Pomegranate Health

REWIND<< Medical fitness to drive Aug 3, 2026 2780 This popular episode was first published in 2019. Australia and NZ are made up of sprawling cities and far-flung towns and driving is often viewed as a fundamental freedom. It can be hard for clinicians to challenge that freedom with patients who they consider unfit to drive safely. And harder still to deal with the consequences if a patient does have a crash. There are diagnoses that should raise

[Contagious Conversations] Approaching HIV elimination Jul 13, 2026 2732 This is the second episode of in the series, [Contagious Conversations] from the Australasian Society for Infectious Diseases. Expert guests in this series will come from right across the interface of research, clinical care and public health.In today’s episode we look at the immense progress that has been made over three decades in the management of HIV. Once a fatal diagnosis, the disease can no

[RACP LIFT] What you need to know about metabolic dysfunction-associated fatty liver disease Jun 30, 2026 1329 This episode is a teaser for RACP LIFT 2026, a series of in-person events to promote Learning, Innovation and Forward Thinking. Coming up on the 1st of August in Melbourne there will be a Rapid Fire Clinical Update on Respiratory medicine, infectious diseases and critical illness. And on the 20th In Brisbane another one themed around Palliative medicine and also population health. In March, the Sy

REWIND<< Drug Interactions and deprescribing Jun 15, 2026 2502 Adverse drug events cause 5-15% of admissions to hospital and drug-drug interactions make up about a fifth of these. Most common are pharmacodynamic situations where two drugs have a similar outcome thereby overdoing the intended outcome. Pharmacokinetic interactions are more complicated to understand as they’re more indirect. For example, while medications are cleared by oxidative metabolism in t

Ep149: Could it be syphilis? Jun 1, 2026 2512 Syphilis is often thought of as a disease from the historic literature, but in August last year, it was declared a Communicable Disease Incident of National Significance by Australia’s Chief Medical Officer. Case numbers have grown year on year since it became a notifiable disease in 2004, peaking at around six and a half thousand in 2023. Syphilis is sometimes described as ‘the great imitator’ be

[Contagious Conversations] Responding to vaccine hesitancy May 4, 2026 3002 Contagious Conversations is a new series brought to you by ASID, the Australasian Society for Infectious Diseases. Once a month, these podcasts will explore evolving evidence and real-world challenges for the practice of ID medicine. The hope is that you’ll come away with practical knowledge to support your clinical confidence and continuous learning. Expert guests in this series will come from

REWIND<< Genomics for the generalist Apr 21, 2026 2867 In Pomegranate <<REWIND>> we go back to some classic episodes from the last ten years that have stood the test of time. The first throwback takes us back to 2017 with episodes 20 and 21 titled “Genomics for the Generalist.” While there’s been a flood of genomic discoveries since this story was first published, it’s still a good primer on fundamental concepts and everyday challenges for

Ep146: Dealing with the next pandemic 2- lockdowns and human rights Apr 6, 2026 3344 While waiting for COVID-19 vaccines to be rolled out, Australian jurisdictions adopted strong social restrictions to minimise community transmission of the virus. It’s estimated that together, these public health measures spared around 50,000 lives up to December 2022 and that vaccines saved three times as many again. While this public health response the pandemic is described as one of the most e

Ep145: Dealing with the next pandemic 1- border closures and vaccine mandates Mar 30, 2026 3947 While waiting for COVID-19 vaccines to be rolled out, Australian jurisdictions adopted strong social restrictions to minimise community transmission of the virus. It’s estimated that together, these public health measures spared around 50,000 lives up to December 2022 and that vaccines saved three times as many again. While this public health response the pandemic is described as one of the most e

[Case Report] 62yo undergoing procedure for a lung nodule Mar 16, 2026 1463 A 62‐year-old man is undergoing a CT‐guided core biopsy of a lung nodule when he develops an iatrogenic pneumothorax. After admission to the Royal Adelaide hospital he has ongoing dyspnoea, oxygen desaturation, and chest pain not helped by a preexisting Chronic Obstructive Pulmonary Disease. The treatment for the patient’s symptoms doesn’t immediately go to plan but his care team apply a combinati

