Clinical Conversations

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.rcpe.ac.uk/

The 'Demystifying PACES' podcast series can be found at https://podcasts.rcpe.ac.uk/show/career-conversations/category/paces/

Recording date: 23 January 2024

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This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

In the second of two episodes on Long COVID, Dr Hannah Preston discusses Long COVID and ME/CFS (Myalgic Encephalomyelitis / Chronic Fatigue Syndrome) with Dr Binita Kane.

Long COVID, also known as Post-Covid Syndrome, is further explored. Dr Preston and Kane discuss Postural Tachycardia Syndrome (PoTS), immune dysregulation, Mast Cell Activation Syndrome (MCAS), the impact of Long COVID on women's and men's health, investigations, emerging research and treatments, and the importance of listening to your patient.

Dr Binita Kane is a Consultant respiratory physician in Manchester. She has worked on the frontline of the pandemic since 2020 and set up the first COVID virtual ward model in the UK and has advised nationally on the role of virtual wards across England.

In January 2021, Dr Kane’s 10 year old daughter developed COVID and subsequently Long COVID. This has led her on an international search for answers, culminating in her becoming a campaigner, researcher, patient advocate, champion for the Long COVID Kids charity and now a specialist Long COVID physician.

Dr Kane is a member of the World Health Network Long COVID Executive Committee, Independent SAGE and a campaigner for clean air.

Dr Hannah Preston is a Renal Registrar in Edinburgh and RCPE Trainees and Members' Committee (T&MC) Co-Chair.

Listen to Part 1: https://podcasts.rcpe.ac.uk/show/clinical-conversations/long-covid-part-1-27-nov-2023/

-- Links --

PoTS UK:

https://www.potsuk.org

Standing up to PoTS:

https://www.standinguptopots.org/videos-about-pots

Visible app - Visible Health

https://www.makevisible.com

BMJ Long COVID - an update for primary care (2022):

https://www.bmj.com/content/378/bmj-2022-072117

Nature review article: Long COVID, major findings, mechanisms and recommendations:

https://www.nature.com/articles/s41579-022-00846-2

Review article: Long COVID pathophysiological factors and abnormalities of coagulation

https://pubmed.ncbi.nlm.nih.gov/37080828/

Dr Kane's YouTube channel 'The Long COVID Clinic - What you CAN do' in partnership with The Long COVID Support Charity:

https://www.youtube.com/@LCCWYCD

Gez Medinger YouTube channel - interviews with the world's leading Long COVID researchers and more:

https://www.youtube.com/channel/UCln_SCEd4JiGkHIUZd1VlXw

The World Health Network - Long COVID resources, bringing together knowledge from across the world:

https://whn.global/long-covid/

Long COVID Kids Charity - resources for children and families affected by Long COVID:

https://www.longcovidkids.org

World Physio Long COVID resources - international repository of resources regarding safe rehabilitation approaches:

https://world.physio/covid-19-information-hub/long-covid

-- Related RCPE content --

For RCPE's COVID-19 content, see https://learning.rcpe.ac.uk/tag/index.php?tc=1&tag=COVID-19&ta=2&excl=1

Recording date: 26 November 2023

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Feedback: [email protected]

This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

In the first of two episodes on Long COVID, Dr Hannah Preston discusses Long COVID and ME/CFS (Myalgic Encephalomyelitis / Chronic Fatigue Syndrome) with Dr Binita Kane.

Long COVID, also known as Post-Covid Syndrome, is explored in depth, including prevalence, risk factors, symptoms and impact, pathophysiology, and management. Dr Kane also busts some common myths about Long COVID.

Dr Binita Kane is a Consultant respiratory physician in Manchester. She has worked on the frontline of the pandemic since 2020 and set up the first COVID virtual ward model in the UK and has advised nationally on the role of virtual wards across England.

In January 2021, Dr Kane’s 10 year old daughter developed COVID and subsequently Long COVID. This has led her on an international search for answers, culminating in her becoming a campaigner, researcher, patient advocate, champion for the Long COVID Kids charity and now a specialist Long COVID physician.

Dr Kane is a member of the World Health Network Long COVID Executive Committee, Independent SAGE and a campaigner for clean air.

Dr Hannah Preston is a Renal Registrar in Edinburgh and RCPE Trainees and Members' Committee (T&MC) Co-Chair.

