Clinical Conversations Royal College of Physicians of Edinburgh

In this episode, Edward Foo discusses spontaneous bleeding presentations and their identification and management with Dr Andrew Page.

Dr Andrew Page is a Consultant Haematologist with a special interest in bleeding and thrombotic disorders at the Royal Infirmary of Edinburgh, and Director of the Edinburgh Haemophilia Centre. Before training as a medic, he worked in basic scientific research in the field of genetics. This continues to inform his clinical interests, and Dr Page is also the Clinical Lead of the Scottish Bleeding and Platelet Disorders Genetic Diagnostic Service.

Edward Foo is a medical student at the University of Edinburgh and Student Observer of the RCPE Trainees and Members' Committee (T&MC).

--- Notes for the listener ---

At c. 10.55, Dr Page discusses European licensing for gene therapy in haemophilia B. The situation has changed since recording (13/12/2022), and gene therapy in haemophilia B now has conditional authorisation in Europe: https://www.ema.europa.eu/en/news/first-gene-therapy-treat-haemophilia-b

At c. 24.23, Dr Page discusses reversal of warfarin. Dr Page mentions Beriplex, which is the brand of prothrombin complex concentrate (PCC) used in NHS Lothian, where Dr Page works. However, it should be noted that other brands are available and Beriplex is just being given as an example. Other brands can be found in the BNF: https://bnf.nice.org.uk/drugs/dried-prothrombin-complex/medicinal-forms/

--- Link ---
The ISTH Bleeding Assessment Tool is available from:
https://www.isth.org/page/reference_tools

Recording date: 13 December 2022

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In this episode, Dr Marilena Giannoudi discusses the role of the 'first fit' clinic and seizure diagnosis and management with Dr Richard Davenport.

Dr Richard Davenport has been a Consultant Neurologist since 1999. While very much a general neurologist, he undertakes NHS first seizure, movement disorder and MND clinics, and has particular interests in education and training. Dr Davenport became President of the Association of British Neurologists (ABN) in May 2023. Outside of neurology, Dr Davenport enjoys cycling.

Dr Marilena Giannoudi is the T&MC Podcast Lead and Vice-Chair for Careers and Communications.

-- Link --
https://www.gov.uk/epilepsy-and-driving

Recording date: 24 January 2023

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This week Dr Jonny Bardgett discusses Guillain–Barré syndrome (GBS) with Dr Gavin Langlands. Topics include; what GBS is, when to suspect GBS and diagnose, when to start treatment and escalate and the prognosis and rehabilitation of patients.

Dr Gavin Langlands is in their penultimate year of neurology Registrar training at the Institute of Neurological Sciences, Glasgow in the West of Scotland, with a developing interest in neuromuscular disorders.

Recording Date: 07 December 2022

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Dr Jonathan Bardgett talks with Dr Zoë Fritz about treatment escalation plans and the ReSPECT process, contextualised with patient case vignettes.

Dr Zoë Fritz is a Wellcome fellow in Society and Ethics, and a Consultant Physician in Acute Medicine at Addenbrooke’s Hospital, Cambridge. Her research is focused on identifying areas of clinical practice that raise ethical questions and applying rigorous empirical and ethical analysis to explore the issues and find effective solutions. This applied clinical ethics research allows her to translate ethical analysis into improving healthcare experience and outcomes.

-- Links --
ReSPECT - https://www.resus.org.uk/respect
REDMAP - https://www.spict.org.uk/red-map/

Recording date: 26 October 2022

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In this episode Dr Hannah Preston interviews Dr Emma Lunan about physical activity, what advice to give patients about moving more and how doctors can get involved in the interesting field of Sports & Exercise Medicine.

Dr Lunan (@emma_lunan) is a GP Partner and Consultant in Sports & Exercise Medicine and Chair of Movement for Health.

--Useful Links--
Moving Medicine - https://scotland.movingmedicine.ac.uk/
Movement for Health - https://www.movementforhealth.scot/
British Association of Sports & Exercise Medicine (BASEM) - https://basem.co.uk/


Recording Date: 26 September 2022

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In this episode, Dr Amy Prideaux interviews Professor Patrick Kiely about giant cell arteritis (GCA; a.k.a. temporal arteritis), covering diagnosis and management of this rheumatology emergency.

Professor Patrick Kiely is a consultant rheumatologist and Professor of Practice in Clinical Rheumatology.

-- Links --

British Society for Rheumatology guideline on diagnosis and treatment of giant cell arteritis
https://doi.org/10.1093/rheumatology/kez672

Trial of Tocilizumab in Giant-Cell Arteritis
https://doi.org/10.1056/NEJMoa1613849

Tocilizumab for treating giant cell arteritis – NICE Technology appraisal guidance [TA518]
https://www.nice.org.uk/guidance/ta518

Sound issues: We apologise for the audio disturbances in this episode.

Recording date: 24 August 2022

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