Primary Care Update 2023

Dermatology tips and tricks 

Including:

• Stubborn acne in women: beyond isotretinoin.
• Adjuvant treatment for seborrheic dermatitis.
• Topical treatment for vitiligo.
• Update on isotretinoin use.

AJ Seine bio

Dr Seine studied a Bachelor of Science at The University of Auckland before completing his medical degree through Otago University. His dermatology training was completed in Waikato, Auckland and Brisbane, Australia. AJ completed a one-year laser fellowship under Dr Shobhan Manoharan and became proficient with the use of energy-based devices within the field of dermatology and their utility in treating a vast range of conditions.

AJ is a fellowship trained Mohs micrographic surgeon with the American College of Mohs Surgery.

Reducing antibiotic use, and other infectious disease updates

• Cellulitis - mimics and treatment
• Recurrent UTI - Ix, Treatment (Hiprex, prophylaxis)
• Rabies PEP
• The febrile returned traveller

Matthew Broome bio

I have been an Infectious Diseases and General Medicine Physician since December 2020 working at Te Whatu Ora Waitemata across both North Shore Hospital and Waitakere Hospital as well as clinical educator through the University of Auckland Waitemata Clinical Campus.

I am a member of the Royal Australasian College of Physicians Advanced Training Committee for General and Acute Care Medicine, as well as a member of the Northern Regional Alliance Vocational Training Committee for Medical Registrars.

I have an interest in Meningococcal disease, Enterococcal disease, Cryptococcal disease and COVID-19 in the immunocompromised host.

COVID v vaccine myocarditis

While the benefits of the COVID-19 mRNA vaccines outweigh the risks across all age groups, like any vaccine, they are not risk-free. This talk will highlight the risks of COVID-19 in the age of the XBB lineage, the effectiveness of the current vaccine, and explain how adverse events such as myocarditis have been assessed, including in the NZ primary care setting.

Helen Petoussis-Harris bio

Helen is a Vaccinologist at the University of Auckland, Senior Lecturer in the Dept of General Practice and Primary Health Care and The Dean’s Research Fellow. Her research is focussed on the effects of vaccines, in particular vaccine effectiveness and vaccines safety.

She is Chair of the WHO Global Advisory Committee on Vaccine Safety (GACVS), Chair of the GACVS sub-committee on vaccine Safety communication, and Co-Director of the Global Vaccine Data Network, a multinational collaboration in vaccine safety data.

Common referral questions, when to refer, and a new disease

Topics:

• GCA and PMR 
• Back pain
• Chronic pain/fibromyalgia
• ANA testing – when to test and how to interpret
• DMARDs – how to manage during infections or surgery
• New disease - VEXAS

Bio Vicki Quincey

Vicki is the current President of the New Zealand Rheumatology Association, Head of Rheumatology and Clinical Informatics Director for the Waikato District. 

She originally trained in the UK in General Medicine and Rheumatology, stepping out of GM into Clinical Informatics in 2018. She has a specialist interest in vasculitis and sits on the Australia and New Zealand Vasculitis Society board.

Time conscious strategies for general practice

Topics:

• Overview of mental health presentations in primary care
• Introduction to brief interventions for mental and behavioural health
• Best practice for delivering brief interventions in 10 minutes or less
• How to incorporated brief mental health interventions into your practice
• Tips for overcoming barriers to delivering brief interventions

Marcia Sasano Bio

I have a lifelong interest in the intrinsic relations among psychological factors, behaviour, and physical health and illness. I have special training in behavioural medicine and am passionate about helping individuals maintain wellness and successfully cope with life challenges.
I work from an evidence based, strength focused, and holistic perspective and value the therapeutic relationship and compassion as a vehicles for change. I help people adopt new strategies to improve their overall health and live life meaningfully.

Evidence and controversies of pharmacotherapy

Brief updates on recent evidence and controversies of pharmacotherapy that impact on primary care

Linda Bryant bio

Linda is a clinical advisory and prescribing pharmacist who has worked in primary care as a pharmacist facilitator and clinical advisory pharmacist for many years with East Health Trust PHO, and now works with Newtown Union Health Service and Porirua Union and Community Health Service as a clinical advisory and prescribing pharmacist. Linda taught postgraduate clinical pharmacy students for over 20 years with a focus on moving from theoretical pharmacotherapy to the practical application and optimisation of medicines therapy for individual patients.

Linda’s research area of interest includes the benefits of having clinically trained and qualified pharmacists working within general practice as part of the general practice team.

ONZM, MClinPharm, PhD, PGCert(Prescr), FNZHPA, FNZCP, FPSNZ, Gold Medal (PSNZ) MCAPA, NZRegPharm(prescr)

Bronchiectasis + other 

Paul will discuss the findings of the recent publication in Respirology of the Thoracic Society of Australian and New Zealand (TSANZ) position statement on chronic suppurative lung disease and bronchiectasis in children, adolescents and adults in Australia and New Zealand dated March 2023.

The presentation will include an overview of bronchiectasis and then the most relevant areas for primary care in pharmacological and non-pharmacological management of bronchiectasis in adults and children will be covered.

