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In episode 56 of This Medical Life, Dr Travis Brown and Steve Davis delve into the critical topic of iron studies, with a special focus on iron deficiency, under the expert guidance of returning guest, Professor Ken Sikaris.
Iron deficiencyâs prevalence is influenced by factors such as age, sex, and ethnicity, noting that women, especially those of childbearing age and pregnant women, are at higher risk. Prof Sikaris addresses the challenges and misconceptions surrounding iron studies, particularly the reliability of various tests like serum iron, transferrin saturation, and ferritin. While ferritin is the most reliable marker for total body iron stores, it can be influenced by factors like inflammation.
Through this episode, we provide This Medical Life provides a comprehensive exploration of iron deficiency, combining historical context, clinical insights, and practical advice, all aimed at improving understanding and management of this prevalent health issue.
Our special guest:
Professor Ken Sikaris is a chemical pathologists and Director of Chemical Pathology at Melbourne Pathology. Professor Sikaris is a NATA-accredited laboratory assessor, Founding Fellow of the RCPA Faculty of Science and a principle examiner in Pathology Informatics. He is a Fellow of the Department of Pathology at the University of Melbourne.
This Medical Life podcast is available on all podcasting services and Spotify
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In this episode we delve into the nuanced world of the Pomegranate Health podcast with our guest, Mic Cavazzini. Pomegranate Health, a creation of the Royal Australasian College of Physicians, serves as a platform to explore the multifaceted culture of medicine. It weaves through the clinical intricacies of medicine with episodes that span from the deeply technical aspects of healthcare to broader discussions on skills essential for effective practice and systemic issues within global health.
This episode embarks on a journey through the confused history of opium use, offering a rare focus on historical narratives as a foundation for modern medical discussions. Join us as Mic Cavazzini shares insights from his diverse background in science and journalism, illustrating how the past informs current medical practices and the human factors that influence care. Through this conversation, we aim to shine a light on the complexities of medicine's culture, underscoring the importance of history, philosophy, and the human experience in shaping healthcare today.
Our special guests:
Mic Cavazzini - is a journalist and audio geek passionate about engaging people with ethics, health and the natural world. He produces the Pomegranate Health which is a podcast with the Royal Australasian College of Physicians and won an Australian Podcast Award in 2018. Mic has a background in neuroscience and is associated with the University of Sydney. He has worked as a research scientist at Oxford and ANU where he investigated how brain cells process information and learning. He has also written for The Medical Republic, Australian Doctor, and The Canberra Times.
This Medical Life podcast is available on all podcasting services and Spotify. Help support us at https://www.patreon.com/ThisMedicalLife
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In Chronic Traumatic Encephalopathy (CTE) Part 1, we learned that CTE is a neurodegenerative disease caused by repetitive cumulative brain injury. Patients suffer from debilitating mental health symptoms and may even have suicidal thoughts or actions. Unfortunately, there is no treatment for this disease and it can only be official diagnosed at autopsy (after death). The only successful strategy to combat this illness is prevention.
Unfortunately, this is an ongoing challenge as there is a lot we donât know about CTE but some features are clear. The largest risk factor for CTE is the duration of time participating in contact sport. In order to prevent CTE, the aim is to reduce life time exposure to repeated head impacts (either direct or indirect ie. significant acceleration and deceleration injuries). We also delve into grass-roots education aimed at informing school-aged children about concussion and brain health.
This Medical Life podcast is available on all podcasting services and Spotify. Help support us at https://www.patreon.com/ThisMedicalLife
** Please note: General Practitioners in Australia, will be able to claim 2.25 CPD points after listening to this episode and part 1. Full details and registration on our GP CPD Points page.
Our special guests:
Amanda Green â wife to National Rugby League legend player and coach Paul Green who played 162 first-grade games and represented Australia. At the end of 2022, Paul was found unresponsive in his home. Paulâs brain was donated to the Australian Sporting Brain Bank for examination where he was diagnosed with CTE. Paul was 49 years old.
Associate Professor Michael Buckland â Head of the Neuropathology department at Royal Prince Alfred Hospital, founder and director of the Australian Sports Brain Bank (ASBB), co-director of the Multiple Sclerosis Australian Brain Bank, and Head of the Molecular Neuropathology Program at the Brain & Mind Centre.
