Pomegranate Health

the Royal Australasian College of Physicians

Pomegranate Health is a podcast about the culture of medicine. You'll hear clinicians, researchers and advocates discuss all aspects of professionalism and quality improvement in healthcare. This includes clinical ethics, diagnostic bias, better communication and more equitable systems. For a sampler of these diverse themes of professional practice take a listen to Episode 132 and Episode 125.

If RACP is your CPD home, you can log time spent listening to each episode with the "Add activity to MyCPD" button. And if you're a Basic Physician Trainee, the [Case Report] series might help you prepare for your long case clinical exams.

This is also the home of [IMJ On-Air], featuring authors from the Internal Medicine Journal sharing their latest research. Meanwhile, the [Journal Club] episodes give RACP members a place to talk through their research published in other academic journals.

Feel free to send feedback and suggestions by email at podcast@racp.edu.au.

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#157
Tuesday · 36 min
Ep157: AI models for discharge letters and clinical coding
In part 1 of this series we talked about the efficiency gains from use of ambient scribes observed in some hospital settings. In this episode we discuss other opportunities that arise from granting large language models access to all the notes and test results in the patient record. The potential comes most clearly into perspective in regards to discharge summaries. Discharge from hospital is a notorious example of discontinuity in care, with up to half of discharged patients experiencing a related medical error over a year. This results from delays in the release of discharge letters to community practitioners, and gaps or misunderstandings in the communications contained within them. Inconsistent standards of clinical documentation also lead to inaccurate coding of clinical activity that fails to reflect the true complexity of care. This means that hospitals are inadequately remunerated through the activity-based funding model for Australian public health services. For private practitioners, poor documentation of clinical encounters also exposes them to risks should they ever be investigated by the Professional Services Review about their billing activity. We also question the light touch that regulators take towards ambient scribes and large language models. Chapters 1:20 Reliable discharge summaries 11:53 Improved clinical coding 21:55 Safety regulation 30:51 Patient satisfaction Guests Dr Andrew Vanlint FRACP AFRACMA (North Adelaide Local Health Network; Adelaide University; Genesis Care) Professor Ian Scott FRACP MHA MEd (Princess Alexandra Hospital, Metro South Health; University of Queensland) Dr Adam Brand FACEM MPH (Gold Coast University Hospital) Production Production by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Midnight sun serenade’ and ‘End of the Ocean’ by Tellsonic and ‘Multicolor’ by Chill Cole. Feedback on this episode kindly provided by Dr Aidan Tan, Dr Simeon Wong, Dr Joseph Lee, Assoc Prof Paul Cooper PhD and Loryn Einstein. Image by da-kuk purchased from Getty Images. Visit the Pomegranate Health web page for a transcript and supporting references. Add educational activity to MyCPD. Subscribe through any podcasting app or our email alerts list.
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#156
September 14 · 36 min
Ep156: AI scribes in hospital
The burden of clinical documentation is one of the top reasons given for job dissatisfaction in medicine. Physicians typically give up an hour of personal time per shift to complete paperwork and the frustration is experienced by patients too, who sometimes feel that their doctors are more focused on the computer. The promise of ambient AI scribes is that they could slash the time you spend hovering over the keyboard and in general practice some 40 percent of Australian GPs are using scribes already. Among private specialists, adoption been slower and use of ambient scribes in hospital has been prohibited until now. In this podcast we hear the outcomes of two pilot studies of ambient scribes in Queensland’s public hospital networks; the quality of scribe outputs and the errors you need to keep an eye out for. The efficiencies gains differ from the clinic, to the ward round to the ED, and not all specialty consults benefit to the same degree. And while some have raised questions about the gaps in skills that might result from this technology, todays’ guests expand on the training opportunities that it creates too. Part 2 of this series explores further benefits from giving large language models access not just to the consult, but the whole patient record. Chapters 6:58 Quality of outputs from ambient scribes 17:53 Real world time savings 21:55 Ward Rounds and the ED Guests Dr Andrew Vanlint FRACP AFRACMA (North Adelaide Local Health Network; Adelaide University; Genesis Care) Professor Ian Scott FRACP MHA MEd (Princess Alexandra Hospital, Metro South Health; University of Queensland) Dr Adam Brand FACEM MPH (Gold Coast University Hospital) Production Production by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘End of the Ocean’ by Tellsonic and ‘Multicolor’ by Chill Cole. Feedback on this episode kindly provided by Dr Aidan Tan, Dr Simeon Wong, Dr Joseph Lee, Assoc Prof Paul Cooper PhD and Loryn Einstein. Image by da-kuk purchased from Getty Images. Visit the Pomegranate Health web page for a transcript and supporting references. Add educational activity to MyCPD. Subscribe through any podcasting app or our email alerts list.
