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In this episode, Dr Angus Sinclair speaks with Dr Jonathan Malo about dyslipidaemias. They discuss the different types of dyslipidaemias, the treatments (including some new ones) and the types of cases that should be referred. Dr Jonathan Malo is a consultant chemical pathologist at the Department of Clinical Biochemistry in NHS Lothian. And is the clinical lead for the Lipid Clinic at the Royal Infirmary of Edinburgh. He currently chairs a Scottish network of lipid clinic specialists, and is in...
In this episode, Dr Marilena Giannoudi talks with Rebecca Howard and Bruce Cruickshank from Guide Dogs UK, one of the UK's leading sight loss charities. They discuss some of the small acts and considerations that medical professionals can practice to help their patients with sight loss. Rebecca Howard is a Sighted Guide Trainer with Guide Dogs UK. Bruce Cruickshank is a volunteer with Guide Dogs UK and is a guide dog owner. Dr Marilena Giannoudi is a cardiology registrar based in Leeds. She is C...
In this episode, Dr Marilena Giannoudi chats with Dr Heeraj Bulluck about preventive cardiology. They discuss the little habits that can make a big difference in preventing heart disease and the importance of taking care of yourself as a doctor as well as the patients you see. Dr Heeraj Bulluck is a UK-based interventional cardiologist with a keen academic interest. Alongside his clinical work, he recently developed an interest in cardiovascular prevention - helping individuals understand and ac...
In this episode Professor Tom Fardon returns to Clinical Conversations to discuss updates in asthma diagnosis and management from the joint BTS/SIGN/NICE guideline on Asthma. Prof Fardon and Dr Ben Warner discuss the changes to practice since the guidelines were released and the evolving role of biologics in asthma treatment. Professor Fardon is a Consultant Respiratory Physician at NHS Tayside and Honorary Professor at the University of Dundee. They are also the chair of the Scottish Severe Ast...
Dr. Marilena Giannoudi and Dr. Manav Sharma delve into aerospace medicine, a specialty focused on optimizing human performance in extreme environments like aviation and space. They discuss the broad scope, from classical medicine and ergonomics for pilots and astronauts to managing ground crew health and international regulatory standards. Dr. Sharma shares insights into unique training pathways, diverse career opportunities, and memorable cases, highlighting a dynamic field for those passionate about physics, medicine, and aviation.
In this episode, Dr Aoife Duignan speaks with Dr Mireia Moragas about how to treat headaches in a pregnant person. They discuss what questions physicians should ask themselves when a pregnant person attends the acute ward with headaches, the green and red flags for headaches as well as the medications that are safe during pregnancy. Dr Mireia Moragas is a Consultant Neurologist in Edinburgh where she also runs the Headache Clinic, as well as participating in the acute care of patients with strok...
In this episode of Clinical Conversations, Dr Marilena Giannoudi discusses cardiorenal metabolic disease with Dr Andrew Frankel. Their discussion provides an overview of this common cause of chronic kidney disease (CKD) and they focus on the management of cardiorenal metabolic disease, with Dr Frankel highlighting the importance of lifestyle management and patient education and engagement, and the pharmacotherapy 'four pillars' of RAAS inhibition, SGLT2 inhibition, blood pressure control, and MR...
In this episode, Dr Kat Ralston speaks to Professor Edwin Jesudason about how his experience of whistleblowing as a paediatric surgeon changed his practice. They reflect on the importance of listening and creating a shared dialogue with patients, discuss how experiencing moral injury can help clinicians better understand and navigate patient suffering and explore the art of being human in medicine. Professor Edwin Jesudason is a Consultant in Rehabilitation Medicine in NHS Lothian. Dr Kat Ralsto...
In this episode, Dr Kat Ralston speaks to Dr Jane Rimer about a challenging clinical case which had an unexpected outcome. They discuss the importance of reflection with trusted colleagues and consider systems to help us cover the basics well. They explore how we can reduce the sense of isolation and vulnerability that is often encountered when we have to navigate complaints, adverse event reviews and legal processes, as illustrated by the title 'Defence against The Dark Arts'. Dr Jane Rimer is ...
In this episode of Clinical Conversations, Professor James Dear recounts a memorable case of necrotizing fasciitis that profoundly influenced his medical practice. He and Dr. Marilena Giannoudi delve into the complexities of managing patients with mystery diagnoses, emphasizing the importance of open communication with senior colleagues, advocating for appropriate care pathways, and fostering an environment where doctors can openly discuss uncertainties and learn from errors. The discussion also covers identifying clinical red flags and navigating end-of-life conversations in ambiguous situations.