Doctor Stephanie Adams â Honorary Fellow in Sports & Brain Health at the University of Edinburgh. She is founder and director of ConcussEd which is an education program for school-aged children to learn about brain health. She is a retired rugby and equestrian athlete.
This Medical Life podcast is available on all podcasting services and Spotify. Help support us at https://www.patreon.com/ThisMedicalLife
See omnystudio.com/listener for privacy information.
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In 2005, Dr Bennet Omalu would publish a report in the United States on the autopsy brain findings of a former professional footballer from the NFL. His conclusion was the former athlete suffered from Chronic Traumatic Encephalopathy (CTE); a disease caused by repeated brain injuries most likely due to sport. The response was swift and severe claiming that the findings were incorrect, the conclusions erroneous, and a retraction of this report was demanded.
Surprisingly, this was not the first time medical literature has noted the link between sport, repeated head injuries and brain damage. The first publication was written in 1928 by Dr Harrison Martland who was the Chief Medical Examiner of Essex County in New Jersey. Harrison performed hundreds of autopsies on people with head injuries including boxers. He noted twenty-three examples of boxers with permanent brain damage that he called âpunch drunkâ. Other researchers found this was not limited to boxing but other contact sports such as football. Later, this condition became known as âDementia pugilisticaâ.
This disease has surged into the spotlight in the last decade due to a number of high-profile athletes who have been diagnosed with CTE. Unfortunately, both professional and amateur athletes are at risk. This condition also greatly impacts the family and friends of those who suffer from it. However, a great deal of misinformation also exists about the risks and causes of this disease. These two episodes (of which this is part 1) are designed to explain what we know, what we donât, and what can be done about this debilitating condition.
This is the story of CTE, part 1.
** Please note: General Practitioners in Australia, will be able to claim 2.25 CPD points after listening to this episode and part 2. Full details and registration on our GP CPD Points page.
Our special guests:
Renee Tuck â sister of Shane Tuck who was a professional footballer in the Australian Football League (AFL) playing 173 games and a brief career as a boxer. Later in Shaneâs career, he suffered from mental health issues and in July 2020 took his own life. Shane was diagnosed with a severe form of CTE. He was only 38 years old.
Associate Professor Michael Buckland â Head of the Neuropathology department at Royal Prince Alfred Hospital, founder and director of the Australian Sports Brain Bank (ASBB), co-director of the Multiple Sclerosis Australian Brain Bank, and Head of the Molecular Neuropathology Program at the Brain & Mind Centre.
Associate Professor Linda Iles â Head of the Forensic Pathology Services at the Victorian Institute of Forensic Medicine (VIFM). VIFM is in partnership with the ASBB to send brain specimens for further examination/analysis for suspected CTE or other neurodegenerative diseases.
This Medical Life podcast is available on all podcasting services and Spotify. Help support us at https://www.patreon.com/ThisMedicalLife
See omnystudio.com/listener for privacy information.
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We begin this year with one of the most important topics for General Practitioners in 2024: what are the Continuous Professional Development requirements for doctors and how have they changed?
Our special guest is Rachel White who is the Managing Director for the Australian Medical CPD Standards (AMcpdS) who has over twenty years supporting high quality medical education. We discuss the yearly requirements for doctors, component breakdown and what has changed.
This is the story of CPD for 2024.
And here is a summary of CPD requirements, supplied by Rachel.
We are also thrilled to announce that 6 of our genetics episodes from our catalogue (âgenetics moduleâ) have been approved for official CPD hours for General Practitioners. These episodes are:
Episode 10: Familial hypercholesterolaemia (FH)Episode 15: Lynch syndromeEpisode 21: Marfan syndromeEpisode 30 & Episode 31: BrCa (Breast Cancer genes)Episode 40: Carrier screeningRegister with us on our website (https://thismedicallife.com.au/) and we will send you a certificate to lodge with your CPD home to claim 5.75 hours when you have listened to them.
We have also registered with https://www.patreon.com/ThisMedicalLife where you can subscribe for free to get a short update when new episodes are published, or make a one-off or regular contribution to help fund this work, which is being created without any outside funding support.
With your support, we hope to accredit more of our episodes in the future. Thank you to all of our listeners.
See omnystudio.com/listener for privacy information.