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#155
August 31 · 33 min
[Contagious Conversations] H5N1 avian flu hits our shores
The avian flu H5N1 known as 2.3.4.4b has been tearing around the globe since 2021 causing significant mortality in sea birds and mammals. The Australian and New Zealand mainland were the last holdouts, but this virus was first detected near Esperance, WA on June 20th 2026 and then near Wellington, NZ on Jul 14th. Both cases involved a bird known as the brown skua, which travels across the Southern Ocean, and by August 24th the H5N1 had also been confirmed in fur seals in South Australia and associated with one seal death. While risk to humans from this clade is currently negligible, ID experts are concerned for the health of this domestic poultry and livestock, which have been hard hit internationally, and wild birds and marsupials which would be much harder to protect. This podcast discusses the surveillance and response from a One Health perspective. Guests Michelle Wille PhD (University of Melbourne; Doherty Institute; WHO Collaborating Centre for Reference and Research on Influenza) Associate Professor Michael Nissen MBBS FRACP FRCPA FFS (Royal Brisbane Hospital; Research Director, Prince Charles Hospital; University of Queensland. Host Associate Professor Sanjaya Senanayake FRACP (Canberra Hospital; Australian National University) Production Production by Mic Cavazzini DPhil AND Dr Candice Holland, ASID. Thanks also to Inge Meggitt, events coordinator at ASID. Music licenced from Epidemic Sound includes ‘Exploring the Lake’ by View Points and ‘Emerlyn’ by Valante. Image copyright ASID (2026). Visit the Pomegranate Health web page for a transcript and supporting references. Add educational activity to MyCPD. Subscribe through any podcasting app or our email alerts list.
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#154
August 17 · 46 min
Ep154: Delabelling penicillin allergy FAST
Allergies to first-line antibiotics complicate care, and use of broad-spectrum alternatives is associated with prolonged hospital stays and increased rates of admissions to ICU. It also makes emergence of antimicrobial-resistant pathogens more likely. Ten to 16% of adult patients are marked in the record as being allergic to penicillins but the majority of these labels are applied inaccurately or have become outdated over time. While skin-prick testing is a safe and reliable way to delabel patients who can tolerate penicillin, it is resource-intensive and requires trained allergists on-site. In this podcast we describe a decision tool called PEN-FAST that helps to quickly identify patients suitable for direct oral challenge in almost any setting. Guests include two of the leading academics behind the validation and scale-up of this algorithm. Guests Prof Jason Trubiano FRACP FAAAAI‍ (Austin Health, Director of Infectious Diseases; Peter Doherty Institute for Infection and Immunity) Prof Suran Fernando FRACP FRCPA PhD OAM (recent!) (Royal North Shore Hospital; University of Sydney) Dr Fionnuala Fagan FRACP FRCPA (Dunedin Hospital; Otago University) Chapters 10:42 PEN-FAST tool 22:23 Multi-site testing of PEN-FAST 28:27 Non allergist-led testing 32:42 System-wide outcomes Production Production by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘The Bayou’ and ‘Feels like I’m going Crazy’ by Tigerblood Jewel. Feedback on this episode kindly provided by Dr Marion Leighton, Dr Robin Sia, Dr Aidan Tan, Dr Hugh Murray, Arnika Martus and Paul Cooper PhD. Image courtesy of Thirteen of Clubs at Flickr. Visit the Pomegranate Health web page for a transcript and supporting references. Add educational activity to MyCPD. Subscribe through any podcasting app or our email alerts list.
