The GP Show

A/Professor Megan Munsie PhD is the Deputy Director for the Centre for Stem Cell Systems at The University of Melbourne and the Head of the Education, Ethics, Law & Community Awareness Unit at Stem Cells Australia www.stemcellsaustralia.edu.au

Stem cell therapy is something I am being asked more and more about so I did some research and came across A/Prof Munsie. Are they just another snake oil or do stem cells hold great opportunity for treating a wide range of severe and common disorders? Today we find out:

- What are stem cells

- What conditions is there consistent evidence in treatment?

- What treatment avenues are we exploring?

- Where is it too early to be recommending stem cells?

- The occurrence of commercial exploitation

- Risks, cost and ethics of stem cell therapy

Below is a list of helpful resources:

• NHMRC Quick Guide for GPs: Stem Cell Treatments
• NHMRC Stem Cell Treatments: Frequently Asked Questions
• Australian Stem Cell Handbook (co-developed by National Stem Cell Foundation of Australia and Stem Cells Australia)
• Patient Handbook - International Society for Stem Cell Research _ multiple languages
• Stem cell treatment and regulation - a quick guide for consumers - Therapeutic Goods Administration
• A Closer Look At Stem Cells website (also developed by ISSCR)
• EuroStemCell Factsheets about what are stem cells and how they could help different conditions
• MOVE - Stem Cell Treatments (PDF also available; co-developed with Stem Cells Australia and relates to muscle, bone, joint applications)
• Australasian College of Sports and Exercise Physicians - Position Statement on MSCs

Today I am joined by Dr Johanna Lynch, GP, completing a PhD in primary care mental health assessment, post graduate training in grief and loss and a special interest in trauma and attachment.

At least 1 in 8 consults in GP is related to mental health and this is increasing. According to the World Health Organization, unipolar depressive disorders alone were ranked as the third leading cause of the global burden of disease in 2004 and will move into the first place by 2030.

Upskilling in mental health care is crucial in all areas of GP, not just classic mental illness but also in behaviour change, giving difficult diagnosis and managing treatments and expectations.

What i love about talking with health professionals are their varied interests and developed skills. Johanna is a GP who has dedicated her life to mental health, and she is a treasure trove of wise analogies and useful resources. As usual we barely scratched the surface. The learning never stops...

Further reading:

Australian Society of Psychological Medicine (ASPM) - https://www.aspm.org.au/

CORE assessment tool = Clinical Outcomes in Routine Evaluation - Outcome Measure http://www.coreims.co.uk/About_Measurement_CORE_Tools.html https://www.sussex.ac.uk/webteam/gateway/file.php?name=core.pdf&site=322

Mood Assessment Program (MAP) - https://www.blackdoginstitute.org.au/education-training/health-professionals/mood-assessment-program

Internal Family Systems - Dr Richard Schwartz -https://www.selfleadership.org/

Today I am joined by Dr Johanna Lynch, GP, completing a PhD in primary care mental health assessment, post graduate training in grief and loss and a special interest in trauma and attachment.

At least 1 in 8 consults in GP is related to mental health and this is increasing. According to the World Health Organization, unipolar depressive disorders alone were ranked as the third leading cause of the global burden of disease in 2004 and will move into the first place by 2030.

Upskilling in mental health care is crucial in all areas of GP, not just classic mental illness but also in behaviour change, giving difficult diagnosis and managing treatments and expectations.

What i love about talking with health professionals are their varied interests and developed skills. Johanna is a GP who has dedicated her life to mental health, and she is a treasure trove of wise analogies and useful resources. As usual we barely scratched the surface. The learning never stops...

Further reading:

Australian Society of Psychological Medicine (ASPM) - https://www.aspm.org.au/

CORE assessment tool = Clinical Outcomes in Routine Evaluation - Outcome Measure http://www.coreims.co.uk/About_Measurement_CORE_Tools.html https://www.sussex.ac.uk/webteam/gateway/file.php?name=core.pdf&site=322

Mood Assessment Program (MAP) - https://www.blackdoginstitute.org.au/education-training/health-professionals/mood-assessment-program

Internal Family Systems - Dr Richard Schwartz -https://www.selfleadership.org/

Today I am joined by A/Professor David Colquhoun, Cardiologist, Lipidologist, President of the QLD Heart Foundation, Co-President of the Clinical and Preventative Council of the Cardiac Society of Australia and New Zealand, and Senior Lecturer at the University of Queensland School of Medicine. He has dedicated his life to reducing cardiovascular disease, and pleasingly with a strong focus on improving lifestyle factors.