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And thatâs another year done. A huge thank you to all of our guest speakers who have been generous with their time and expertise. We would also like to thank our listeners and hope you enjoyed the episodes.
This episode is a mini reflection on this yearâs episodes, a link to one of Steveâs favourite podcasts, some TML clips, and an embarrassing memory lapse on my behalfâŠthanks for keeping that part in Steve & Tim.
Random acts of Medicine on EconTalk podcast: https://www.econtalk.org/anupam-bapu-jena-on-random-acts-of-medicine/
This Medical Life podcast is available on all podcasting services and Spotify.
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During the mid-twentieth century, menopause was touted as a severe disease that destroyed womenâs femininity and was a burden to their husbands. Thankfully, today we recognise menopause as a natural part of ageing and conversations about it are happening more and more.
In this episode, we have four special guests:
Niki Bezzant: award-winning writer, author, journalist and media personality from New Zealand who has written the book âThis Changes Everything: the Honest Guide to Menopause and Perimenopauseâ. Dr Carmel Reynolds: General practitioner and SA/NT board member on the Australian Menopause SocietyDr Angelique Swart: Obstetrician & Gynaecologist with an interest in post-menopausal bleedingDr Ashley Winter: Urologist and Sexual health specialistAustralasian Menopause Society
This Medical Life podcast is available on all podcasting services and on Spotify
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In July 2020 in the midst of a global pandemic, we released our first episode called âWhat is pathology?â with This Pathological Life podcast. We hoped to create something that would entertain and education the audiencem and shed light on to some of the amazing stories and characters in medicine.
In creating these podcasts, I am always thankful and appreciative to our guests who willingly give their time and expertise. If there is anyone who has excited our audience, been an inspiring teacher and a fantastic storyteller, it is Professor Graeme Suthers. He has been involved in the following episodes over the last four years:
This Medical Life podcast:
Ep 40 Carrier screeningEp 30 BRCA (Part 1)Ep 21 Marfan syndromeEp 15 Lynch syndromeEp 10 Familial HypercholesterolaemiaThis Pathological Life podcast:
Ep 45 PharmacogeneticsEp 44 PKU and Cystic FibrosisEp 33 Fragile XEp 13 Trisomy / Chromosomal abnormalitiesOn the 30th of June 2023, Professor Graeme Suthers retired and we wanted to take some time to thank him, but also ask him some questions and reflect on his career.
This is the story of Professor Graeme Suthers.
This Medical Life podcast is available on all podcasting services and Spotify.
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On the 1st of November 2023, the Australian Government will release new guidelines for screening prostate cancer with the Prostate Specific Antigen (PSA) blood test. These guidelines are based upon the Clinical Practice Guidelines (CPG) published in 2016 with new items to be included in the Medicare schedule. These items are based upon the Prostate Cancer Foundation and the Cancer Council of Australia guidelines that have been endorsed by the NHMRC, RACGP, and USANZ. We speak to Professor Ken Sikaris who has been at the forefront of these new recommendations.
Our special guest is Professor Ken Sikaris who is a chemical pathologist and Director of Chemical Pathology at Melbourne Pathology.
This Medical Life podcast is available on all podcasting services and Spotify.
See omnystudio.com/listener for privacy information.
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We continue the second episode of this two part series on breast screening and mammograms focusing on the future.
In this episode, we talk about the importance of breast density as a new risk factor, personalised breast cancer risk assessment (iPrevent developed by Peter MacCallum Cancer Centre https://www.petermac.org/iprevent), and discuss a personal account with Dr Sandy Minck.
Special guests:
Associate Professor Michelle Reintals is the Director of BreastScreen South Australia and an Australian trained radiologist with extensive and international experience in breast screening and mammography.Professor Kelly-Anne Phillips is a medical oncologist who cares for breast cancer patients and is a researcher at Peter MacCallum Cancer Centre that is internationally recognised in breast cancer genetics and treatment.Doctor Sandy Minck is a fellow of the Royal Australian College of General Practitioners and an advocate for breast density awareness and personalised risk assessments. She has personal experience in this area as both a doctor and a patient.This Medical Life podcast is freely available on all podcasting services and Spotify.
See omnystudio.com/listener for privacy information.
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A critical tool in the fight against breast cancer is population screening. Early detection, surgical intervention +/- further treatment has dramatically reduced advanced disease and mortality rates but it still remains the most common cancer worldwide.
