Pomegranate Health

the Royal Australasian College of Physicians
Pomegranate Health

Pomegranate Health is an award-winning podcast about the culture of medicine, from the Royal Australasian College of Physicians. We ask how doctors make difficult clinical and ethical decisions, how doctor-patient communication can be improved, and how healthcare delivery can be made more equitable. This is also the home of [IMJ On-Air], a podcast to accompany the RACP's Internal Medicine Journal.  Interviews with authors are conducted by specialist section editors. Find out more at the website www.racp.edu.au/podcast and get in touch via the address podcast@racp.edu.au

  1. Ep128: Brushing off the cobwebs

    30 APR

    Ep128: Brushing off the cobwebs

    There is evidence that six months or more off the job leads to some loss of practical skills and knowledge and certainly, many doctors a loss of self-confidence. People take time out from medical practice for many different reasons but career breaks to raise children are more common than ever before. Paediatrics is one specialty where female representation exceeds 70 percent and it is also becoming more common for new fathers to take leave as primary carers. Senior staff at Sydney Children’s Hospital have developed a day-long workshop to help medics brush off the cobwebs before they return to practice. It involves rehearsal of specific skills, refreshers on calculation and interpretation tasks and a high-fidelity critical care simulation. Just as importantly, there is open discussion and mentorship to support the transition back to work. The program is called Paediatric Returnees after Maternity or Extended Leave (PRAM) this podcast was recorded during a live workshop at the Kids Simulation Centre, Randwick.   Guests Workshop participants: Elodie, Eliza, Emma, April, Stephanie, Lucy and Paula. PRAM creators: Dr Josephine Goodyer FRACP (Sydney Children’s Hospital, Randwick) Dr Sasha Symonds FRACP FACEM (Sydney Children’s Hospital, Randwick) Renee Byrne (Sydney Children’s Hospital, Randwick) Production Produced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Elm Lake’ by Elm Lake, ‘Quiet Waters’ by Walt Adams, ‘Illuminations 4’ by Johannes Bornlöf, ‘Feeling Minnesota by Gavin Luke, and ‘Maybe This Time’ by Major Tweaks. Image by Maskot licenced through Getty Images.  Editorial feedback kindly provided by RACP physicians Sasha Taylor, Stephen Bacchi,Simeon Wong, Zac Fuller, Hugh Murray, Aidan Tan, Sern Wei Yeoh, Sasha Taylor and Stella Sarlos. Thanks also to RACP staff Arnika Martus and Kathryn Smith.  Please visit the Pomegranate Health web page for a transcript and supporting references. Login to MyCPD to record listening and reading as a prefilled learning activity.

    32 min
  2. [Case Report] 74yo with dyspnoea after AF ablation

    14 APR

    [Case Report] 74yo with dyspnoea after AF ablation

    In this episode we hear about an emergency presentation to a South Australian hospital, of a 74-year-old male with shortness of breath. The curve ball is that he had undergone ablation for drug-refractory atrial fibrillation less than two weeks prior. This discussion gives an overview of developing technologies for AF treatment and developing knowledge about the possible complications. We also have some multiple choice questions to test your understanding. Guest Dr Shaun Evans, FRACP (Royal Adelaide Hospital; University of Adelaide)   Hosts Associate Professor Stephen Bacchi (Massachusetts General Hospital; University of Adelaide) Jasmine Le (University of Adelaide) Production Produced by Stephen Bacchi and Mic Cavazzini. Music licenced from Epidemic Sound includes ‘Rockin’ for Decades’ by Blue Texas and ‘Brighton Breakdown’ by BDBs. Image created and copyrighted by RACP.  Editorial feedback kindly provided by RACP physicians Hugh Murray, Aidan Tan, Aafreen Khalid, Sebastiaan Lambooy, Amy Hughes and Lauren Gomes.    Key Reference (Spoiler Alert) * * * * * Delayed cardiac tamponade from pericarditis following pulmonary vein cryo-balloon ablation [IMJ. 2020] Please visit the Pomegranate Health web page for a transcript and supporting references.Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health’ in Apple Podcasts, Spotify,Castbox or any podcasting app.