Risk assessment and importance of using overall risk instead of single factors, Calcium score scan use, Risk calculation in those >75 years, Risk assessment and treatment options including mediterranean diet, exercise, mental health, social isolation, even owning dogs versus cats! Fibrates and triglycerides

Post production:

Mediterranean Diet detail and benefits

Statins - efficacy, indication, side effects (fatigue, myalgia, diabetes, memory/cognitive impairment, rhabdomyolysis, haemorrhagic stroke) and bias in statin studies

Calcium Score Scans - http://www.csanz.edu.au/wp-content/uploads/2016/11/CAC_Position-Statement_Exec-Summary_ratified-4-August-2016.pdf

Mediterranean Diet:

https://academic.oup.com/eurheartj/article/37/39/2999/2414995/2016-ESC-EAS-Guidelines-for-the-Management-of

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684076/

https://www.ncbi.nlm.nih.gov/pubmed/26528631

http://www.bmj.com/content/337/bmj.a1344

Statins:

https://www.ncbi.nlm.nih.gov/pubmed/27838722

Fatigue - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4285455/

Memory - https://www.ncbi.nlm.nih.gov/pubmed/24247674

Diabetes - https://www.ncbi.nlm.nih.gov/pubmed/25887679

Myalgia/stroke - http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(16)31357-5.pdf,

https://www.mja.com.au/system/files/issues/ham00039.pdf

Bias - http://www.bmj.com/content/349/bmj.g5949

Today I am joined by A/Professor David Colquhoun, Cardiologist, Lipidologist, President of the QLD Heart Foundation, Co-President of the Clinical and Preventative Council of the Cardiac Society of Australia and New Zealand, and Senior Lecturer at the University of Queensland School of Medicine. He has dedicated his life to reducing cardiovascular disease, and pleasingly with a strong focus on improving lifestyle factors.

Part 1 - Cholesterol and CVD risk, Lipid "hypothesis" - is it still a hypothesis? Cholesterol physiology, Measuring sub-fractions and receptor ratios - is there a point? Reducing cholesterol LDL and CVD risk with medication statins, ezetemide and lifestyle, Measuring fasting vs non fasting cholesterol, Cholesterol relevance in age - is it a risk or protective factor? Do statins reduce risk regardless of cholesterol?

Part 2 - CVD risk assessment and treatment,

Risk assessment and importance of using overall risk instead of single factors, Calcium score scan use, Risk calculation in those >75 years, Risk assessment and treatment options including mediterranean diet, exercise, mental health, social isolation, even owning dogs versus cats! Fibrates and triglycerides,

Statins and side effects = what's the evidence?

Further reading:

https://www.heartfoundation.org.au/images/uploads/publications/Absolute-CVD-Risk-Full-Guidelines.pdf

CVD risk, low LDL and artherosclerosis regression https://www.mja.com.au/system/files/issues/ham00039.pdf

Fasting vs non-fasting cholesterol testing - https://www.rcpa.edu.au/getattachment/0961c6d1-ec80-4500-8dc0-de516500e05b/Lipid-and-lipoprotein-testing.aspx

Mediterranean Diet and CVD - https://www.ncbi.nlm.nih.gov/pubmed/26528631

https://academic.oup.com/eurheartj/article/37/39/2999/2414995

http://www.bmj.com/content/337/bmj.a1344

Calcium Score Scans - http://www.csanz.edu.au/wp-content/uploads/2016/11/CAC_Position-Statement_Exec-Summary_ratified-4-August-2016.pdf

Evidence and resources for part 2 will be placed in part 2 show notes

Cheers all

Today I am joined by exercise physiologist Tim Douge to discuss what role EPs play in disease management and prevention and how GPs and allied health can work more closely to benefit patients.

Today I am joined by exercise physiologist Tim Douge to discuss what role EPs play in disease management and prevention and how GPs and allied health can work more closely to benefit patients.