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#153
August 3 · 46 min
REWIND<< Medical fitness to drive
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 red flags for driving fitness in various specialty areas, and a clinician can be drawn into the issue by two main pathways. The more straightforward is when a patient presents with a medical assessment form. It's the Driver Licencing Authority in each state which ultimately issues the driving permits and may require the recommendation of a medical professional. The other way is when the clinician detects a new or worsening condition in a patient who is already licenced. They are expected to warn their patients off driving and in some jurisdictions to report them to the DLA if this advice isn't being heeded. Chapters 7:48 Legal expectations on a practitioner 17:20 Medical conditions affecting to fitness to drive 24:48 Considering age in driving performance 35:28 Approaching driving ‘retirement’ 45:28 Updates to national standards Guests Dr Genevieve Yates FRACGP (Principal Medical Educator RACGP, MDA National's Education Services Advisory Group, Black Dog Institute) Prof Roy Beran FRCP FAFPHM FRACP FRACGP FACLM (University of UNSW) Marilyn Di Stefano PhD (Victorian Department of Transport and Planning) Serge Zandegu (Victorian Department of Transport and Planning) Production Written and produced by Mic Cavazzini DPhil. Recording assistance in Melbourne from Sam Loy of Human/Ordinary. Music courtesy of Free Music Archive; 'John Stockton Slow Drag' and 'What True Self? Feels Bogus, Let's Watch Jason X' by Chris Zabriskie, 'Noir' by Daniel James Dolby, 'Hélice' by Monplaisir. Music licenced from Epidemic Sound includes ‘Knowledge is Power’ by Matt Large. Visit the Pomegranate Health web page for a transcript and supporting references. Add educational activity to MyCPD. Subscribe through any podcasting app or our email alerts list.
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#152
July 12 · 45 min
[Contagious Conversations] Approaching HIV elimination
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 now be completely controlled by anti-retroviral therapy. Access to prophylactic treatment has also made a huge impact on rates of transmission in the community although barriers still remain to equitable access. Guests Professor Sharon Lewin OA FRACP PhD (Peter Doherty Institute for Infection and Immunity, Director; University of Melbourne; Cumming Global Centre for Pandemic Therapeutics, Director) Professor Dato’ Dr Adeeba Kamarulzaman FRACP FASc (Monash University Malaysia, President & Pro Vice-Chancellor; Centre of Excellence for Research in AIDS). Richard Keane (Living Positive Victoria, CEO) Host Associate Professor Sanjaya Senanayake FRACP (Canberra Hospital; Australian National University) Production Production supported by Mic Cavazzini DPhil, and the Viral Hepatitis and HIV Special Interest Group particularly Dr Emma Paige and Dr Sushena Krishnaswamy. Thanks also to Inge Meggitt, events coordinator at ASID. Music licenced from Epidemic Sound includes ‘Exploring the Lake’ by View Points and ‘Emerlyn’ by Valante. Image copyright ASID (2026). Visit the Pomegranate Health web page for a transcript and supporting references. Add educational activity to MyCPD. Subscribe through any podcasting app or our email alerts list.
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#151
June 30 · 22 min
[RACP LIFT] What you need to know about metabolic dysfunction-associated fatty liver disease
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 Sydney RACP offices hosed a meeting on cardiometabolic and vascular health, and the talk shared here covers everything a generalist needs to know about metabolic dysfunction-associated fatty liver disease. The seminar was presented by Professor Jacob George, Director of the Storr Liver Centre at the Westmead Institute for Medical Research, and author of over 1300 peer-reviewed papers. He explains why fatty liver disease is a "canary in the coal mine" for metabolic health more generally, how to diagnose using scans and bloods, and the use of the FIB-4 index. Professor George also describes how patients can be stratified and managed for risk of more complex liver disease and reviews outcomes from the latest pharmacological interventions. Guests Professor Jacob George FRACP PhD FAASLD (The Westmead Institute for Medical Research, Centre Director; University of Sydney) Chapters 3:09 MAFLD is a positive definition 4:29 How common are MAFLD and MASH? 5:58 How do you define metabolic health? 9:02 Mortality and cardiovascular outcomes in patients with T2D 10:07 MAFLD in primary care guideline 12:40 Current and future therapies for MAFLD / MASH 15:24 Management algorithm for MAFLD 16:50 Test your knowledge Production Rapid Fire Clinical Update developed by LIFT advisory group and hosted/recorded by RACP Events team and. Podcast production by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Kryptonite’ by Blue Steel and ‘Simmering Anxiety’ by Christian Andersen and ‘Little Liberty’ by Paisely Pink. Visit the Pomegranate Health web page for a transcript and supporting references. Add educational activity to MyCPD. Subscribe through any podcasting app or our email alerts list.