Ep143: On the ground with MSF Mar 2, 2026 3810 Médecins Sans Frontières has projects in more than 70 countries that might be affected by natural disasters, armed conflict or disease outbreaks. Its clinics see over two million emergency room admissions a year and another 16 million outpatient consults. Emergency Paediatrics consultant Josephine Goodyer and ID consultant Tasnim Hasan are two of more than a hundred Australians and New Zealanders

[Case Report] 75 yo with a porcelain aorta Feb 16, 2026 1810 A 75 year-old man with severe aortic stenosis is deemed unsuitable for surgery on the basis of a porcelain aorta detected with cross-sectional imaging. The patient had, a decade earlier, been diagnosed with hypertrophic cardiomyopathy after presenting with cardiac arrhythmia. A dual chamber ICD was implanted at the time for secondary prevention and other comorbidities were managed. The patient is

Ep141: Space Medicine Part 2- really remote practice Feb 2, 2026 2471 The record for the longest space-flight is held by physician-cosmonaut Valeri Polyakov. Back in 1994-95, he spent 437 days on the Mir space station and grew 4 centimetres in height through elongation of his spine in micro-gravity. Polyakov had an uncomfortable ride back to Earth in the very precisely customised descent module. Microgravity also causes demineralization of weight-bearing bones that

Ep140: Space Medicine Part 1- radiation and retinopathy Feb 2, 2026 2275 In 2027, NASA’s is planning to land astronauts on the moon for the first time in 53 years with the expectation that there will be a permanent base there by the early 2030s. And the ever-humble Elon Musk reckons he’ll be sending people to Mars by then too. This has prompted a renewed interest in the prolonged effects of space travel on the human body, and a lot of fascinating research has been cond

[Case Report] 72yo with anterior uveitis Dec 4, 2025 1765 A 72-year-old female presents to an Adelaide emergency department with bilateral eye pain and redness lasting several days. She has a history of hypertension, hypercholesterolemia and age-related macular degeneration for which she has received a range of medications. Anterior uveitis is identified as the proximal cause of the ocular pain but there are many possible aetiologies that require careful

Ep138: Amyloid busters- the benefit and the burden Oct 9, 2025 3365 Australia has just approved a second amyloid-targeting therapy for patients with incipient Alzheimer’s dementia. Lecanemab (Leqembi) now joins donanemab (Kisunla) on the Australian Registry of Therapeutic Goods but the impact of both has been modest in Phase III trials to date. After 18 months of therapy they delay progression of disease, as quantified on neurocognitive tests, by around 5 months o

[Case Report] 27yo with left limb weakness and a mediastinal mass Sep 24, 2025 1398 A 27-year-old male wakes up with weakness in the left arm and leg and gets himself admitted at Royal Adelaide Hospital. Shockingly, for an otherwise well young man with no significant medical history, a right middle cerebral artery acute ischaemic stroke is identified by CT angiogram. His condition deteriorates in hospital, and a mediastinal mass is discovered on review which gives a lead as to th

[IMJ On-Air] DKA and insulin infusion protocols Sep 4, 2025 2689 Diabetic ketoacidosis can be life-threatening but there’s some variability in the way it’s managed between health settings. Intervention involves intravenous insulin administration, hydration, electrolyte replacement and treatment of the underlying precipitant. In a survey of practitioners from 31 different hospitals in Australia there was an even split between those organisations which followed a

Ep135: “Wherefore a Pomegranate?” and other classics from the last ten years Aug 22, 2025 1925 Pomegranate Health has been streaming since June 2015, so we’re going to share a few more classic eps from the last ten years. First up, presenter Mic Cavazzini digs deep to find the origins of the pomegranate, featured not just on this podcast but on the crest of the RACP. The journey starts 500 years ago at an unlikely place, the marriage of Henry VIII and the first of his six wives. You’ll find

[IMJ On-Air] Microbleeds and Memory Aug 4, 2025 2804 Cerebral microbleeds are a finding on MRI that are usually asymptomatic. There are two main aetiological pathways, one occurring as a result of uncontrolled hypertension and the other from the accumulation of amyloid-beta peptide. The link between cerebral amyloid angiopathy and Alzheimer’s Disease is not understood and even the impact that cerebral microbleeds more generally have on cognition. Fo

