areas, particularly the groin and thigh, and warns clinicians to remain vigilant for pain indicators that may suggest non-hip-related diagnoses. The significance of a patient’s functional state is stressed, as the impact of hip pain varies substantially across different patient demographics. Tools like the Oxford Hip Score are introduced as valuable resources for assessing the functional impairment caused by hip disorders.

Assessment of hip pain is presented as a multi-faceted process, where a thorough patient history forms the core of accurate diagnosis. Professor Addy emphasizes the importance of understanding the nature of the pain, previous treatments received, and any co-morbidities that may complicate the clinical picture. His insights extend to the physical examination process, where he advocates for assessing gait, joint motion, and conducting targeted imaging studies such as weight-bearing X-rays, prior to resorting to advanced imaging like MRI or CT scans.

The discussion then transitions to non-surgical management strategies for hip pain, underscoring the importance of foundational treatments that should be implemented before considering surgical options. Professor Addy advocates for patient education, regular physiotherapy, and exercise as primary interventions. He encourages patients to adopt a proactive approach to their condition, noting that lifestyle adjustments and maintaining physical activity can significantly enhance quality of life.

Professor Addy outlines clear criteria for when referrals to specialists or surgical intervention may become necessary. He identifies persistence of joint-related pain despite conservative management, confirmatory imaging showing arthritis, and significant functional impairment as key indicators that should prompt specialist consultation. Additionally, he conveys his personal observations about the variable outcomes of surgical interventions, particularly noting that while hip replacements can offer substantial relief and high satisfaction rates for patients, outcomes can be more unpredictable compared to other joint surgeries.

In conclusion, Professor Addy encapsulates the essence of hip arthritis management by highlighting that a clinical assessment remains paramount, and that while conservative treatments are foundational, timely referrals can optimize patient outcomes. His insights serve as a guide for primary care providers, emphasizing the...

Hip Osteoarthritis and surgical interventions Dr Razvan Stoita

In this podcast, Dr Razvan Stoita, a highly skilled orthopedic surgeon specialized in hip and knee surgeries, delivers an extensive lecture on the treatment of hip osteoarthritis. He emphasizes the importance of distinguishing between non-operative and surgical management of the condition, clarifying that while non-replacement options were already addressed by a colleague, his focus will primarily be on hip replacement techniques and their applications in various patient scenarios.

Starting with a review of non-operative treatments, Dr Stoita contrasts recommendations from the College of General Practitioners with those from the Osteoarthritis Research Society International, highlighting common ground in the emphasis on education and exercise. He discusses the effect of low-impact activities such as walking and cycling, while identifying limitations in utilizing medications like non-steroidal anti-inflammatories and weight loss strategies, particularly in patients with severe obesity.

The core of his lecture revolves around the surgical intervention of hip replacement, where he discusses various techniques, including resurfacing options for younger patients. He explores the criteria for recommending surgery, stressing that symptoms such as pain and functional deficits are critical factors in decision-making rather than solely relying on radiological findings. He further elaborates on validated scoring systems like the HOOS score to assess patients' pain, stiffness, and overall quality of life, advocating for a thorough assessment of disability before offering surgical options.

Dr Stoita delves into the surgical planning process, emphasizing the need for detailed preoperative assessments including imaging techniques like CT scans to evaluate bone anatomy. He illustrates with case studies, showcasing diverse patient profiles from young individuals with complex deformities to elderly patients presenting multiple comorbidities. Each case is analyzed with a focus on tailored approaches to surgery, particularly concerning determining the appropriate surgical approach (anterior vs. posterior) to optimize outcomes.

Managing postoperative care is a significant aspect of his presentation. He discusses the importance of rapid mobilization and minimizing complications post-surgery, notably in elderly patients who face higher risks of falls and mobility issues. Dr Stoita highlights the ERAS (Enhanced Recovery After Surgery) model, outlining strategies to improve patient recovery times, reduce hospital stays, and enhance overall patient satisfaction.

In conclusion, the lecture encapsulates the intricacies of diagnosing and managing hip osteoarthritis, advocating for comprehensive care that encompasses both surgical interventions and responsible non-surgical management. Through this detailed exploration, Dr Stoita underscores the role of patient education, individualized care planning, and the consideration of each patient’s unique medical history and needs in achieving optimal surgical outcomes.

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Access thousands of additional conference podcasts and 'full video' podcasts including synchronised PowerPoint slides at https://www.armchairmedical.tv/podcasts

Disclaimer: Content is for health professionals and general educational purposes only. It is not medical advice or a substitute for independent clinical judgement. Always consult current guidelines, product information and local protocols. Views expressed are those of the presenters and not necessarily ArmchairMedical. ArmchairMedical accepts no responsibility or liability for any loss or harm resulting from reliance on the information provided.

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