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#150
June 14 · 41 min
REWIND<< Drug Interactions and deprescribing
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 the liver and gut, there are many drugs that interfere with the function of the cytochrome enzymes responsible. This can result in clearance of the first drug at too fast or too slow a rate. Polypharmacy has become more frequent over the decades with more than half of people over the age of 75 on five or more prescriptions. This episode examines some of the systems that have led to current rates of polypharmacy, and strategies for deprescribing safely in a given patient. We're REWINDing it nine years after it was first published to celebrate the career of Professor Ric Day who has just retired after sixty years of service at St Vincent’s Hospital, Sydney. He has been a much-appreciated clinician and prolific research academic with several hundred published papers that have been cited more than forty thousand times. Chapters 0:50 Prevalence of drug interactions 5:52 Pharmacodynamic vs pharmacokinetic interactions 9:25 Cytochrome enzymes 17:33 ACE inhibitors and more 26:48 Strategies for deprescribing Guests Professor Richard Day AM MBBS, FRACP (St Vincent’s Hospital; UNSW), Professor Sarah Hilmer AM PhD FRACP FAAHMS (Royal North Shore Hospital; Kolling Institute/ USyd). Production Produced by Mic Cavazzini DPhil. Music courtesy of FreeMusicArchive includes ‘Flying Pea’ and ‘Cherry Blossom’ by Daddy Scrabble and “Manly Nunn Steps Out” by Doctor Turtle. Music licenced from Epidemic Sound includes ‘Train Ride’ (Instrumental) by Alex Kehm and ‘Yellow Leaf’ by Autohacker. Image adapted for RACP Add educational activity to MyCPD as educational activity or visit web page for a transcript and references. Key References Life-threatening drug interactions: what the physician needs to know [Internal Medicine Journal] Polypharmacy in older people: when should you deprescribe? [Medicine Today]
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#149
June 1 · 41 min
Ep149: Could it be syphilis?
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’ because it can have so many different presentations. And it can hide away for years before revealing itself in one system of the body or other. In this podcast we’ll go over the neurologic, ophthalmic and nephrotic symptoms that can eventuate, and also some worrying examples of congenital transmission seen today. Today’s podcast will expand your library of differential diagnoses and give you confidence to go down the pathway of testing, treatment and contact tracing. It has been promoted with financial assistance from ASHM and the Australian CDC. Guests Clinical Professor Louise Owen FRACGP FAChSHM MBBS(Hons) (Statewide Sexual Health Service in Tasmania, Director; University of Tasmania) Dr Janet Towns FRACP FRACGP AChSHM PhD (Melbourne Sexual Health Centre; Monash University) Dr Nele Legge FRACP PhD (Liverpool Hospital) Production Produced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘A Forest Melody’, ‘Time Traveller’ by Tellsonic, ‘Reconstruct’ by Amaranth Cove and ‘Beat Street’ by VV Campos. Music courtesy of FreeMusicArchive includes ‘Namaste’ by Jason Shaw. Historic poster courtesy of the US Library of Congress Archive. Editorial feedback kindly provided by members of the Doctors Aidan Tan, Courtney Dowd, Marion Leighton, Lauren Gomes, Rahul Barmanray and Rachel Murdoch. Dissemination of this podcast was supported by ASHM and campaign to Stop Syphilis. Add educational activity to MyCPD as educational activity or visit web page for a transcript and references.
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#148
May 4 · 50 min
[Contagious Conversations] Responding to vaccine hesitancy
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 right across the interface of research, clinical care, and public health. Today we start with a paediatrician from Melbourne and a clinical nurse from the Sunshine Coast, who both make an important contribution to Australia’s National Immunisation Program. As we’ll hear today, public adherence to the NIP has been declining in recent years. In today’s conversation we hear about some of the reasons for vaccine hesitancy in parents and ways to reinspire confidence. Guests Professor Margie Danchin FRACP, PhD (University of Melbourne; the Royal Children’s Hospital; Murdoch Children’s Research Institute) Wendy Tout (Public Health Unit, Sunshine Coast Health Service) Host Associate Professor Sanjaya Senanayake FRACP (Canberra Hospital; Australian National University; University of New South Wales) Production Production supported by Mic Cavazzini DPhil, the ASID Vaccine Special Interest Group chaired by Dr Archana Koirala and staff support from Inge Meggitt. Music licenced from Epidemic Sound includes ‘Exploring the Lake’ by View Points and ‘Emerlyn’ by Valante. Image copyright with ASID (2026). Add educational activity to MyCPD as educational activity or visit web page for a transcript and references.