Paul Dawkins Bio

Paul is a Respiratory Physician at Middlemore Hospital and Honorary Senior Lecturer in Medicine at University of Auckland. He runs a multidisciplinary bronchiectasis clinic and has been principal investigator in a number of bronchiectasis studies. He is an author on the new TSANZ position statement on chronic suppurative lung disease and bronchiectasis. He is Director of Physician Education at Middlemore Hospital and is an examiner and training workshop facilitator for RACP. 

 Managing PID, the latest syphilis outbreak and more

Heather will discuss embedding simple principles of sexual health medicine outlined in the Aotearoa New Zealand STI Management Guidelines, including case management of pelvic inflammatory disease including how it presents, causes, history taking, diagnostic criteria, grading, testing, treatment, management of sexual contacts and follow-up.

There will be an additional brief update on the infectious syphilis outbreak in Aotearoa and simple measures to combat the rise in congenital syphilis.

Heather Young bio

Heather is a sexual health physician working at the Christchurch Sexual Health Service for Te Whatu Ora Canterbury and is on the board of the consumer STI Education Foundation (NZ Herpes Foundation, the HPV Project, Just the Facts).

Ōtautahi Christchurch is the only hospital sexual health service in the south island employing specialist physicians - and as such provides tertiary support to other regions.

Heather has an interest in sexual health guidelines and governance. She has been involved in multiple guideline updates for the Aotearoa NZ STI Management Guidelines for Use in Primary Care and in regionalising Communityhealthpathways. She provides sexual health teaching to medical students and has previous MEDSAC training. Clinical work includes pelvic inflammatory disease, recurrent vaginal discharge, genital pain, complex STIs and response to outbreaks such as infectious syphilis and monkeypox.

Protein requirements: From adolescent athletes to the weekend warrior

Talk outline:

• Why protein matters (the role in health and performance)
• The protein distribution is just as important as daily intake.
• Protein requirements for athletes, the weekend warrior and adolescents.
• What to consider for those on a plant based diet.
• Protein supplements, what to watch out for (contamination and efficacy)

Dane Baker bio

Dane is a Performance Dietitian, who has worked extensively with New Zealand's elite athletes and organisations over the past 15 years (Chiefs, Blues, Black Ferns 7s, NZ Hockey & NZ Swimming). He was the NZ team dietitian for the Rio Olympics and Gold Coast Commonwealth games. He has a leadership role as part of WHISPA, a specialist group dedicated to optimising female health and performance at high performance sport. He is an active researcher in the field of RED-s and a lecturer at the University of Otago. When he’s not in the Axis Clinic, he’s educating New Zealand’s elite coaches as the lead nutrition provider for the HPSNZ core knowledge, coach education program.  In addition to sport, Dane specialises in working with patients suffering from RED-S, fertility issues, osteoarthritis and diabetes.

Responding to increasing adolescent mental health needs

Over the last 10 years the proportion of young people reporting anxiety, depression or significant distress has doubled in New Zealand. This is similar in other high income English speaking nations.

Why and what do we do about it? Terry will outline New Zealand data and options for responding to increased demand from young people and parents. 

Terry Fleming bio

Terry is an Associate Professor in the School of Health at Victoria University of Wellington. Previously she worked as a clinical social worker in youth health and mental health, mainly in South Auckland. Terry co-developed SPARX computerised CBT.

She is the president of the Internet Society for Research on Internet Interventions (ISRII) and co-leads the Digital Mental Health Catalyst at Te Herenga Waka, Victoria University of Wellington. 

Tips and tricks from head to toe

A series of quick and easy clinical pearls that can help conditions across the body ranging from shoulder pain to Achilles tendinopathy.

Dan Exeter bio

MBChB, MMedSci, FACSEP

Dan is a Sport and Exercise Physician and Clinical Director at Axis. Dan has active research interests in the areas of injury prevention and cardiac screening of athletes. He is also interested in point-of-care ultrasound and performs ultrasound-guided procedures. Dan has been a Team Physician for Hawthorn Football Club in the AFL and is currently Medical Director for Athletics New Zealand. 
 

Diagnosing and managing type 1, pancreatogenic + monogenic diabetes

At least 5-10% of diabetes is not type 2 diabetes – what are the other types?

• Why it matters if you misdiagnose your patient with type 1 or type 2 diabetes
• How to differentiate between the different types of diabetes
• When to refer patients with suspected non-type 2 diabetes to Secondary Care
• How to manage non-type 2 diabetes in Primary Care

Ryan Paul bio

Ryan is an endocrinologist at Te Whatu Ora Waikato and is an Associate Professor of Medicine at the University of Waikato. He is also an honorary Senior Lecturer at the University of Auckland and a Clinical Associate of the Maurice Wilkins Centre. He is the Immediate Past-President of the New Zealand Society of Endocrinology (NZSE) and is an Executive Member of the New Zealand Society for the Study of Diabetes (NZSSD). Ryan has created the Advanced Diabetes Management Course for all health professionals in Primary Care and was awarded the NZ Medical Educator of the year in 2019.