In this episode, Dr Kat Ralston hears about a case that changed the practice of Dr Chris Tiplady. They discuss the importance of recognising when a patient may be entering the last phase of life, what we owe to patients and families in understanding what matters to them, and how we can navigate managing uncertainty and being wrong as clinicians. Dr Chris Tiplady has been a Consultant Haematologist in Northumbria since 2001 and has held a number of roles in postgraduate and undergraduate medical ...
In this episode of Clinical Conversations, Dr Aoife Duignan chats with Dr Claire Steel and Dr Shelagh O'Riordan about Hospital at Home. They explore what Hospital at Home is, and the evidence base behind it, thinking through which patients may benefit from it. They also consider how technology can enable patients to receive care in their own homes and what a day in the life might look like. Finally they consider some top tips for becoming involved with Hospital at Home. Dr Claire Steel is a cons...
In this episode Dr Emma Spencer discusses decompensated cirrhosis with Dr Michael Williams. This discussion includes the definition of a decompensation event, how to recognise these events on the medical take and the importance of doing so. They also discuss key steps in investigating causes of decompensations of cirrhosis and how to manage these unwell patients. Dr Michael Williams is a consultant hepatologist, working on the Scottish Liver Transplant Unit in Edinburgh. His clinical interests a...
In this episode of clinical conversations, Dr Kat Ralston chats with consultant toxicologist Dr Emma Morrison about poisoning in the older adult. They explore why we need to think differently about deliberate self-harm in the older adult and talk through common toxicology cases, including decision-making around escalation. Finally, they consider a common sense approach to what we can do differently as clinicians to reduce the risk of self-harm and suicide in this patient group. Dr Morrison train...
In this episode, Dr Kat Ralston chats with Prof Miriam Johnson about palliative care in heart failure. They discuss the evidence supporting specialist palliative care input in this patient group and explore how to develop effective integrated services. They chat about holistic, needs based assessment and share top tips on the approach to the debilitating symptom of breathlessness. Professor Miriam Johnson is Professor of Palliative Medicine at Hull York Medical School, Associate Director of the ...
In this episode, Dr Marilena Giannoudi discusses Type 1 diabetes with Dr Sam Pearson. Topics include diagnosing T1 diabetes, recognising the impact of a new diagnosis of diabetes on patients and possible treatments, including technological interventions. Dr Sam Pearson is a diabetes consultant at St James hospital in Leeds. They help look after patients with all types of diabetes mellitus but have a particular interest in helping younger adults with type 1 diabetes and how technology may help th...
In this episode, Dr Kat Ralston chats with Dr Imogen Smith about palliative care in hospital inpatients. They discuss what is different about the older adult when considering palliative care, including thinking about trajectories, communicating uncertainty, and parallel planning. They explore symptom control including a practical approach to syringe drivers (continuous subcutanous infusions) for the non-specialist. Dr Imogen Smith was appointed as Consultant in General Internal Medicine and Medi...
In this episode, Dr Kat Ralston chats with Dr Nik Rae about infective endocarditis. They discuss the complexities of clinical presentation in this condition and share tips to help you in your diagnostic journey. They explore a pragmatic approach to management, including individualised decision making and the emerging evidence base for use of oral agents. Dr Nikolas Rae is a Consultant Physician in Infectious Diseases and Acute Medicine with a range of clinical interests including infections in p...
This is a co-release with our sister podcast, Career Conversations. In this episode, Dr Marilena Giannoudi speaks with Dr Neil Shepherd about remote and rural medicine. Dr Shepherd highlights the benefits as well as the challenges of working in remote and rural areas and some of the professional support in place for this career path. Dr Neil Shepherd considers himself to be a rural generalist. He completed his GP training in 2014 and acute care rural GP fellowship in 2018. He currently works as ...
In this episode of Clinical Conversations, Dr Kat Ralston chats with Dr Alan Japp about heart failure with reduced ejection fraction. They discuss an approach to clinical assessment, share top tips for diuresis and explore the four pillars of heart failure therapy. Dr Alan Japp is a Consultant Cardiologist at the Edinburgh Royal Infirmary and St John's Hospital, Livingston. He is also the Clinical Lead for Heart Failure in NHS Lothian and the Local Principal Investigator for DAPA HF and IRONMAN ...
