Essentially every culture, modern or ancient, understood that health and faeces are inherently linked. The Ancient Chinese practiced ‘copromancy’ which was the assessment of health based upon the shape, size and texture of faeces. Today we have the Bristol Stool Chart that helps us to classify faeces/poo into seven different groups. As disconcerting as it may be, the state of our poo can tell us a lot about our own health and this is only going to increase as our knowledge about our faecal micro...
Jul 10, 2023•50 min•Season 4Ep. 41
In 1891, Guido Werdnig documented two cases of brothers who had global progressive muscular weakness. In 1935, Dr Dorothy Anderson conducted an autopsy on a young child who had died from malnutrition due to suspected coeliac disease despite being on the upon treatment. In 1943, in inherited form of intellectual disability in boys was described by Martin and Bell. The diseases are Spinal Muscular Atrophy, Cystic Fibrosis, and Fragile X syndrome respectively. The learning curve for genetics in the...
Jun 26, 2023•1 hr•Season 4Ep. 40
Seasonal influenza causes significant morbidity and mortality every year but can often fall into the underestimated category. Between 10-30% of the general population are infected each year with influenza that leads to an increase in hospital and intensive care unit admissions, the onus for prevention and early intervention has never been more important. Our special guest is Associate Professor Paul Griffin from the School of Medicine at the University of Queensland and is an Infectious Disease ...
Jun 12, 2023•39 min•Season 4Ep. 39
In 1998, a 6 page report published in the Lancet that would later be described as one of history’s great science frauds. The article was titled “Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive development disorder in children” but the news headlines ran with a much shorter version: the MMR vaccine causes autism. The article was written by Andrew Wakefield, a British gastroenterologist turned researcher, who had taken it upon himself to deceive the medical community and ge...
May 29, 2023•54 min•Season 4Ep. 38
In 1834, Robert Graves gave a lecture series on the ‘Newly observed affection of the thyroid gland in females’. He presented three women who had violent palpitations, enlarged thyroids, and an apparent enlargement of the eyeballs (later it would be called ‘exophthalmos’). In 1912, Hakaru Hashimoto reported a new disease in a German journal after examining microscopically the thyroid tissue from four middle-aged women. He noted the lymphocytic infiltration and likened it to other conditions conta...
May 15, 2023•32 min•Season 4Ep. 37
Since recorded history, heartburn has been a common complaint and the descriptions from ancient physicians are virtually indistinguishable from today’s accounts. However, one thing we do know that they did not is a small subset of patients whose long standing heartburn could predispose them to a precancerous condition known as Barrett oesophagitis. Barrett oesophagitis is caused by chronic gastro-oesophageal reflux disease with a number of known risk factors for developing this. These patients r...
May 01, 2023•54 min•Season 4Ep. 36
Professor Ian Frazer pioneered the development of the first Human Papilloma Virus (HPV) vaccine which has seen a reduction of HPV infections in young women between 70-86% and the incidence of cervical cancer rates drop by 90%. Few doctors/scientists have had such a profound impact on the health of so many people. Today we talk to Professor Ian Frazer about his career, the events leading up to the HPV vaccine development, and the future of this life-saving medicine. Some of Professor Ian Frazer a...
Apr 17, 2023•41 min•Season 4Ep. 35
In 1964, a young woman was murdered as she walked to her apartment in Queens, New York. Her screams were left unanswered. No one came to her help. Within the space of thirty minutes, the assailant would return two more times to stab her again and again. The woman died. The number of witnesses to this crime who did not help was: 38. Two psychologists posed a question: how could this happen in such a heavily populated city? Two other landmark studies occur around this time including the Milgram ex...
Apr 03, 2023•34 min•Season 4Ep. 34
In 1912, Merck Pharmaceuticals was searching for a blood clotting agent to compete with a competitor in the market. One of the agents, a chemical by-product (and not even named) was produced and patented without any significant testing. This was a drug that we would come to know as MDMA or Ecstasy. In the 1960s, this drug found it’s way into use by a Chilean psychiatrist for psychotherapy, Dr Claudio Naranjo. He found that it helped patients to open up, it intensified emotions, gave access to su...
Mar 21, 2023•44 min•Season 4Ep. 33
The medicinal properties of aspirin (acetylsalicylic acid) have been well-documented for hundreds of years. It seems even our ancient ancestors thousands of years ago had some insight into its healing properties even if the usage was misguided. We are still learning about aspirin and the best ways to use it. Our special guest is Professor Simon Dimmitt, a Physician in General and Cardiovascular Medicine. He has released a website providing evidence-based prescribing for Doctors. This is the stor...