[Case Report] 46yo with psychosis and cold intolerance Jul 24, 2025 1390 A 46-year old man is admitted to hospital following a first time presentation of psychosis that involved barricading himself inside a neighbour’s home. At admission he appears disorganised with slow movements and speech. His rambling reveals bizarre delusional beliefs of a paranoid and persecutory nature. At moments he shows aggression towards staff but when examines reports occasional dizziness a

Ep132: Ten Years of Pomegranate Health Jul 8, 2025 2092 Pomegranate Health marks ten years of podcasting since its launch in June 2015. This episode will be one of two samplers that dip into the back catalogue of 131 episodes to showcase some of the most compelling stories. You’ll hear how podcast themes are identified from all the domains of medicine and professionalism. And a little bit about the motivations of long-time producer and presenter, Mic C

Ep131: The semantics of CPR Jun 19, 2025 3317 In this podcast we discuss low-value care that has emerged from a decay in the specificity of the terms “cardiac arrest” and “cardiopulmonary resuscitation.” Patients who experience cardiac arrest in hospital are rarely more than a minute or two away from defibrillation. But the proportion of shockable rhythms in these patients is low as the heart has typically stopped after the decline of other s

Ep130: "The motherhood penalty" May 29, 2025 3295 Despite filling more than half of places in Australian medical schools, women represent 45 per cent of all medical practitioners and just 36 per cent of specialists. Female representation dwindles further in many areas of clinical leadership, prompting what has been termed a “leaky pipeline”. It has been reported that women would progress at similar rates to men, and achieve similar remuneration,

[Case Report] 65yo with ST elevation during AF ablation procedure May 20, 2025 1581 ST elevation is clearly a worrying finding that can herald life-threatening conditions, such as ST elevation myocardial infarction. But not all ST-elevations are created equal, and Trainees would benefit from considering a broader number of causes for this presentation. In today’s podcast the team will discuss a case of ST elevation observed in a 65-year-old female during the routine elective proc

Ep128: Brushing off the cobwebs May 1, 2025 1896 There is evidence that six months or more off the job leads to some loss of practical skills and knowledge and certainly, many doctors report 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. Senior staff at Sydney Children’s Hospital have developed a day-long workshop to help medic

[Case Report] 74yo with dyspnoea after AF ablation Apr 14, 2025 1655 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 hav

Ep126: Trying times for Māori medics Mar 27, 2025 2721 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 do

[Case Report] 52yo with hand clumsiness after Chiari operation Mar 13, 2025 1653 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 compli

Ep124: Pleural medicine comes of age Feb 27, 2025 3471 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

[Case Report] 42yo male with fever following liver transplant Feb 11, 2025 1619 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

Ep122: Funding pan-cancer therapies Jan 28, 2025 3005 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 tumo

Ep121: Precision oncology explained Jan 16, 2025 2799 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 ca

[Case Report] 35yo male with proximal weakness and skin changes Dec 19, 2024 1816 This case report describes a 35-year-old Caucasian male presenting with 5 weeks of progressive weakness in the proximal limbs and trunk and associated changes to the skin. The man was previously well and not taking any regular medications. There are many pathways this undifferentiated patient could go down. Consultant physician, Professor Josephine Thomas demonstrates a systematic way to work thro

[Case Report] 47yo with rapidly progressive respiratory failure requiring ECMO Nov 21, 2024 2041 In 2019 a man was referred to Royal Adelaide Hospital with worsening breathlessness and a productive cough. He was a 47 year old electrician with a history of tobacco smoking who’d been well before the onset of symptoms. Over a couple of admissions the patient’s condition progressed to type 2 respiratory failure. While the ultimate explanation for this presentation was a bit of a unicorn, the dram

[Journal Club] Thrombolysis up to 24hr after ischaemic stroke Oct 25, 2024 2582 Thrombectomy for acute ischaemic stroke has undergone great advances in the last decade, but the expertise and technology is restricted to tertiary hospitals. Outside of large metropolitan centres, thrombolytic treatment can buy a patient time, but for almost 30 years the first line agent has remained unchanged. Alteplase is an analog of the human tissue plasminogen activator which activates plasm

[Case Report] 48yo with diarrhoea and lymphadenopathy Oct 10, 2024 1488 This podcast follows the case of a 48-year-old male with a 3-month history of diarrhoea and associated lymphadenopathy. A complex constellation of symptoms accompanies this presenting complaint, along with a key radiological finding that enabled the treating team to arrive at the correct diagnosis. Can you arrive at the correct diagnosis before the treating team? This case was managed at the Queen