In this episode, we focus on the history of breast cancer, the development of mammograms and early detection with our understanding of the underlying pathology. Our special guests include:
Associate Professor Michelle Reintals is the Director of BreastScreen South Australia and an Australian trained radiologist with extensive and international experience in breast screening and mammography.
Associate Professor Wendy Raymond is a histopathologist who has specialised in breast pathology and cytology. A/Professor Raymond is a past president of the Australian Society of Breast Disease and co-edited the IAC Yokohama system for reporting breast FNA biopsies.
This is the first part of a two-part series on breast screening, focusing on the present. The second part (coming soon) will focus on the future.
See omnystudio.com/listener for privacy information.
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Our understanding of the world today is constantly changing. What was once considered truths and facts can, in hindsight, be seen as misguided or wrong. It may be challenging to accept but becomes evident over time that the things we learn today may become irrelevant or superseded in the future and this is particularly relevant to medicine.
Scientometrics is the quantitative study of science and the rate at which change occurs. Today, we discuss this topic with scientist and author Sam Arbesman, to ask the following question: what is the rate of change of facts in the field of medicine?
Our special guest is Sam Arbesman who is a scientist and author of Overcomplicated: Technology at the Limits of Comprehension and The Half-Life of Facts.
See omnystudio.com/listener for privacy information.
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Vitamin D has been a controversial topic in recent times with the debate continuing over appropriate testing, adequate levels, and the evidence for treatment. We discussed the appropriateness of testing and chemical pathology component with Professor Ken Sikaris (Episode 25), but what does the research tell us about diseases associated with Vitamin D and the utility of replacement? We discuss this with Professor Scott Byrne from The University of Sydney.
Our special guest is Professor Scott Byrne from the Westmead Institute for Medical Research. Professor Byrne is also Co-director of the Centre for Immunology and Allergy Research and Head of the Cellular Photo-immunology Group in the School of Medical Sciences at Sydney University.
This is the second chapter in the story of Vitamin D.
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Professor Peter Doherty trained as a veterinarian before venturing into immunology research. Professor Doherty travelled extensively throughout his career and has undertaken numerous research posts around the world. The achievement that he is most noted for is he was able to demonstrate how the body distinguished between virus-infected cells from non-infected cells and was awarded the Nobel Prize for Physiology or Medicine in 1996. However, there is far more that he has achieved throughout his career.
Professor Doherty has been a strong advocate for science communication to the general public at large. He has written numerous books, commented extensively on environmental sustainability and climate change, as well as an active participant and medical voice to the public during the recent Covid-19 pandemic.
Our special guest is Professor Peter Doherty, Nobel Prize winner in Physiology or Medicine 1996, Author, Science commentator, and Professor at the faculty of medicine at the University of Melbourne.
This is the story of Professor Peter Doherty.
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The double helix structure of DNA was the discovery of the century. However, the story about the discovery is mired in controversy as one of the major contributors, Rosalind Franklin, was conspicuously absent from acknowledgements and died (and subsequently not named) before the Nobel Prize was awarded.
In 1968, James Watson wrote the book âThe Double Helix: A Personal Account of the Discovery of the Structure of DNAâ and reads more like a fictional detective novel than an autobiographical account with the portrayal of Franklin as a forceful, gruff and confrontational. Recently, an article in Nature shows an unpublished news article from 1953 (at the time of the discovery) that Franklinâs contribution was crucial to uncovering the structure of DNA.
Today, we talk to one of the authors of the article in Nature, Nathaniel Comfort, who is Professor of the History of Medicine at John Hopkins University. Link to the article: https://www.nature.com/articles/d41586-023-01313-5
Our special guest is Professor Nathaniel Comfort from the John Hopkins University. His interest lies in the histories of genetics, eugenics, genomics and biomedicine. He has authored two books (The Tangled Field and The Science of Human Perfection), written for Nature, The Atlantic, The Nature as well as appeared on PBS, National Public Radio and the BBC.
This is the story of the DNA double helix.
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Essentially every culture, modern or ancient, understood that health and faeces are inherently linked. The Ancient Chinese practiced âcopromancyâ which was the assessment of health based upon the shape, size and texture of faeces. Today we have the Bristol Stool Chart that helps us to classify faeces/poo into seven different groups. As disconcerting as it may be, the state of our poo can tell us a lot about our own health and this is only going to increase as our knowledge about our faecal microbiome expands.
