Thyroid lumps have always been with us. Often referred to as goitres (interpreted from Latin to mean neck swelling), numerous ancient medical sources mention these and how to manage them.

However, it has only been with modern medicine and investigations that we can distinguish between benign and malignant lesions. In this episode, we examine the investigations, diagnosis, management and prognosis of thyroid lumps.

This is the story of Thyroid lumps (Part 2)

Part 1 focuses on cytology and surgery for thyroid.
Part 2 focuses on anatomical pathology and molecular/genetics.

Our special guests:

Professor Yuri Nikiforov is the Director of the Division of Molecular Anatomic Pathology at the University of Pittsburgh School of Medicine. Co-developer of the test we discuss in this episode, ThyroSeq.

Dr Tiffany Symes is a histopathologist and deputy director of Anatomical Pathology at Melbourne Pathology. She is also featured in part one.

Dr Rachael Chambers is a histopathologist at Sullivan Nicolaides Pathology, Brisbane.

This Medical Life podcast is available on all podcasting services and Spotify.

See omnystudio.com/listener for privacy information.

Thyroid lumps have always been with us. Often referred to as goitres (interpreted from Latin to mean neck swelling), numerous ancient medical sources mention these and how to manage them.

However, it has only been with modern medicine and investigations that we can distinguish between benign and malignant lesions. In this episode, we examine the investigations, diagnosis, management and prognosis of thyroid lumps.

This is part one of the story of Thyroid lumps.

Our special guest:

Dr Tiffany Symes is a histopathologist and deputy director of Anatomical Pathology at Melbourne Pathology.

Associate Professor James Lee is a leading endocrine surgeon in Australia, co-editor of the Endocrine Surgery section of the ANZ Journal of Surgery and deputy co-chair of the Endocrine Surgery Section of the Royal Australasian College of Surgeons.

This Medical Life podcast is available on all podcasting services and Spotify.

See omnystudio.com/listener for privacy information.

A common myth about epilepsy is that women who suffer from this condition should avoid getting pregnant. This is simply not true. It can be safely managed for both the mother-to-be and future child. Epilepsy is not a contraindication for pregnancy.

Certainly there are additional precautions and steps that should be taken when a woman who has epilepsy is considering starting a family and it requires a multidisciplinary approach.

This is the story of pregnancy and epilepsy.

Our special guests include:

Daisy Beyer who lives in Melbourne with her husband and son expecting their second child in August of this year. Daisy is a registered psychiatric nurse and lives with generalised epilepsy.

Dr Amber Moore is an obstetrician and gynaecologist working in Melbourne, Federal Councillor for the Royal Australian & New Zealand College of Obstetricians & Gynaecologists, and deputy chair of the Continuing Professional Education Committee.

Professor Mark Cook is a consultant neurologist, Director of Neurology and Chair of Medicine at St Vincent’s Hospital in Melbourne. He was awarded an Officer in the Order of Australia for distinguished service to neurological medicine and treatment research for epilepsy.

Anna Heldorf lives in Melbourne with her partner and is a public servant. Anna was diagnosed with juvenile myoclonic epilepsy and had her first baby in April this year.

Our gratitude goes to Dr Amber Moore for her assistance in helping get this episode together.

This Medical Life podcast is available on all podcasting services and Spotify

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Tonsillectomies are one of the most common operations both today and historically, however, it has always been mired in controversy. In ancient times, this was touted as being either life-saving or completely unnecessary and continued to be a polarising topic into the twentieth century.

An evidence based approach has helped to provide guidelines such as the Paradise criteria. However, there is always nuance and particular patient circumstances that play a role in deciding if surgical management is appropriate. We talk to one of Australia’s foremost experts to help us navigate this topic.

This is the story of Tonsillectomies.

Our special guest:

Dr Eric Levi is a triple-Fellowship trained Specialist Otolaryngologist (Ear Nose & Throat), Head & Neck Surgeon based in Melbourne, Australia. He has completed Fellowships in Head & Neck Surgery, Facial Plastic & Reconstructive Surgery and Paediatric Otolaryngology.

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Over two-thirds of the world’s population lose the ability to metabolise during their lifetime (the majority during childhood). We know today that lactose intolerance, or lactase persistence, has a strong genetic predisposition. Almost 100% of Asians, 70% of African-Americans, East Indians, US Hispanics and approximately 50% of Spanish and French have very low levels of lactase in adulthood (what we would call lactose intolerant). Alternatively, the majority of Caucasians can tolerate lactose into adulthood.

Testing for lactose intolerance/lactase persistence can be done either via chemical or genetic testing. Each has their advantages and disadvantages but is important for any doctor or patient to know about.

This is the story of Lactose intolerance.

Our special guests:

Dr Michael Page is a Chemical Pathologist and Chief Executive Officer at Clinipath in Western Australia.

Dr Melanie Galea is a Genetic Pathology specialist and Director of genetics at Douglass Hanly Moir Pathology in Sydney.

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Pelvic pain is a difficult and challenging medical condition for both patients and doctors. It can be debilitating for women that can begin as a teenager or a young adult and progress for years impacting every facet of their lives.

Similiarly, pelvic pain can be challenging for symptom to assess and manage for doctors as there are a multitude of causes that range from simple and straight forward to complex and chronic diseases such as endometriosis.

In this episode we discuss pelvic pain and endometriosis with two guests who are leaders in diagnosis, treatment and management.