[Guest Lecture] Fighting hepatitis C in prisons and the community Sep 20, 2024 2017 This recording comes from the launch of the 2nd Monitoring and Evaluation Report on Hepatitis C Elimination in NSW. The work was conducted through the Kirby Institute under the guidance of infectious diseases specialist, Professor Greg Dore. As presented in this seminar, data show that the state is on track to meet the 2025 target set by NSW Health, and the national target for 2030, but there have

Ep115: One day as a nuclear medicine registrar Sep 9, 2024 2631 Dr Karan Singh loves his job as a registrar in nuclear medicine but he thinks there isn’t enough exposure to the specialty during medical school and basic training. In this podcast we spend a day in his department at Prince of Wales Hospital Sydney and get a taste of the many different referrals that come his way; a bone scan for a young man experiencing leg spasms after recovering from a car cras

[IMJ On-Air] Understanding readmissions better Aug 22, 2024 1851 The LACE index is a prognostic algorithm for predicting the likelihood that a newly discharged patient will come back into hospital within 30 days because of complications. Today’s IMJ paper describes a validation of the LACE index in a regional Victorian setting. Identifying patients who are at risk could allow for better targeted care at the first admission, reducing harm to patients and ineffic

[Case Report] 58yo with acute myeloid leukaemia and diplopia Aug 9, 2024 1489 This podcast follows the case of a 58 year old man who presented to the haematology department at Flinders Medical Centre with intravascular coagulation and leukocytosis. He was diagnosed with acute myeloid leukaemia and treated on standard cytarabine and daunorubicin combination therapy. Nine days after initiation, the patient developed painless diplopia and ptosis, and the story is picked up wit

Ep112: The resilient workplace Jul 31, 2024 2584 The RACP Congress in May this year was opened by a fascinating lecture on mental health in the medical workforce, which has been trimmed down for audio. Professor Neil Greenberg is an occupational psychiatrist with more than 23 years in the UK Armed Forces. His extensive research within defence and health settings has informed a very pragmatic understanding of the impact of trauma and relationship

[CPD On Demand] Advance Your CPD Through Effective Supervision Jul 16, 2024 946 From 2024, supervising has been recognised as a Category 2 CPD activity. This short and insightful episode focuses on recent updates to the 2024 MyCPD Framework, highlighting the recognition of supervisory activities as a critical element of Category 2 Reviewing Performance CPD. Please join Professor Martin Veysey, a renowned expert in supervision and medical education, and Associate Professor Kud

[Case Report] 32yo with abdominal pain two years after pancreas-kidney transplant Jul 3, 2024 1253 This case report has been developed by Trainees, to assist their peers with preparation of long-case presentations. It is not a fully-vetted Education resource but a “passion project” from editors of the Pomegranate Health podcasts. The case is that of a 32-year-old woman presenting with constant and dull abdominal pain that had been sudden in onset. The pain is accompanied by nausea and vomiting

Ep109: Cultivating a rural workforce Jun 11, 2024 2741 Australia is a big continent and sparsely populated continent. 28 percent of Australians live in areas classified regional, rural or remote and their access to health services is much more limited. It’s estimated that between 2009 and 2011 there were 19,000 excess deaths in regional and remote areas as compared to the major cities. No doubt, socioeconomic disadvantage is factor in that mortality g

[Case Report] 68yo with cardiometabolic risk factors and transient monocular vision loss May 15, 2024 1930 Pomegranate [Case Report] is a Q&A style podcast developed by trainees, for trainees. In our debut episode, we hear about w a who man presented to the emergency department reporting sudden onset vision loss in his right eye lasting several hours. He was 68 year old with a history of type 2 diabetes mellitus. Three differential diagnoses being considered were optic neuropathy, vitreoretinal dis

[Journal Club] Baricitinib immune therapy for new onset type 1 diabetes Apr 11, 2024 2444 Type 1 diabetes has a very high treatment burden in terms of direct costs, inconvenience and lost productivity for patients and their carers. Further, all the glucose checking, hormone replacement and consults don’t abolish the vascular complications associated with poor glycaemic control. Only in the last few years has it been possible to pharmacologically alter the course of type 1 diabetes and