    28 min
  3. Ep126: Trying times for Māori medics

    27 MAR

    Ep126: Trying times for Māori medics

    In Aotearoa-New Zealand, the proportion of doctors identifying as Māori has doubled from where it was a decade ago to over 5 percent. But there is still a long way to go before the workforce is representative of the broader population which is 17 percent Māori. The Auckland and Otago Medical Schools have in recent years turbocharged their intake of Māori and Pasifika students but these graduates don’t seem to have trickled through to the RACP in great numbers. Just 3.5 percent of general physicians and 4.8 percent of paediatricians identify as Māori, and Pasifika doctors make up a further 1 and 2 percent respectively. In this podcast, three Māori medics discuss how the culture of training environments can be made more welcoming to junior doctors with diverse ethnic backgrounds. This discussion takes place in light of an independent review into the clinical examination for paediatrics in Aotearoa-New Zealand which found issues with standardization, transparency and cultural safety. 2024 was a tough year for Māori Health more broadly, as it saw the disestablishment of a dedicated Health Authority, Te Aka Whai Ora, after just twelve months of operation.  Guests Dr Danny de Lore FRACP (Rotorua Hospital; University of Auckland) Dr Matthew Wheeler FRACP (Tauranga Hospital; University of Auckland) Dr Ngaire Keenan PhD (Sydney Children’s Hospital, Westmead; University of Otago) Production Produced by Mic Cavazzini DPhil. Music provided courtesy of FreeMusicArchive includes ‘Periodicals’, ‘In Paler Skies’ by Blue Dot Sessions and ‘Wake Up’ by Kai Engel. Music licenced from Epidemic Sound includes ‘Subdivision of the Masses’ by Philip Weigl and ‘Abyss’ by Luwaks. Image of Dr Danny de Lore property of RACP   Editorial feedback kindly provided by RACP physicians Zac Fuller, Aidan Tan, Hugh Murray, Sasha Taylor, Anne-Marie Juengling and Simeon Wong. Thanks also to RACP staff Nick McCurdy and Sarah Millar.  Please visit the Pomegranate Health web page for a transcript and supporting references.Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health’ in Apple Podcasts, Spotify,Castbox or any podcasting app.

    45 min
  4. [Case Report] 52yo with hand clumsiness after Chiari operation

    13 MAR

    [Case Report] 52yo with hand clumsiness after Chiari operation

    This case report comes to you from Brigham and Women’s Hospital in Boston, a huge teaching hospital that serves the Harvard Medical School. The 52-year-old female presented with clumsiness and paresthesia of the right hand that had persisted for several days. She also had a headache and three weeks prior to presentation had undergone a suboccipital craniotomy for a Chiari I malformation. To complicate things, there was a past medical history of migraines and a family history of a Factor V Leiden mutation. The identified diagnosis is one in which evidence is limited for aspects of management, and the topics of uncertainty and mentorship in medicine also arise in this discussion. Guest Galina Gheihman, MD D (Brigham and Women’s Hospital; Harvard Medical School)   Hosts Associate Professor Stephen Bacchi (Massachusetts General Hospital; University of Adelaide) Haelynn Gim (Harvard Medical School) Production Produced by Stephen Bacchi and Mic Cavazzini. Music licenced from Epidemic Sound includes ‘Rockin’ for Decades’ by Blue Texas and ‘Brighton Breakdown’ by BDBs. Image created and copyrighted by RACP.  Editorial feedback kindly provided by Dr Sebastiaan Lambooy. Key Reference (Spoiler Alert) *  *  *  *  * Isolated Cortical Vein Thrombosis [Neurohospitalist. 2023]     Please visit the Pomegranate Health web page for a transcript and supporting references. Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health’ in Apple Podcasts, Spotify,Castbox or any podcasting app.