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#147
April 21 · 47 min
REWIND<< Genomics for the generalist
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 the physician advising a patient. The expert guests include a genetic pathologist, a clinical geneticist, a genetic counsellor and a medical oncologist. The podcast covers the different roles for single gene tests and whole genome sequencing, which has become much more accessible. We tackle question of disease risk and how to present uncertain predictive diagnoses to consumers. This is particularly relevant to using genome-wide association studies, which re finding more and more markers with very small associated risks of disease. This increases the likelihood of picking up diagnoses incidental to the ones a clinician might be looking for. The ethics of consenting patients to genome screening and informing them of incidental findings are also discussed. Chapters 3:04 Mendelian vs multi-gene diseases 6:42 Whole genome sequencing 10:09 Prenatal testing 12:38 What do physicians need to know? 17:07 Pharmacogenomics 19:52 Genetic counselling 22:40 Funding of genetic tests 33:46 Incidental findings 39:13 Consent and privacy issues Guests (2026 affiliations) Professor Leslie Burnett FRCPA, FHGSA, FCAP (University of New South Wales; Virtus Health) Professor Michael Gabbett FRACP (Queensland University of Technolgy; Mendel Genetics) Associate Professor Kristine Barlowe-Stewart FHGSA (University of Sydney; Children’s Cancer Institute) Prof David Thomas FRACP PhD (University of New South Wales; Omico) Production Produced by Mic Cavazzini DPhil. Music courtesy of FreeMusicArchive includes, 'Cloud Line' by Blue Dot Sessions, 'Is That You or Are You You?' by Chris Zabriskie, First Holes’ by Cory Gray, ‘Brand New World’ by Kai Engel. Music licenced from Epidemic Sound includes ‘Abyss’ by Luwaks. Image customised for RACP. Editorial feedback for 2017 podcast provided by members of the podcast editorial group Dr Pavan Chandrala, Dr Tessa Davis, Dr Rebecca Grainger, Dr Michael Herd, Dr Paul Jauncey, Dr Joseph Lee, Dr Marion Leighton, Dr Anutosh Shee and Dr Ellen Taylor, and Advanced Trainee Dr Katrina Gibson. Add educational activity to MyCPD as educational activity or visit web page for a transcript and references.
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#146
April 5 · 55 min
Ep146: Dealing with the next pandemic 2- lockdowns and human rights
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 effective in the world it did cause unintended social harms and lingering resentment. Our leaders and community need some sober reflection on how to we might respond to the next such pandemic respiratory virus. Over two podcasts we look carefully at the how the cost-benefit calculation stacks up for each of the major interventions. In Part 1 we discuss the international borders closures and overcooked parochialism between state jurisdictions, and also how messaging around vaccine risks and mandates could be improved. In Part 2 we look at the controversial stay-at-home orders and interruptions to in-person schooling and even the evidence for faces-masks. Ultimately, there are some questions that can’t be answered scientifically, and it is for politicians and the public to decide what the cost of freedom and dignity against human lives left exposed. Chapters Part 2 3:38 Social restrictions 16:39 Facemasks 21:19 Missing behavioural and epidemiological data 30:35 Psychological morbidity from social restrictions 39:39 Human rights and moral preparedness Guests Professor Paul Kelly FRACP (Australia’s Chief Medical Officer during the pandemic) Professor Catherine Bennett PhD GAICD (Deakin University; co-author of the “COVID-19 Response Inquiry” ) Professor James McCaw PhD (The University of Melbourne; modeler for the Federal government’s “National Plan”) Lorraine Finlay PhD (Australian Human Rights Commissioner; co-author of the "Collateral Damage" report) Production Produced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Organic Textures 2’ by Johannes Bornlöf, ‘RGBA’ by Chill Cole, ‘Axon Terminal’ by Out to the World, ‘Soundbed’ by Blue Saga, and ‘Echo (Kerstin Ljungstrom Remix)’ by Bonsaye. Music courtesy of FreeMusicArchive includes ‘Namaste’ by Jason Shaw. Image by Westend61 licenced from GettyImages. Editorial feedback kindly provided by members of the podcast editorial group Dr Rahul Barmanray, Dr Zac Fuller, Dr Aidan Tan, Dr Maansi Dr Arora, Joseph Lee and Fionnuala Fagan. Add Part 2 to MyCPD as educational activity or visit web page for a transcript and references.