Ep106: The whiskey fix and the apple of Granada Mar 25, 2024 1850 Today’s guests are the hosts of This Medical Life, a wonderful podcast that delves into the archives of medical history. Dr Travis Brown describes the period after World War I when the Spanish Flu was killing tens of millions around the world. In the USA, whiskey was thought to be a powerful prophylactic but distribution was not an easy thing. Later in the episode (22min) is the equally unlikely t

Ep105: When parents and paediatrics clash Feb 27, 2024 2947 Last November an NHS Hospital Trust in Nottingham sought permission from the UK High Court to withdraw life support from a seven-month old girl called Indi Gregory. The devastated parents did not want to give up on her although they were advised there was no hope of treatment for her profound developmental disability. The family and the medical teams returned to court two more times, right up to t

[IMJ On-Air] Is the jury still out on omega-3 supplementation? Jan 31, 2024 1544 The theory that certain fatty acids are essential to the diet and associated with reduced cardiovascular risk has been controversial since it was floated in the 1950s. In 1971 Danish researchers published the results from a cross-sectional study of Inuit people living on the west coast of Greenland. They ate a fish-based diet rich in polyunsaturated fatty acids known as omega-3s, which were found

[IMJ On-Air] HepatoCare: a model for palliative and supportive care in advanced cirrhosis Dec 11, 2023 2372 Median survival for patients diagnosed with advanced cirrhosis is around 2 years and quality of life is poor. Fewer than a quarter of such patients receive referrals to palliative care and advanced care plans are also rare. Existing research from abroad suggests that hepatology staff aren’t familiar with referral criteria and assume that palliative services become involved only at the very end of

Ep102: Staying on script with semaglutide Nov 13, 2023 3285 Semaglutide, branded as Ozempic or Wegovy, is an analogue of glucagon-like peptide 1 which has glucose-dependent effects on insulin secretion. In this episode we discuss how semaglutide performs as an antihyperglycaemic agent compared to previous GLP-1 analogues and the soon-to-be launched tirzepatide. This dual agonist also binds receptors to glucose-dependent insulinotropic polypeptide, GIP.GLP-

Ep101: Setting the standard for workforce wellbeing Sep 26, 2023 3386 We’ve known for a decade that about 50 percent of doctors meet the criteria for burnout, and the figure is up to 70 percent among trainees. But organisations have been left to come up with their own solutions to this, the result being that many simply offer band aid solutions rather than systemic ones. Unforgiving work conditions pose a problem for both recruitment and retention of staff to the he

Ep100: Conversations with ChatGPT Aug 16, 2023 2204 This is the final episode in a five-part series about artificial intelligence in medicine. We start by weighing up the costs and benefits of automation in a health system that’s increasingly pushed beyond capacity. One of the biggest time sinks for health practitioners is filling out and searching through medical records. Some of this could be performed by natural language processors which are bec

Ep99: When AI goes wrong Aug 9, 2023 2323 This is the fourth part in a series on artificial intelligence in medicine and we try and unpick the causes and consequences of adverse events resulting from this technology. Our guest David Lyell is a research fellow at the Australian Institute of Health Innovation (Macquarie University) who has published a first-of-its kind audit of adverse events reported to the US regulator, the Federal Drugs

[IMJ On-Air] A tiger in the mallee: Victoria’s JEV cluster Jul 17, 2023 2626 On the 28th of January 2022 a 75-year-old man was admitted to the regional Albury Wodonga Health Service with a high fever and Parkinsonian symptoms. The patient spent over a week in intensive care, but brain scans did not reveal an obvious aetiology and assays for a range of pathogens came up negative.When serology eventually revealed the presence of antibodies against Japanese encephalitis virus

Ep97: The governance of AI Jul 5, 2023 2065 This is the third part of a series on artificial intelligence in medicine. Previously we explained how to train and test machine learning models that assist in decision-making, and then how to iron out ergonomic friction points in the clinical workflow. We’ve mentioned how deep learning neural networks are more capable than classical models at dealing with big noisy data sets, but also that the re

Ep96: The ergonomics of AI Jun 21, 2023 2508 The allure of having devices and tasks assisted by artificial intelligence is that they will help overcome some of the natural limits of human cognition with regards to working memory and attention. And in helping with the mundane tasks, AI can buy clinicians back time to spend with the complex patients who really need it. But the way all this pans out will really depend on how seamlessly the mach