    28 min
  5. Ep124: Pleural medicine comes of age

    27 FEB

    Ep124: Pleural medicine comes of age

    Professor Gary Lee established the first dedicated pleural service in the southern hemisphere in 2009, at the Sir Charles Gairdner Hospital in Perth. He says that pleural disease has finally come to be regarded as an area of subspeciality interest in its own right, not just a complication of other comorbidities. In this podcast he presents a potted history of key developments in the management of pleural effusion in particular.  This is diagnosed in about 60,000 people every year in Australia, mainly as a result of infection or malignancy. With mentors in the UK, Professor Lee conducted some of the earliest trials on fibrinolytics and DNAses to break down purulent effusions. They also put to the test protocols for pleurodesis via talcum insufflation that date back to the 1930s.  Professor Lee’s more recent clinical research has focused on the use of indwelling pleural catheters that a patient can use to drain pleural effusate when feeling breathless. He has also a made an important contribution to conservative management guidelines for primary spontaneous pneumothorax. This story is great example of how clinical practice emerges imperfectly from a soup of evidence, accidents, human biases and system.   Guest Prof Gary Lee PhD FRACP FRCP FCCP (Pleural Service, Sir Charles Gairdner Hospital in Perth; University of Western Australia). Co-host Dr Marion Leighton FRACP (Wellington Hospital). Production Produced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Reconstruct’ by Amaranth Cove, ‘Nagba Algooah’ by Ebo Krdum. ‘Vittoro’ by Borrtex provided courtesy of FreeMusicArchive. Image by ilbusca licenced through Getty Images.    Editorial feedback kindly provided by RACP physicians Aidan Tan, Maansi Arora, Simeon Wong, Hugh Murray and Vanessa Wong. Please visit the Pomegranate Health web page for a transcript and supporting references.Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health’ in Apple Podcasts, Spotify,Castbox or any podcasting app.

    58 min
  6. [Case Report] 42yo male with fever following liver transplant

    11 FEB

    [Case Report] 42yo male with fever following liver transplant

    This case report describes a 42-year-old male from Arizona with a complex course characterised by fever following an orthotopic liver transplant. A general approach to fever in the post-transplant patient is discussed, along with specific considerations regarding travel in post-transplant patients or those on immunosuppressants for other indications. A/Prof Camille Kotton and Dr Simran Gupta from the Massachusetts General Hospital and Brigham and Women’s Hospital take listeners through the case and related issues in a step-by-step manner at a level targeted for trainees and generalists. Guest A/Prof Camille Kotton (Massachusetts General Hospital, Harvard University)Dr Simran Gupta (Brigham and Women’s Hospital, Harvard University) Hosts Associate Professor Stephen Bacchi FRACP (Fulbright Fellow, Mass General Brigham; University of Adelaide) Christina Gao (University of Adelaide) Production Produced by Stephen Bacchi and Mic Cavazzini. Music licenced from Epidemic Sound includes ‘Rockin’ for Decades’ by Blue Texas and ‘Brighton Breakdown’ by BDBs. Image created and copyrighted by RACP.  Editorial feedback kindly provided by doctors Maansi Arora, Brandon Stretton, Matt Lim and Ben Cook. Key Reference (Spoiler Alert) *  *  *  *  * Coccidioidal Meningitis after Liver Transplantation in a Nonendemic Region: A Case Report [Transplantation 2006] Please visit the Pomegranate Health web page for a transcript and supporting references.Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health’ in Apple Podcasts, Spotify,Castbox or any podcasting app.