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#145
March 30 · 1 hr 5 min
Ep145: Dealing with the next pandemic 1- border closures and vaccine mandates
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 effective in the world it did cause unintended social harms and lingering resentment. Our leaders and community need some sober reflection on how to we might respond to the next such pandemic respiratory virus. Over two podcasts we look carefully at the how the cost-benefit calculation stacks up for each of the major interventions. In Part 1 we discuss the international borders closures and overcooked parochialism between state jurisdictions, and also how messaging around vaccine risks and mandates could be improved. In Part 2 we look at the controversial stay-at-home orders and interruptions to in-person schooling and even the evidence for faces-masks. Ultimately, there are some questions that can’t be answered scientifically, and it is for politicians and the public to decide what the cost of freedom and dignity against human lives left exposed. Part 1 Chapters 6:46 Border Closures 35:04 Vaccine Hesitancy Guests Professor Paul Kelly FRACP (Australia’s Chief Medical Officer during the pandemic) Professor Catherine Bennett PhD GAICD (Deakin University; co-author of the “COVID-19 Response Inquiry” ) Professor James McCaw PhD (The University of Melbourne; modeler for the Federal government’s “National Plan”) Lorraine Finlay PhD (Australian Human Rights Commissioner; lead author of the "Collateral Damage" report) Production Produced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘End of the Ocean’ and ‘Raised by Wolves' by Tellsonic, ‘RGBA’ by Chill Cole, ‘Organic Textures 1’ by Johannes Bornlöf and ‘Echo (Kerstin Ljungstrom Remix)’ by Bonsaye. Image by mrs licenced from GettyImages. Editorial feedback kindly provided by members of the podcast editorial group Dr Rahul Barmanray, Dr Zac Fuller, Dr Aidan Tan, Dr Maansi Dr Arora, Joseph Lee and Fionnuala Fagan. Add Part 1 to MyCPD as educational activity or visit web page for a transcript and references.
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#144
March 15 · 24 min
[Case Report] 62yo undergoing procedure for a lung nodule
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 combination of recent technologies to bring the condition under control. Pomegranate [Case Reports] have been developed to help Trainees rehearse diagnostic problem solving and case presentation. Guests Associate Professor Arash Badiei FRACP (Royal Adelaide Hospital; Adelaide University) Hosts Associate Professor Stephen Bacchi FRACP (Northern Adelaide Local Health Network; Adelaide University) Dr Brandon Stretton (Central Adelaide Local Health Network;) Production Produced by Dr Stephen Bacchi and Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Desert Whispers’ by Tellsonic and ‘Brighton Breakdown’ by BDBs. Image created and copyrighted by RACP. Editorial feedback kindly provided by RACP physicians Aidan Tan and med students Srishti Sharma, Prakriti Sharma and Cindy Shi. Key Reference (Spoiler Alert) * * * * * Persistent air leak successfully treated with endobronchial valves and digital drainage system [Altree, Respirol Case Rep. 2018] 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.
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#143
March 1 · 1 hr 3 min
Ep143: On the ground with MSF
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 who contributed to MSF’s missions last year. Between them they have covered practice settings as varied as Kiribati, South Sudan and Gaza. In this interview they describe the experience shipping out with MSF on their first assignment and then the kinds of responsibilities one is given with more experience. We’ll also hear how gaps of six months or more affect career progression and financial stability back home. Chapters 3:05 Starting out with MSF 15:04 Practicing in a conflict zone 50:53 Career impacts Guests Dr Josephine Goodyer FRACP (Canberra Hospital; Australian National University) Dr Tasnim Hasan FRACP (Western Sydney LHD; University of Sydney) Dr Aidan Tan (Sydney Children’s Hospital Network) Production Produced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Intimacy’ by Alex Kehm, ‘At the end of nothing’ by Silver Maple, ‘Below the Horizon’ by Dawn, Dawn, Dawn and ‘Nagba Algooah’ by Ebo Krdum. Image by Pablo Tosco ©2018 used with permission by MSF. Editorial feedback kindly provided by members of the podcast editorial group Dr Aidan Tan, Dr Stephen Bacchi, Dr Rahul Barmanray, Dr Maansi Arora and Dr Leon Li. Add educational activity to MyCPD or visit web page for a transcript and references.
