Chapter 1: What are peptides and why are they becoming popular in Australia?
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Norman, I know you're on social media.
Am I? Yes. I try not to be.
In some capacity. Hashtag peptides. Have you encountered it?
I've tried to avoid it because as soon as I do that, it's going to come into my Instagram feed and I'll see nothing else. The algorithm is going to hit me. So I kind of know what's out there, but it's ugly.
I went peaking.
Oh, did you?
I went peaking and it is ugly. It's stuff marketed for anti-aging, gaining muscle. A lot of it's deeply seated in diet culture. Give your pennies, big promises. And a recent study that's looked into this, it's pretty scary stuff with lots of potential harm and it's an unregulated Wild West out there.
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Chapter 2: What are the risks associated with unregulated peptide use?
And whilst it's really good guidance, Norman... I thought some of this is still not implementable because of equity issues. It's still not on the PBS.
So in other words, if you don't have type 2 diabetes, you've got to pay for it out of your own pocket.
Yes. So access equity here is a real problem. So whilst it's nice to have the guidance, I know lots of patients of mine still won't be able to access it.
So we're talking about a fair society, but those who've got the dough can reduce their cardiac risk further because they've got the money.
Yeah, which just widens the gap further and further.
It's not fair.
Good news on RSV.
Yeah, respiratory syncytial virus vaccine. So this is a vaccine that is given to mothers to protect them against respiratory syncytial virus, a nasty, a potentially nasty respiratory virus. But it's very nasty if babies get it and cause of hospitalisation and worse.
And so there is a maternal vaccine available, which then protects the baby because of the antibodies going through to the placenta and also presumably through breast milk as well. Now, we have to say to start with, this paper has not been published yet. So this is a preprint. The results may change when it's been properly reviewed. But they're pretty impressive results in terms of protection.
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Chapter 3: What does the latest research say about Parkinson's disease and pesticides?
That is significant numbers. And worth just pointing out to people that this vaccine rollout happened early last year. We covered it on the health report. So it started in February 2025. And over that period, they've seen hospital admissions for newborns cut by almost half in its first year. So it's a successful program.
For people who are pregnant or who are thinking about it, we give it to you any time from 28 weeks. And most of my patients normally come in at 30 weeks for their whooping cough in one arm, RSV in the other.
Presumably influenza as well.
Yes. They've usually had influenza by then. We're getting influenza in the arm now, but you can have that at any gestation. But, you know, the timings do matter.
And interesting, they also looked at, there's a monoclonal antibody drug which simulates the immune effects of the vaccine. So it's not a vaccine, but it simulates the vaccine.
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Chapter 4: How can certain heart failure treatments be avoided safely?
You give it to newborn babies. And these are babies before the vaccine was available to mothers. And they looked at the effectiveness of this monoclonal antibody. It's called nocebimab. And it was very effective too, up to nearly 90% reduction in risk.
So babies get that if mum didn't get the vaccine in pregnancy, if the baby is high risk or if mum got vaccinated and then gives birth less than two weeks later because there's not been time for the antibodies to cross the placenta and get to the baby. So some babies will get it, not all. And it depends on the state as well.
So good news there in terms of respiratory virus vaccine. And we just need to touch base with two infections which are roiling the world or roiling Australia and the world. One is Ebola and the other is diphtheria. And I suppose I want to say, I'm going to editorialize here.
Mm-hmm.
We should be ashamed as a nation of this outbreak of diphtheria. And we look at Ebola in the Congo and in neighboring Uganda, which has almost certainly been underreported. It could well turn out to be an incredibly nasty outbreak, or it may already be a nasty outbreak. with this form of Ebola, and we can come back to that later.
And it's no epidemic or pandemic in human history has occurred just because of the bug. It's the bug's interaction with the way we live, the way our lives are organized, the disruption to our environment. So you've got Ebola in a failed state where there's warfare, where they don't trust the government,
and where the health services are woefully inadequate, not just because they might be inadequate anyway, but because health services can't get into that region. And also there's cultural aspects to that too, where people don't want to declare that somebody in their family has died, and therefore there aren't proper burial practices, and you come in contact with the body and you spread Ebola.
Let's look at diphtheria. A vaccine preventable illness. Words fail me that we have now, depending on when you're listening to this episode of the health report, the numbers will almost certainly have gone up, but we're at nearly 200 as we talk now.
And in several states and impacting remote Aboriginal communities. I think just to go to your point, Dr. Matt Mason, who's from the University of Sunshine Coast, has said, we must be honest, this is not simply a matter of individual vaccine hesitancy. It reflects decades of underinvestment in culturally appropriate community-led health infrastructure. So this is a failure.
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Chapter 5: What is the current situation regarding the diphtheria outbreak in Australia?
It can synchronise things. But.
But. Yes. What cardiologists have also been doing is going in and fixing up the atrial fibrillation by burning around the pulmonary vein called ablation. We've done this many times in the health report and we'll have some links to those stories in the past. And the question is, do you really need to do that ablation? Because anything you do extra is extra cost and extra potential risk.
And we should explain perhaps that by ablating that node, really what you're saying is to the device, you take over and we'll get rid of the body's system.
That's right. Yes. In other words, the theory was that the device could work, the defibrillation could work better.
Yes.
So Professor Prash Sanders, who's Director of the Centre for Heart Rhythm Disorders in Adelaide, what do we get out of 10 for our description of what's going on here?
That's a fantastic description. I think the important thing, though, is there's two different types of ablation. One is to ablate the pulmonary veins to get normal rhythm, which really we should be trying to do in most people with heart failure because it's got a proven mortality benefit. But the second is where we damage the AV node, where we render the person dependent on the pacemaker.
The thought there is really to say that we're going to allow the pacemaker to work more efficiently by ensuring that it's going to be pacing the heart and resynchronizing it.
And we should just explain the AV node is, if you like, our endogenous pacemaker in the heart. This is our natural pacemaker.
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