Travis also references a previous episode that touched on this issue: The Tragedy Of The Wandering Womb.

Also, Associate Professor Susan Evans, promised to share a link to this paper (click to download): An Embodied Predictive Processing Theory of Pain Experience (NEI Ensemble Paper).

This is the story of pelvic pain and endometriosis

Our special guests:

Dr Alecia Macrow who is a General Practitioner, owner of Thrive Family Practice, and one of 22 clinics around Australia that received government funding to assist patients with pelvic pain and endometriosis.

Associate Professor Susan Evans who is a Gynaecologist, Surgeon and Pain management physician in Adelaide. Associate Professor Evans is Executive Chair of the Pelvic Pain Foundation of Australia and CEO of Alyra Biotech which is a biopharmaceutical company developing intrauterine products for pain relief.

This Medical Life podcast is available on all podcasting services and Spotify.

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Vitamin B6 is a common additive in supplements, energy drinks and breakfast cereals. In rare circumstances though, it can reach levels toxic levels and cause neurological symptoms the mimic neurodegenerative disease.

This year newsGP reported a case where a GP took magnesium supplements for muscle cramps and over the course of a few years resulted in vitamin B6 toxicity that caused peripheral neuropathy and difficulty walking.

Fortunately, vitamin B6 toxicity is rare but it is an important condition for doctors to be aware of particularly in the setting of patients presenting with peripheral neuropathy.

This is the story of vitamin B6.

Our special guest:

Our special guest is Dr David Kanowski who is a senior chemical pathologist at Sullivan Nicolaides Pathology.

This Medical Life podcast is available on all podcasting services and Spotify.

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Scleroderma is a disease characterised by the hardening and tightening of the skin and connective tissues. The first medical description can be traced back to the 1750s.

Our understanding has evolved over the centuries but the pathogenesis remains largely unknown. The disease as several forms including diffuse and localised. Symptoms include skin discoloration and tightness to more severe complications like organ dysfunction.

Fortunately we have several different treatment options available for patients that can assist them in managing this disease.

This is the story of Scleroderma.

Our special guest:

Our special guest is Dr. Daman Langguth, a renowned clinical and laboratory immunologist with deep expertise in autoimmune diseases. Dr. Langguth discusses the importance of recognising scleroderma’s symptoms, the critical nature of early diagnosis, and the latest advancements in treatment.

This Medical Life podcast is available on all podcasting services and Spotify. Help support us at https://www.patreon.com/ThisMedicalLife

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In 1901, the state of Montana organised for scientists and doctors to investigate a mysterious illness from the Bitterroot Valley called ‘Black measles’ and ‘Black typhus’. People of all ages were affected but predominantly those who worked in the brush and were exposed to tick bites. The investigators called it ‘tick fever’ and this particular strain had a mortality rate over eighty percent.

Today this disease is known as Rocky Mountain spotted fever. In Australia, it is sometimes called ‘spotted fever’ or ‘Queensland tick typhus’. It is caused by an obligate intracellular bacterial micro-organism (needs a cell to survive). This organism is very difficult to culture and can be even more difficult to diagnose but surprisingly easy to treat. Rickettsial disease is an under-recognised infection and important in the differential diagnosis of any patients presenting with fevers, headaches and rash.

This is the story of Rickettsia

Our special guest:

Our special guest is Professor Stephen Graves who is a medical microbiologist and founder of the Australian Rickettsial Reference Laboratory (ARRL). He specialises is infectious diseases transmitted by ectoparasites such as ticks, lice, fleas and mites.

This Medical Life podcast is available on all podcasting services and Spotify.

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Our understanding of infectious disease and pathology stems from the 19th century with Robert Koch pioneering research. Dr Koch help to shaped modern microbiology and medicine when he identified the causative agents for anthrax and tuberculosis. Since that time, the number of infectious microorganisms that we know of that cause illness and diseases has increased exponentially. Thanks to modern day techniques, laboratories can test for these agents directly or indirectly and get an answer often within hours.

As such, microbiology is on the verge of a new era. Instead of the principle of one test: one micro-organism, we are moving into the realm where one test can detect hundreds of potential pathogens and antimicrobial resistance genes in a single stool sample. The new test is called Metapanel. This includes 175 gene targets using metagenomics (shotgun gene sequencing) and is able to detect bacteria, viruses, helminths, protozoa, fungi, microsporidia. This information is collated and reported by a pathologist and advice given as to what is the implications of the result. The test is ideally suited for patients with chronic diarrhoea, inflammatory bowel disease and/or inflammatory bowel syndrome.

This is the story of advanced faeces testing and Metapanel

** Please note: General Practitioners in Australia, will be able to claim CPD points after listening to this episode. Full details and registration, coming shortly.

Our special guest:

Dr Michael Wehrhahn is the Director of Molecular Biology and Infectious serology at Douglass Hanly Moir Pathology. Michael has a Master in Public Health, is an Infectious Disease Specialist as well as a Microbiologist and Adjunct Senior Lecturer at the University of Notre Dame.

Dr Wehrhahn is actively involved in research on clinical and laboratory aspects of a range of microorganisms and is a reviewer for a number of journals. Michael has been involved in researching and validating the new Metapanel available through Sonic in conjunction with Microba.

This Medical Life podcast is available on all podcasting services and Spotify. Help support us at https://www.patreon.com/ThisMedicalLife

See omnystudio.com/listener for privacy information.