Ep95: Machine Learning 101 Jun 14, 2023 2253 AI-assisted healthcare is reaching maturity in many applications and could alleviate some of the capacity gap increasingly faced by health systems . Over the next three podcasts we focus on artificial intelligence tools designed to assist directly with clinical practice. Most commonly reported on are the algorithms capable of pattern recognition on medical images, that in some settings perform as

Ep94: Facing up to racial bias May 12, 2023 3539 In today’s podcast we try and understand the impact that racial bias makes on variation in clinical care. For example, racialized patterns in the use of analgesia were brought to light over 20 years ago but are still occurring today. In research from the UK published in March it was found that women of African or South Asian extraction were significantly less likely to receive an epidural during v

Ep93: The rise and fall of mpox Apr 17, 2023 2558 The first time most of us heard of monkeypox was in May 2022. The smallpox-like infection appeared to spring from nowhere and make its way through Europe then the Americas, largely within the gay and bisexual community. But the first documented human case of mpox actually occurred in 1970 in Central Africa and it’s been endemic ever since. Last year’s mpox outbreak eclipsed prior case numbers in j

Ep92: Data-driven practice improvement Feb 27, 2023 2681 Medical and administrative records are normally collected to help the management of patients or institutions, but it can be time consuming to extract metrics useful for practice improvement. The field known as Practice Analytics seeks to transform these data and provide clinicians with a bird’s eye view of their case load and performance. Practice Analytics can draw attention to cases that stood o

[IMJ On-Air] Hyperglycaemia and COVID-19 Jan 16, 2023 2122 In the first year of the COVID-19 pandemic, a handful of international studies showed that there was increased risk of adverse outcomes in hospitalised patients comorbid for diabetes. Odds ratios for mortality conferred by pre-existing diabetes ranged from 1.5 to 3.6. What this relationship might be in Australia was not known until researchers in Melbourne retrospectively examined electronic medic

[IMJ On-Air] High readmission rates in cirrhotic patients Dec 21, 2022 2342 Hospitalisation rates for cirrhosis are increasing in Australia in part associated with the high prevalence of obesity and subsequent non-alcoholic fatty liver disease. More concerning still is the frequency with which discharged patients are readmitted within 30 days. One systematic review put the average readmission rate at 26%, but the studies cited varied greatly in their inclusion and exclusi

[Guest Lecture] What we know about long COVID Dec 14, 2022 2482 ADAPT is a prospective cohort study that has been following up COVID-19 patients since the earliest days of the pandemic. It has allowed researchers to track the emergence of long COVID, a syndrome that includes symptoms such as ongoing breathlessness, fatigue, chest tightness and "brain fog". Over the course of the study, participants have contributed blood cells, cardiac and brain MRIs

[IMJ On-Air] Making sense of HACs Nov 17, 2022 2313 Clinical complications suffered by patients during hospital stays are assumed to be preventable and to provide some metric of quality of care. To assist in their understanding and mitigation the Australian Commission on Safety and Quality in Healthcare established a national programme to track hospital-acquired complications (HACs) in a formalised way. Comparison data can be found through the Heal

[IMJ On-Air] Managing cannabinoid use in palliative care Oct 25, 2022 2640 About two thirds of Australians use complementary and alternative medicines but only around half of these people will mention it to their doctor. Patients in palliative care settings may be more inclined than most to try therapies from outside the box. But they are also more vulnerable to side effects and interactions given that their drug metabolism and clearance mechanisms are often impaired. In

[IMJ On-Air] Recent advances in asthma management Sep 14, 2022 2814 This is the first episode of a new format called “IMJ On-Air” inspired by the RACP’s Internal Medicine Journal. Each episode will be have as guest-host a section editor or reviewer of the IMJ interviewing authors of a recent article. Often these will be Clinical Perspectives reviews which summarise the latest in management of major medical disorders. In this episode we have leading respiratory phy

Ep85: The ASD Odyssey- a reply Aug 31, 2022 2434 The National Guideline for the Assessment and Diagnosis of Autism Spectrum Disorders in Australia aspires to streamline referral pathways so that children can get the right help as early as possible. But despite the best intentions of many clinicians, there are drivers in the health system that make implementation difficult. There are constraints in the way specialists can be reimbursed for time s