-- Links --

BMJ Long COVID - an update for primary care (2022):

https://www.bmj.com/content/378/bmj-2022-072117

Nature review article: Long COVID, major findings, mechanisms and recommendations:

https://www.nature.com/articles/s41579-022-00846-2

Review article: Long COVID pathophysiological factors and abnormalities of coagulation

https://pubmed.ncbi.nlm.nih.gov/37080828/

Dr Kane's YouTube channel 'The Long COVID Clinic - What you CAN do' in partnership with The Long COVID Support Charity:

https://www.youtube.com/@LCCWYCD

Gez Medinger YouTube channel - interviews with the world's leading Long COVID researchers and more:

https://www.youtube.com/channel/UCln_SCEd4JiGkHIUZd1VlXw

The World Health Network - Long COVID resources, bringing together knowledge from across the world:

https://whn.global/long-covid/

Long COVID Kids Charity - resources for children and families affected by Long COVID:

https://www.longcovidkids.org

World Physio Long COVID resources - international repository of resources regarding safe rehabilitation approaches:

https://world.physio/covid-19-information-hub/long-covid

-- Related RCPE content --

For RCPE's COVID-19 content, see https://learning.rcpe.ac.uk/tag/index.php?tc=1&tag=COVID-19&ta=2&excl=1

Recording date: 16 October 2023

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This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

Dr Kat Ralston and Dr Sarah Bartlett discuss free e-learning on the '10 things a doctor can do to combat climate change' initiative from the Royal College of Physicians of Edinburgh's College Advisory Forum on the Environment (CAFE).

This initiative has featured in The BMJ, the College's journal JRCPE and in Scotland's Chief Medical Officer's Annual Report.

Dr Sarah Bartlett is Co-Chair of RCPE's CAFE with Dr Marion Slater, and Registrar in Geriatric Medicine, General Internal Medicine and Stroke in Edinburgh.

Dr Kat Ralston is a Geriatric Medicine Registrar and member of the RCPE Trainees and Members’ Committee, currently working in Edinburgh.

-- Links --

CAFE '10 things...' e-learning

https://learning.rcpe.ac.uk/10things

Last podcast episode: Sustainability - be lazy to save the planet

https://podcasts.rcpe.ac.uk/show/clinical-conversations/sustainability-be-lazy-to-save-the-planet-30-oct-2023/

CAFE '10 things...' in The BMJ

https://doi.org/10.1136/bmj.o2650

CAFE '10 things...' in JRCPE

https://doi.org/10.1177/14782715231158878

CAFE '10 things...' in CMO Annual Report (page 56)

https://www.gov.scot/publications/realistic-medicine-doing-right-thing-cmo-annual-report-2022-2023/

-- Related content --

RCPE Fellows & Members can explore planetary health content on the Education Portal: https://learning.rcpe.ac.uk/tag/index.php?tc=1&tag=Planetary%20Health&ta=2&excl=1

Recording dates: 23 August 2023 (Dr Bartlett) and 3 November 2023 (Dr Ralston)

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This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

This week Dr Kat Ralston discusses sustainability in healthcare with Dr Shauna Golden. They explore why striving for individual perfection isn't the answer, and discuss the importance of using your sphere of influence to drive change. They share practical tips on how you can improve sustainability where you work, including projects that are 'win-win' - saving the planet, saving money and improving staff and patient experience.

Dr Shauna Golden has a background in Emergency Medicine and was the first Medical Education Fellow in Sustainability in NHS Lothian. She studied and trained in Ireland, became interested in the climate crisis while working in Australia, and thereafter completed a Masters in Global Health Policy at The University of Edinburgh.

Dr Kat Ralston is a Geriatric Medicine Registrar and member of the RCPE Trainees and Members’ Committee, currently working in Edinburgh.

-- Links --

Sustainable QI

https://www.susqi.org/

Sustainable QI specialties

https://sustainablehealthcare.org.uk/what-we-do/sustainable-specialties

Mary Robinson podcast

https://www.mothersofinvention.online/

NHS Scotland Strategy

https://www.gov.scot/publications/nhs-scotland-climate-emergency-sustainability-strategy-2022-2026/

NHS Lothian Climate Challenge Grants

https://nhslothiancharity.org/apply-for-funding/climate-challenge-grants/

Charing Cross Quality Improvement project

https://www.england.nhs.uk/greenernhs/whats-already-happening/reducing-unnecessary-cannulation-at-charing-cross-hospital/

Centre of sustainable healthcare

https://sustainablehealthcare.org.uk

-- Related content --

RCPE Fellows & Members can explore planetary health content on the Education Portal: https://learning.rcpe.ac.uk/tag/index.php?tc=1&tag=Planetary%20Health&ta=2&excl=1

Recording date: 6 July 2023

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This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

This week Dr Jonathan Bardgett discusses how to manage patients with a red hot painful swollen foot with Dr Callum Mutch. Jonathan and Callum discuss diagnostics, treatment and examples of different case presentations.