    27 min
  7. Ep122: Funding pan-cancer therapies

    28 JAN

    Ep122: Funding pan-cancer therapies

    In the previous episode we heard how some rationally-designed therapies work on almost any cancer with the right molecular signature. Tumour-agnostic medications could be godsend for patients with rare cancers which have classically been overlooked by drug developers, and those with advanced cancers of unknown origin. 15,000 such patients have undergone comprehensive genome profiling of their tumours through the organisation, Omico. In this podcast, Omico’s founder explains that while the majority have received recommendations about matched therapies, clinical trials are typically the only way to enable access. Professor David Thomas discusses why Australia’s Health Technology Assessment process appears to be so conservative and how the market price of next-generation oncotherapies might be brought down by changes across the local ecosystem.  Guest Prof David Thomas FRACP PhD (Director, Centre for Molecular Oncology UNSW; Founder and Chief of Science, Omico)   Professor Thomas or Omico have received grants, consultancies or research support from Roche, Astra Zeneca, Pfizer, Eisai, Illumina, Beigene , Elevation Oncology, RedX Pharmaceuticals, SunPharma , Bayer, George Clinical, Novotech , Merck Sharpe and Dohme, Boehringer Ingelheim, Hummingbird, Microba , BioTessellate , PMV Pharma, Australian Unity and Foundation Medicine.  Production Produced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes  ‘Multicolor’ and ‘Pulse Voyage’ by Chill Cole. ‘Impulsing’, ‘the City of Hope’ ‘Over Again’, and ‘Going Undercover’ by Borrtex provided courtesy of FreeMusicArchive. Image by Guido Mieth licenced through Getty Images.    Editorial feedback kindly provided by RACP physicians Simeon Wong, Stephen Bacchi. Thanks also to Kym Bramich and Arnika Martus on staff with Omico and RACP respectively.   Please visit the Pomegranate Health web page for a transcript and supporting references.Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health’ in Apple Podcasts, Spotify,Castbox or any podcasting app.

    50 min
  8. Ep121: Precision oncology explained

    16 JAN

    Ep121: Precision oncology explained

    The genomic understanding of cancer has transformed a tissue-based classification model that had been dominant for 150 years or more. The last three decades have seen highly targeted therapies developed at blistering pace, and unprecedented improvements in patient outcomes.  To date, these advances have been focused on more common cancers. The financing model for drug development means that rare cancers get overlooked, given the small pool of potential buyers relative to the costs and risks of investment.  However, the molecular targets characterised in more common cancers are often found in cancers of a different histotype. As such, precision therapies will sometimes have tissue-agnostic efficacy and offer a lifeline for patients with neglected diseases or cancers of unknown origin.  Professor David Thomas has founded an NGO called Omico to enable such patients to undergo profiling for hundreds of potential molecular targets. In this interview he explains the rationale for the most promising pan cancer therapies, and in the next episode we discuss changes to the regulatory and funding model required to sustain this screening program.  Guest Prof David Thomas FRACP PhD (Director, Centre for Molecular Oncology UNSW; Founder and Chief of Science, Omico) Professor Thomas or Omico have received grants, consultancies or research support from Roche, Astra Zeneca, Pfizer, Eisai, Illumina, Beigene , Elevation Oncology, RedX Pharmaceuticals, SunPharma , Bayer, George Clinical, Novotech , Merck Sharpe and Dohme, Boehringer Ingelheim, Hummingbird, Microba , BioTessellate , PMV Pharma, Australian Unity and Foundation Medicine. Production Produced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘the Orchard’ by Jakob Ahlbom; ‘Dusty Electronics’ and ‘Pulse Voyage’ by Chill Cole; ‘Tam’ by LJ Kruzer. ‘See you soon’ and ‘Going Undercover’ by Borrtex provided courtesy of FreeMusicArchive. Image by filo licenced through Getty Images. Editorial feedback was kindly provided by RACP physicians Nichola Ball, Stephen Bacchi, Aafreen Khalid, Simeon Wong, Maansi Arora and Aidan Tan. Please visit the Pomegranate Health web page for a transcript and supporting references.Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health’ in Apple Podcasts, Spotify,Castbox or any podcasting app.

    47 min
4.8
out of 5
62 Ratings

About

Pomegranate Health is an award-winning podcast about the culture of medicine, from the Royal Australasian College of Physicians. We ask how doctors make difficult clinical and ethical decisions, how doctor-patient communication can be improved, and how healthcare delivery can be made more equitable. This is also the home of [IMJ On-Air], a podcast to accompany the RACP's Internal Medicine Journal.  Interviews with authors are conducted by specialist section editors. Find out more at the website www.racp.edu.au/podcast and get in touch via the address podcast@racp.edu.au

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