In this episode, Dr Marilena Giannoudi speaks with Dr Sarah Schoeman about the genitourinary medicine (GUM) clinic. Dr Schoeman discusses the prevalence of sexually transmitted infections, provides non-GUM specialists tips on how to ask a patient's sexual health and describes some interesting cases from her clinical experience. Dr Sarah Schoeman is a GUM Consultant in Leeds based at the Leeds Teaching Hospitals Trust. She is also Clinical Lead for the Leeds Teaching Hospitals Trust HIV service. ...
For Sepsis Awareness Month, Dr Marilena Giannoudi speaks with Dr Ron Daniels about sepsis. They discuss the causes, investigation, management, and prevention of sepsis. Topics include the Sepsis 6 and escalation of care, use of blood cultures, septic shock, and post-sepsis syndrome. Dr Ron Daniels is an NHS Consultant in Intensive Care, based at University Hospitals Birmingham, U.K. He’s also Founder and Chief Executive of the UK Sepsis Trust and Vice-President of the Global Sepsis Alliance. In ...
In this episode, Professor Eylem Levelt and Dr Marilena Giannoudi discuss the early stages of cardiometabolic disease, its asymptomatic challenges, and key risk factors. They cover how junior doctors can protect at-risk patients and the prevalence of diabetes and weight issues among those diagnosed. Reflecting on trends over the past decades, they share insights into improving patient outcomes. Looking ahead, they discuss reducing heart failure and managing conditions like obesity-related heart ...
This week Dr Ben Warner interviews Professor Tom Fardon on the topic of asthma. Through a case study, Prof Fardon discusses how to assess and treat a severe exacerbation of asthma and what needs to be considered when discharging patients. Tom and Ben also discuss diagnosing asthma and the treatments available to patients. Professor Fardon is a Consultant Respiratory Physician at NHS Tayside and Honorary Professor at the University of Dundee. They are also Clinical Lead for the Scottish Governmen...
In this brief episode, Dr Marilena Giannoudi, Co-Chair of the Trainees and Members’ Committee, gives an overview of the Royal College of Physicians of Edinburgh's podcasts relevant to doctors-in-training. These include: this podcast, 'Clinical Conversations'; 'Career Conversations' including the new 'Demystifying PACES' series; and the Recently Appointed Consultants' Committee's podcast, 'Consultant Conversations', relevant to senior trainees. All RCPE podcasts can be found at https://podcasts.r...
What happens at the Inherited Cardiac Conditions clinic? In this episode, Dr Marilena Giannoudi and Dr Anshu Sengupta discuss Inherited Cardiac Conditions (ICCs) and the ICC clinic, including who makes up this multi-disciplinary team. They discuss the approach to patients with ICCs covering investigations and management including guideline-led treatment, monitoring, risk assessment and exercise advice. Dr Anshu Sengupta is a Consultant Cardiologist in the Yorkshire Heart Centre, specialising in ...
In this episode, Dr Kat Ralston chats to Dr Matt Lambert about hyperacute stroke. They discuss a targeted approach to first assessment, including how to utilise your team effectively in a time-pressured environment. They explore the evidence behind different treatment options and share practical tips on thrombolysis and thrombectomy. Dr Lambert is a consultant in Stroke and Medicine for the Elderly in NHS Tayside and was clinical lead for stroke in Tayside from 2016 until 2023. During this time ...
In this episode Dr Ben Warner discusses multimorbidity, also known as multiple long-term conditions, with Professor Frances Mair. They discuss what multimorbidity is, how the concept differs from frailty and how the burden of treatment and health inequalities impact patients with multiple long-term conditions. Professor Frances Mair is the Norie Miller Professor of General Practice, Head of General Practice and Primary Care, and Director of a Wellcome funded Multimorbidity PhD Programme for Heal...
In this episode, Dr Marilena Giannoudi and Dr Vidhya Nair discuss orthogeriatrics, including frailty and fragility fractures, osteoporosis, and falls risk assessment, and the importance of a multi-disciplinary (MDT) team throughout patient care. Dr Vidhya Nair graduated from Newcastle University in 2002 and moved down to Leeds in 2003. Dr Nair became a Consultant in Elderly Medicine specialising in Orthogeriatrics in 2011 and worked in Pinderfields General Hospital on a dedicated hip fracture un...
In this episode, Dr Kat Ralston chats with Dr Emma Phillips about clinical debriefing. They talk about what clinical debriefing is (and isn’t) and why we should be incorporating this into our everyday work. They explore when and how to facilitate a clinical debrief and share tips on how we can embed clinical debriefing into our practice. Dr Phillips is an Anaesthetic Registrar working in South-East Scotland. She completed a simulation fellowship at Scottish Simulation Center in 2018 and maintain...