Ep84: The ASD Odyssey Aug 16, 2022 2397 The average age at which autism spectrum disorder is diagnosed four, though signs are often present well before that. Even where families and GPs may have concerns early in a child’s development, it can take a year or more for a consult with a paediatrician to become available. There are similar waiting lists to see other allied health and sub-specialists who may contribute opinions to a diagnosis

Ep83: Loving Medicine Again Jul 11, 2022 2495 In the last episode we heard some powerful examples of the challenges faced by some practitioners in medicine. Every situation has its idiosyncrasies, but most people start out with a passion for what they’re doing. In today’s podcast we hear from doctor-career coaches Ashe Coxon and Sarah Dalton who help medics solve the workplace challenges, and remember what drew them to the profession. Associa

Ep82: Coming back from Burnout— Congress 2022 Jun 21, 2022 2944 Not a day goes by that there isn’t a headline about the overstretched health service and the struggling professionals within it. It isn’t COVID that has created this situation. The pandemic was just the straw that broke the camel’s back.At the RACP Congress in May, ENT surgeon Eric Levi explained why burnout should be considered not as a mental health condition but as an occupational disorder. And

Ep81: Advocacy from the Top Jun 3, 2022 1193 In episode 78 we heard from some physicians who found themselves taking up the role of advocate, not just for their own patients but for broader system change. And health policy lobbyist Patrick Tobin explained how physicians and the College as whole can best get the attention of parliamentarians. For example, the RACP’s Healthy Climate Futures campaign calls on Government to make the healthcare s

Ep80: Healthcare in a Volatile Climate May 2, 2022 2007 The globe has already warmed by more than one degree Celsius over pre-industrial levels and is on track to exceed two degrees by the end of the century. It doesn’t sound like a lot but this will have profound effects on human health with Australia being particularly vulnerable. Most obviously, Australia’s biggest cities will become furnaces in summer with a more than doubling of heat-related morta

Ep79: Melanoma vs the Double-Edged Sword Mar 29, 2022 2818 Immune checkpoint inhibitors have revolutionised care for patients with advanced melanoma and other cancers. These days around half of patients with unresectable metastatic melanoma can expect to live to five years after a regime of agents such as nivolumab and pembrolizumab. That’s up to ten times the survival rate of patients a decade ago, when the chaemotherapy Dacarbazine was the front-line tr

Ep78: The Advocate’s Journey Mar 2, 2022 2316 The core work of being a physician is demanding enough. But if you’re seeing patients come in day after day with ailments that have social determinants behind them, you may start to feel like Sisyphus; heaving that boulder up the hill only to have to start from the bottom every time it slips your grasp. Surely it would be better to change those socioeconomic drivers but where do you even begin? In

Ep77: Deciding with Children Jan 11, 2022 2776 This episode is shared from the Essential Ethics podcast produced at the Royal Children's Hospital in Melbourne. It is presented by paediatric respiratory physician John Massie and clinical ethicist Lynn Gillam who are respectively the Clinical Lead and Academic Director of the Children's Bioethics Centre.In a series titled “Deciding with Children” they raise the following questions. Whe

Ep76: Making Amends- Medical Injury Part 3 Dec 7, 2021 2424 This is the third podcast in a series about medical injury. First we talked about what victims of injury want to hear from the health system after such an event. And then we discussed the guilt and compromised professional identity that doctors might feel when they’ve been involved in a patient harm. We also heard how fear of medicolegal suits is a major obstacle to greater transparency. At least

Ep75: Feeling Guilty- Medical Injury Part 2 Nov 9, 2021 3089 In the last episode we talked about what patients or their families want to hear after a iatrogenic injury. Despite best practice standards for open disclosure, this occurs far less often that it should. The reluctance from health practitioners to be more transparent is in part due to a misplaced fear of exposure to liability, but perhaps the greatest barrier to incident disclosure is culture of m

Ep74: Saying Sorry- Medical Injury Part 1 Oct 22, 2021 2738 Medical injury occurs at a rate of about 12 per cent of admissions, and errors without consequence at a higher rate still. According to Australian and New Zealand guidance documents, disclosure of error “is a patient right, anchored in professional ethics, considered good clinical practice, and is part of the care continuum.” But many practitioners are fearful of the medicolegal consequences of di

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