Dr Dave teaches Dr Jo about Suicide prevention with new NHS and NICE guidance discouraging risk stratification tools and instead emphasising relational safety, a biopsychosocial approach, dynamic safety planning, inclusivity, and clear communication. Dr Dave covers paediatric gastroenteritis, a recent NEJM study confirms oral ondansetron’s effectiveness in reducing vomiting in children, with NZFC guidance supporting its use for dehydration-related cases. Privacy and safety intersect in the discussion of HIPC Rule 11, which allows clinicians to disclose health information without consent if there is a serious threat to life or health, provided specific criteria are met and documentation is thorough. In diabetes care, once-weekly insulin icodec is found to be as effective as daily long-acting insulins, though it is not yet approved in New Zealand and is more costly. Insomnia management advances include the approval of lemborexant, a DORA, with evidence supporting its efficacy and safety, though it remains unsubsidised. COPD management is updated with guidance on triple therapy and the role of eosinophil counts, while iron deficiency is clarified with new diagnostic and monitoring recommendations. Finally, Dr Jo learns about some adult ADHD management resources and gets recent insights into QTc-prolonging medications.
Dr Dave teaches Dr Jo about Malnutrition detection and management, the Breast screening age extension, Serum estradiol measurement in menopause, Anticoagulant monitoring equity concerns, Prostate cancer screening and digital rectal exam, Optimal Cancer Care Pathways (OCCPs), FIT for Symptomatic bowel pathway, Oral iron tablet supply issue:, and Adrenaline administration by vaccinators.
Apologies for the delayed publication of this epsiode.
Dr Dave talks to us about Desmopressin in nocturnal enuresis in children, ADHD resources, changes to the National Community Referral Criteria for Imaging, CT Imaging and Cancer Risk, greater Covid-19 antiviral eligibility, a reminder re hyperkalaemia, and widened access to meningococcal B vaccine.
Apologies for the delayed publication of this episode.
Dr Dave covers Kawasaki Disease, weaning antidepressants, firearms forms, buckle fracture management, carer benefit, mirena use for contraception extension to 8 years, more inhalers per script, resources including Healthify's app store and laughter for dry eyes.
Dr Jo leans the difference between poppers, nangs and nos, and some serious side effects of sniffing gas. Dr Dave share ssome ACC resources, information about accessing records after death and a surprising use for saffron.
Dr Dave teaches Dr Jo about driving tests and drug driving, a possible link between the shingles vaccine and reduced risk of dementia, the role of Denusumab in osteoporosis, that BV is an STI, using tranexemic acid for noseblleds, some drug updates, that it's OK to kiss someone if you are gluten intolerant, and about an unfortunate side effect of using a cellphone whilst on the toilet.
Dr Dave educates Dr Jo about hearing loss, ADHD treatment, SSRIS, Coffee and Afib, Derment resources, bits and bobs about pharmac updates and asks to rice or not to rice ?
Dr Dave reminds Dr Jo about testosterone, its limited indications and how to manage a patient who is using it. We talk about treatment injury overseas and paying for medical records, the dos and don'ts. Dementia and Asthma are our two equity topics. We finish with a few prescriber updates and a resource for coeliac disease identification.
Dr Dave educates Dr Jo about measles long term impacts, lymphocytosis, death docs and cremation rules, herpes testing and treating, and provides tools for cognitive testing, melanoma counselling and long covid management.
Dr Dave educates Dr Jo about prostate cancer screening, FIT for symptomatic colorectal conditions, infrequent Zolendronate in early menopause, dangers of isotretinoin, This Way Up online CBT, the equity topic this month is around H Pylori, plus a few more clinical snippets !
Dr Dave shares updates on empaglaflozin, fosfomycin, latent autoimmune diabetes, HINTS test for vertigo, pertussis, ADHD, treating family and friends this Christmas, and medical aspects of fitness to drive changes.
Dr Dave takes Dr Jo on a trip through sore eyes, syphilis, peripheral neuropthy, heart failure, how to take a BP, naltrexone and long covid, endometriosis and ovarian cancer, ACC via text, clinical gems and health equity.
Dr Dave teaches Dr Jo about the importance of documenting patient refusals and providing written information about treatment options and consequences.
They discuss innovative treatments such as using cooking salt for neonatal umbilical granulomas and duct tape for warts and review a study on habitual coffee drinking and its association with prediabetes remission.
Dave introduces Jo to BreastNet NZ, a knowledge base for clinicians about breast cancer, aimed at promoting best-practice care and other topics include the discontinuation of certain diabetes medications, safety netting advice in primary care, nitrofurantoin safety reminders, methylphenidate supply issues, and updated guidelines for Mpox
Dr Dave teaches Dr Jo about the complexities of deprescribing in older adults, focusing on the balance of benefits and risks associated with statins and aspirin for primary prevention of cardiovascular diseases. We'll also discuss the updated guidelines for managing fever in children, emphasizing the importance of evaluating all vital signs and the role of clinical judgment. Additionally, we'll touch on the latest pain management strategies, including updates on opioid choices and the management of complex regional pain syndrome. Finally, we'll highlight the significance of early diagnosis and management of Charcot neuro-arthropathy in diabetic patients.
Dr Dave covers updates on diverticulitis, post natal depression, WINZ and prescribing in pregnancy resources and shares a cautionary tale about abdominal trauma in children
Dr Dave teaches Dr Jo about Heart Foundation resources, Atrial fibrillation and anticoagulation, Liquid morphine formulations, Liraglutide and dulaglutide, Oestrogen patches, Potassium in dietary supplements, Medicine-induced hyponatraemia, pseudoephedrine, Prescribing to competitive athletes subject to drug testing, Montelukast, Vitamin D supplementation in pregnancy and infants, and Abortion reversal.
Dr Dave updates us about the child disability allowance, istretrinoin may not be quite as risky as feared for mental health issues, scabies treatment and how to maximise impact of permethrin, being wary of erectile dysfunction in young men, some medication updates, the EPIC dashboard and how to manage aggressive patients.
Dr Dave educates Dr Jo about ACC, otitis media, microplastics in his arteries, nsaids, contraceptives and blood clots, MANA tools and apathy in dementia, RSV vaccine, and the benefits of cycling to work in Scotland.
This month Dr Dave educates Dr Jo on issues around dementia and driving, extended use of mirena for contraception, nsaids for short term pain relief after fractures and numerous other topics.
Apologies to regular listeners for the delay in publising this episode we both had time away - hopefully the content was worth waiting for !
Dr Dave tells Dr Jo about weird ear creases, why two defibrillators are better than one, why post concussion syndrome doesn't exist anymore, what to think about when a teenager limps, and lots of stuff about medication supply issues.