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#142
February 16 · 30 min
[Case Report] 75 yo with a porcelain aorta
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 now being considered for staged alcohol septal ablation (for the HCM) and transcatheter aortic valve replacement (for the aortic stenosis), however, additional complications force an experimental two-in-one procedure. Guest Professor Ross Roberts-Thomson FRACP (Central Adelaide Local Health Network; University of Adelaide) Hosts Associate Professor Stephen Bacchi FRACP (Northern Adelaide Local Health Network; University of Adelaide) Dr Alistair Leslie (Central Adelaide Local Health Network;) Key Reference (Spoiler Alert) * * * * * Two-in-one: Combined transcatheter therapy for hypertrophic cardiomyopathy and aortic stenosis [IHJ Cardiovascular Case Reports (CVCR). 2020] Production Produced by Stephen Bacchi and Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Desert Whispers’ by Tellsonic and ‘Brighton Breakdown’ by BDBs. Image created and copyrighted by RACP. Please visit the Pomegranate Health web page for a transcript and supporting references.Login to MyCPDto 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.
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#140
February 2 · 37 min
Ep140: Space Medicine Part 1- radiation and retinopathy
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 conducted aboard the International Space Station over the last two decades. The main objective risk to astronauts is exposure to galactic cosmic radiation. This can be reduced to some degree by shielding of space habitats, however, the impacts of microgravity are much harder to engineer away. In part 1 we’ll discuss spaceflight associated neuro-ocular syndrome and other sensorimotor impacts. In part 2 we’ll focus on the effects of microgravity on bone density and the circulatory system. We’ll also talk through the management of a cases of suspected thrombosis on the international space station from a few years ago. Medical care on orbit has many parallels with the remote medicine you’re already familiar with. Guests Professor Gordon Cable (Australian National University; Co-founder, Human Aerospace) Dr Alicia Tucker FACEM, FAWM (Royal Hobart Hospital; University of Tasmania) Dr John Cherry PhD FACRRM (Deputy CMO, Australian Antarctic Division) Chapters 4:55 Cosmic Radiation 18:34 Spaceflight Associated Neuro-ocular Syndrome 33:01 Occupational Hazards Production Produced by Mic Cavazzini DPhil. Recording of ‘Also Sprach Zarathustra’ by Richard Strauss, licenced under Creative Commons from the Lud and Schlatts Musical Emporium Conducted by Philip Milman. Music licenced from Epidemic Sound includes ‘Orthosie’ by Ben Elson, ‘Spring Water’ By Chill Cole and ‘Temple of Runha’ by ELFL. Music courtesy of Free Music Archive includes ‘The Undertake’ and ‘Operation A’ by Borttex. NASA audio downloaded from SPACE.com YouTube channel. Image courtesy of NASA and WikiCommons. Image of first US moonwalk by Ed White courtesy of NASA and WikiCommons. Editorial feedback kindly provided by members of the podcast editorial group Paul Cooper PhD, Dr Aidan Tan, Dr Rahul Barmanray, Dr Simeon Wong, Dr Fionnuala Fagan, Dr Maansi Arora, Dr Jia-Wen Chong, Dr Aafreen Khalid and Associate Professor Dr Stephen Bacchi. 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.