Mar 08, 2023•49 min•Season 4Ep. 32
This week I talk about a feasibility cohort study which sought to determine whether a larger cohort study addressing this question would be feasible. Listen to hear some interesting preliminary findings. Merza, E.Y., Pearson, S.J., Mallows, A.J. and Malliaras, P., 2023. The relationship between psychological, cognitive, and contextual factors and rehabilitation outcomes in Achilles tendinopathy: A prospective feasibility cohort study. Physical Therapy in Sport . Mallows, A., Jackson, J., Littlew...
Mar 01, 2023•7 min•Ep. 39
We have known for a while that type of exercise intervention (e.g. intensity, frequency, etc) does not seem to influence self-reported outcomes such as pain. Maybe all the benefits from exercise are explained by non-specific effects, or maybe exercise has benefits that do not depend on the type of exercise. In this episode, I discuss 3 studies that look into (at least partly) other benefits that we may see at the level of the muscle and tendon from higher-load exercise interventions. References:...
Feb 21, 2023•15 min•Ep. 38
A continuation of Episode 30. In this episode, we discuss the continued management of patients with Breast Cancer and the BRCA pathological variant. Our special guests: Associate Professor Nick Murray who is a Medical Oncologist and Director of the Medical Oncology Unit at the Royal Adelaide Hospital Cancer Services Dr Eryn Dow – Medical Oncologist and Clinical Cancer Geneticist It is important to note that while Breast Cancer is the most common cancer in women, the discussion of BRCA and famili...
Feb 20, 2023•42 min•Season 4Ep. 31
This week, I had an engaging conversation with Anthony Nasser , an up-and-coming researcher on tendinopathy who recently completed his PhD on proximal hamstring tendinopathy. Our discussion covered the reasons for the lack of research attention towards this condition, the current state of evidence, and insights from his doctoral studies. You can find the full conversation here. Here are Anthony's related publications: Nasser, A.M., Pizzari, T., Grimaldi, A., Vicenzino, B., Rio, E. and Semciw, A....
Feb 15, 2023•25 min•Ep. 37
Palpation can be useful for the diagnosis and assessment of tendinopathy, but there are limits. This is because non-painful tendons can be tender, and tenderness in painful tendons seems to be very slow to get better. Link to Evidence for Improvement in Local but not Diffuse Pressure Pain Thresholds Following Physical Therapist Interventions for Tendinopathy: A Systematic Review Link to Reproducibility and clinical utility of tendon palpation to detect patellar tendinopathy in young basketball p...
Feb 07, 2023•15 min•Ep. 36
In 1866, a French physician by the name of Pierre Paul Broca recognised a terrifying disease running through the women of his wife’s family: breast cancer. He wrote that they could be well and have perfect health before this ‘germ’ of an illness would go off like an ‘explosion’ and could kill within 1 to 2 years. Broca studied his family for the next 30 years where he noted that 15 close relatives including his wife’s mother, his wife, and his daughter were all affected. It would not be until th...
Feb 06, 2023•55 min•Season 4Ep. 30
Interesting perspective paper from Arampatzis et al talking about how we should consider tuning of muscle tendon unit in terms of muscle strength and tendon stiffness when considering training for specific groups. See omnystudio.com/listener for privacy information.
Jan 31, 2023•7 min•Ep. 35
This talking tendons episode will discuss a study by Igor Sancho, PhD, assessing Achilles forces during common rehab exercises and habitual activities and how this relates to reported pain among runners. Some interesting implications for practice. Achilles tendon forces and pain during common rehabilitation exercises in male runners with Achilles tendinopathy. A laboratory study See omnystudio.com/listener for privacy information....
Jan 25, 2023•9 min•Ep. 34
In the 16th century, a curse was foretold about the Scottish MacCrimmon clan that they would cease to be the official (bag) pipers of the chiefs of the Clan MacLeod and would be forced to leave the Isle of Skye forever. The curse came true. The fingers of the men from the MacCrimmons clan became twisted and gnarled resembling a claw and they were unable to play the pipes. Throughout history, this disease has been known by many names: ‘MacCrimmons curse’, ‘Celtic Hand’ or the ‘Vikings disease’. W...
Jan 23, 2023•45 min•Season 4Ep. 29
While I amputated one man’s thigh, there lay at one time thirteen, all beseeching to be taken next… It was a strange thing to feel my clothes stiff with blood, and my arms powerless with the exertion of using the knife.” – Charles Bell, Surgeon at the Battle of Waterloo, 1815. Hippocrates said that ‘war is the only proper school for surgeons’ and, throughout history, we have become experts at battlefield medicine. From swords and spears to ballistic missiles and machine guns, the destructive pow...