The faecal microbiome is the composition of all the microorganisms within our faeces. We are learning that the composition not only affects our health but can also be contributory to diseases we experience. In some circumstances, this has also become a treatment with faecal transplantation to manage treatment resistant clostridium-difficile colitis.
This is the story of the faecal microbiome.
Our special guests:
Dr Piers Mitchell, who is a hospital specialist consultant in the NHS and co-editor of the International Journal of Osteoarchaeology. Dr Mitchell has trained in paleopathology, osteoarchaeology, parasitology, medical history, and orthopaedic surgery.Dr Vincent Ho, who is a Gastroenterologist practicing in NSW, is an Associate Professor at Western Sydney University and head of a research laboratory.See omnystudio.com/listener for privacy information.
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In 1891, Guido Werdnig documented two cases of brothers who had global progressive muscular weakness. In 1935, Dr Dorothy Anderson conducted an autopsy on a young child who had died from malnutrition due to suspected coeliac disease despite being on the upon treatment. In 1943, in inherited form of intellectual disability in boys was described by Martin and Bell. The diseases are Spinal Muscular Atrophy, Cystic Fibrosis, and Fragile X syndrome respectively. The learning curve for genetics in the last 100 years has been a steep one.
Recessive genes circulate in the general community and for the most part, they are hidden and play no part in day-to-day life. Some may even have had a survival advantage in pre-modern times. However, if two parents each carry matching recessive genes, there is an increased chance that their children can have a severe or even life-threatening illness. Carrier screening provides a test for parents to assess this risk, however, it also requires an understanding of the testing paths, risks and cost from requesting doctors.
This is the story of carrier screening
Our special guest is Professor Graeme Suthers who is the Director of Sonic Genetics Australia.
Additional information:
Link to further information about reproductive carrier screening: https://www.sonicgenetics.com.au/patient/test-information/rcs/
Link to carrier screening online patient course: https://www.sonicgenetics.com.au/patient/test-information/rcs/carrier-screening-online-patient-course/
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Seasonal influenza causes significant morbidity and mortality every year but can often fall into the underestimated category. Between 10-30% of the general population are infected each year with influenza that leads to an increase in hospital and intensive care unit admissions, the onus for prevention and early intervention has never been more important.
Our special guest is Associate Professor Paul Griffin from the School of Medicine at the University of Queensland and is an Infectious Disease Specialist at Mater Health.
This is the story of influenza.
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In 1998, a 6 page report published in the Lancet that would later be described as one of historyâs great science frauds. The article was titled âIleal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive development disorder in childrenâ but the news headlines ran with a much shorter version: the MMR vaccine causes autism.
The article was written by Andrew Wakefield, a British gastroenterologist turned researcher, who had taken it upon himself to deceive the medical community and general population at large. Fortunately, investigative journalist Brian Deer uncovered the truth behind this âstudyâ through hard work, significant obstacles and persistence.
Although Wakefieldâs claims have been thoroughly discredited, we still feel the impact of this fraud to this day and he has become an icon of the anti-vax movement.
Our special guest is Brian Deer who is an award winning investigative journalist and bestselling author for The Doctor that Fooled the World, published in 2020.
This is the story of the MMR vaccine fraud.
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In 1834, Robert Graves gave a lecture series on the âNewly observed affection of the thyroid gland in femalesâ. He presented three women who had violent palpitations, enlarged thyroids, and an apparent enlargement of the eyeballs (later it would be called âexophthalmosâ).
In 1912, Hakaru Hashimoto reported a new disease in a German journal after examining microscopically the thyroid tissue from four middle-aged women. He noted the lymphocytic infiltration and likened it to other conditions containing lymphocytes (ie. Sjögren syndrome) and named it âStrum lymphomatosaâ.
It would not be until the 1950s that the underlying mechanism of these diseases would be known: autoimmunity. The former, now known as Gravesâ disease, and the latter Hashimoto disease are the most common causes of hyperthyroidism and hypothyroidism respectively.
Our special guest is Dr Daman Langguth who is an immunology and Head of the Immunology Department at Sullivan Nicolaides Pathology.
This is the story of autoimmune thyroiditis.
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