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#141
February 2 · 41 min
Ep141: Space Medicine Part 2- really remote practice
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 is faster than age-related decline. But the cosmonaut had worked out religiously for the entire mission and after his capsule parachuted to the ground he made a point of walking from it relatively unassisted. One of the main objectives of the marathon flight had been to prove that walking proudly onto the Martian surface after a 9-month journey might be possible, given it only has 37 percent the gravitational force that Earth does. Microgravity additionally results in adaptive plasticity of the vestibular and sensorimotor networks and deconditioning of the cardiovascular system. Indeed, several years ago there was a medical emergency aboard the international space station when an ultrasound investigation revealed thrombosis of the internal jugular vein in one astronaut. In this podcast we discuss how management of cases like this has many parallels with remote medicine on earth. Part 1 of this series examined the risks of cosmic radiation and spaceflight-associated neuro-ocular syndrome among other things. Guests Professor Gordon Cable (Australian National University; Co-founder, Human Aerospace) Dr Alicia Tucker FACEM, FAWM (Royal Hobart Hospital; University of Tasmania) Dr John Cherry PhD FACRRM (Deputy CMO, Australian Antarctic Division) Chapters 1:08 Bone mineral density 15:35 Circulation and a case study in remote medicine 35:04 Historic medevacs from space Production Produced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Spring Water’ By Chill Cole, ‘At the End of Nothing’ by Silver Maple and ‘Mega Woman IV’ by ELFL. Music courtesy of Free Music Archive includes ‘Snowfall’ by Kai Engel. Graphic is AI-generated and shared online with a Creative Commons licence. Editorial feedback kindly provided by members of the podcast editorial group Paul Cooper PhD, Dr Aidan Tan, Dr Rahul Barmanray, Dr Simeon Wong, Dr Fionnuala Fagan, Dr Maansi Arora, Dr Jia-Wen Chong, Dr Aafreen Khalid and Associate Professor Dr Stephen Bacchi. 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.
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#139
Dec 4, 2025 · 29 min
[Case Report] 72yo with anterior uveitis
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 consideration. Pomegranate [Case Reports] have been developed to help Trainees rehearse diagnostic problem solving and case presentation. Guests Associate Professor Jagjit Singh Gilhotra ,FRANZCO (Queen Elizabeth Hospital; University of Adelaide) Dr Yong Min (Shane) Lee FRACP (Royal Adelaide Hospital) Host Associate Professor Stephen Bacchi FRACP (Lyell McEwin Hospital; University of Adelaide) Production Produced by Stephen Bacchi and Mic Cavazzini. Music licenced from Epidemic Sound includes ‘Desert Whispers’ by Tellsonic and ‘Brighton Breakdown’ by BDBs. Image created and copyrighted by RACP. Key Reference (Spoiler Alert) * * * * * Bilateral occlusive retinal vasculitis secondary to intravitreal faricimab injection: a case report and review of literature [Lee, Eye Vis. 2024] 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.
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#138
Oct 8, 2025 · 56 min
Ep138: Amyloid busters- the benefit and the burden
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 on average. For some, the prolonged independence and dignity will justify the $60,000 to $80,000 a year price tag for the drugs. But for the Pharmaceutical Benefits Advisory Committee “the high burden of [donanemab] treatment on both patients and the health system, combined with the risks and modest clinical impact, makes the drug unsuitable for PBS subsidy”. This burden includes specialist consults, gene screening, multiple MRI and PET brain scans, and delivery of monthly or fortnightly infusions, adding up to another $20,000 in costs. Even before considering these logistical requirements, Australian memory clinics don’t have anywhere near the capacity to address the 245,000 new cases of early dementia or mild cognitive impairment every year. Advocates see these disease-modifying therapies as a turning point for dementia research and argue for further investment in the systems infrastructure needed to roll them out. Sceptics argue that the available evidence instead questions the importance of amyloidosis in the Alzheimer’s disease cascade. Guests Professor Michael Woodward AM FRACP FANZSGM FAAG FAWMA (Austin Health, Melbourne; University of Melbourne) Dr Chrysanth Pulle FRACP (Prince Charles Hospital, Brisbane) Chapters 13:18 Time Saved 16:20 Costs of treatment 26:45 Resourcing systems to deliver amyloid therapies 39:11 Scepticism about the amyloid hypothesis and staging options Production Produced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound ‘RGBA’ and ‘Pulse Voyage’ by Chill Cole, ‘A Forest Melody’ by Tellsonic, ‘Axon Terminal’ by Out to the World, ‘Organic Textures 2’ by Johannes Bornlof and ‘Fugent’ by Lupus Nocte. Image courtesy of Wikimedia Commons and University of Pittsburgh. Editorial feedback kindly provided by physicians of the podcast editorial group Ronaldo Piovezan, Aidan Tan, Hugh Murray, Joseph Lee, Rahul Barmanray, Simeon Wong and Sebastian Lambooy. Thanks also to Profs Bruce Campbell, Mike Parsons and Amy Brodtmann and registrars Jamie Bellinge and Karan Singh for additional insights into research methods. 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.
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