Dec 19, 2022•1 hr 4 min•Season 4Ep. 28
In this episode, I am discussing kinesiophobia in the context of tendon rehab and how rehab can be conceptualised as graded exposure for some people. References 1) Physiotherapy management of Achilles tendinopathy See omnystudio.com/listener for privacy information.
Dec 12, 2022•8 min•Ep. 33
In this episode, I talk about load test pain assessment and how this can also be used to assess kinesiophobia and movement apprehension. References 1) Physiotherapy management of Achilles tendinopathy: https://pubmed.ncbi.nlm.nih.gov/36274038/ 2) Kinesiophobia Severity Categories and Clinically Meaningful Symptom Change in Persons With Achilles Tendinopathy in a Cross-Sectional Study: Implications for Assessment and Willingness to Exercise: https://pubmed.ncbi.nlm.nih.gov/35295417/ See omnystudi...
Dec 08, 2022•12 min•Ep. 32
This Medical Life is a podcast for GPs, specialists, allied health professionals, and medical students but in this episode we share content related to the Australian Podcast Awards and talkback radio. Dr Travis Brown and Steve Davis are taking a short break so this episode is a little different. You might consider it an audio snack. It features two pieces of content. The first is the 15-minute submission created for the 2022 Australian Podcast Awards. The criteria state we could select snippets ...
Oct 10, 2022•32 min•Season 3Ep. 27
Intestinal problems are as ancient as human’s themselves. However, the first case was only documented in the 18th century by a great Italian anatomist Giovanni Battista Morgagni, of a 20 year old man who had died with fever, abdominal pain, and bloody diarrhoea. The autopsy findings by Morgagni are consistent with what we know today as Inflammatory Bowel Disease. As time continued, so did our knowledge of these diseases. Today, Crohn’s disease and Ulcerative colitis are as important as they are ...
Sep 26, 2022•1 hr 21 min•Season 3Ep. 26
The sun has always been special to us. Most cultures, particularly in ancient times, worshipped it as a God to be feared. In modern society, we recognise both the potential life-affirming and life-dangers that the sun poses. In this episode, we focus on the beneficial side the sun provides to us via Vitamin D. We discuss the pros and cons of testing, treating, and managing Vitamin D in patients, and of particular concern is identifying those who are at a high risk of deficiency. Our special gues...
Sep 12, 2022•56 min•Season 3Ep. 25
In the 19th century, a French doctor recognised a subset of patients with joint disease that didn’t fit the traditional diagnoses of gout or osteoarthritis. These patients were predominately female with affected hands and fingers, joint stiffness, and often had a low socioeconomic background (gout was traditionally associated with high socioeconomic status). Later, an English Physician noted an important distinction that these patients did not have elevated uric acid such as those with gout. Thi...
Aug 29, 2022•43 min•Season 3Ep. 24
The first ever recorded blood pressure was done by Stephen Hales in 1733 with a glass tube inserted into the artery of a horse. It would be well over a century for us to develop a non-invasive technique to measure blood pressure and another century to understand its significance. Today, hypertension is one of the most common conditions facing General Practitioners. However, in the pursuit of lower blood pressure, can we be causing unnecessary harm by overprescribing and/or increasing doses with ...
Aug 16, 2022•48 min•Season 3Ep. 23
Streptococcus pyogenes is a critical micro-organism for every doctor to know about. It is a gram positive coccus that grows in chains and has the potential to cause significant morbidity and even mortality. It has taken us centuries to learn the significance of this infection and is a testament to modern day medicine that its complications are rare. This is the story of Streptococcus Pyogenes. Support the show: https://theadelaideshow.com.au/listen-or-download-the-podcast/adelaide-in-crowd/ See ...
Aug 02, 2022•35 min•Season 3Ep. 22
This is an interesting study from the Delaware tendinopathy group among others investigating a host of structural, tissue property, functional and pain factors that may persist among people with Achilles tendinopathy making a return to running. Provides guidance to clinicians about potential impairments to consider assessing. Here's the link to the study: Corrigan, P., Hornsby, S., Pohlig, R.T., Willy, R.W., Cortes, D.H. and Silbernagel, K.G., 2022. Tendon loading in runners with Achilles tendin...
Jul 25, 2022•11 min•Ep. 31
In this episode I talk about three qualitative studies that aim to understand the patient perspective and patient motivations in Achilles tendinopathy. I find this work really helps clinicians to understand what patients are gong through so we are able to be empathic and help them. Hope you enjoy! Here's a link to courses in the UK: https://www.eventbrite.com/cc/mastering-lower-limb-tendinopathy-uk-sept-2022-670009 Here are the studies: Turner, J., Malliaras, P., Goulis, J. and Mc Auliffe, S., 2...
Jul 19, 2022•10 min•Ep. 30