Dr Mutch is an infection doctor working in Edinburgh with his time split between the microbiology lab and the infectious diseases ward. He has recently undertaken a medical education fellowship focusing on Simulation Based Mastery Learning and Digital Education. Outside of work he is the co-host of the Infectious Diseases Insight of Two Specialists (ID:IOTS) podcast.

Disclaimer: Please always refer to the most up-to-date local antimicrobial guidelines

-- Useful Links--

NICE guideline [NG141]: Cellulitis and erysipelas: antimicrobial prescribing - https://www.nice.org.uk/guidance/NG141

Sullivan T, de Barra E. Diagnosis and management of cellulitis. Clin Med (Lond). 2018 Mar;18(2):160-163. - doi: https://doi.org/10.7861/clinmedicine.18-2-160

MicroGuide App: https://apps.apple.com/gb/app/microguide/id447171786 / https://play.google.com/store/apps/details?id=com.xancu.utreat&pli=1

NHS Scotland Antimicrobial Companion app: https://www.antimicrobialcompanion.scot/

Shorter is better - https://www.bradspellberg.com/shorter-is-better

NG141 Summary of the Evidence on Antibiotic prophylaxis for the prevention of recurrent cellulitis and erysipelas - https://www.nice.org.uk/guidance/ng141/chapter/Summary-of-the-evidence#antibiotic-prophylaxis-for-the-prevention-of-recurrent-cellulitis-and-erysipelas

Differentials: Lipodermatosclerosis - https://cks.nice.org.uk/topics/venous-eczema-lipodermatosclerosis/, DVT NICE guideline NG158 - https://www.nice.org.uk/guidance/NG158

Fernando SM, Tran A, Cheng W, Rochwerg B, Kyeremanteng K, Seely AJE, Inaba K, Perry JJ. Necrotizing Soft Tissue Infection: Diagnostic Accuracy of Physical Examination, Imaging, and LRINEC Score: A Systematic Review and Meta-Analysis. Ann Surg. 2019 Jan;269(1):58-65. - doi: https://doi.org/10.1097/sla.0000000000002774

Infectious diseases tag on Education Portal - https://learning.rcpe.ac.uk/tag/index.php?tc=1&tag=Infectious%20Diseases

ID:IOTS podcast - https://idiotspodcasting.buzzsprout.com/ (https://idiotspodcasting.buzzsprout.com/1782416/9227705-6-skin-and-soft-tissue-infection and https://idiotspodcasting.buzzsprout.com/1782416/9227743-7-necrotising-fasciitis)

Recording Date: 28 June 2023

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This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

In this episode Dr Marilena Giannoudi discusses the approach to patients with peripheral neuropathy with Dr Louise Davidson. Dr Davidson first covers the basic anatomy and function of the peripheral nervous system and describes lower motor neurone signs. They discuss different peripheral neuropathy presentations and types. Dr Davidson emphasises the importance of a thorough history before moving on to examination, testing/investigations, and management.

Dr Louise Davidson is a Consultant Neurologist based in Edinburgh. Dr Davidson works full time for the National Health Service with interests in epilepsy, general neurology and botulinum toxin for dystonia. Dr Davidson was awarded an MD degree following her research into the diagnostics of Sporadic Creutzfeldt-Jakob Disease. During her general neurology practice, Dr Davidson has managed a number of different cases of peripheral neuropathy and has previously discussed the topic at college meetings and at general medical grand round meetings. Dr Davidson is also actively involved in medical education and is the current local programme lead for neurology training.

Dr Marilena Giannoudi is a cardiology registrar based in Leeds. She is a member of the Trainees and Members’ Committee, a Fellow of the Higher Education Academy, and is currently undertaking a PhD.

-- Related content --

RCPE Fellows & Members can explore neurology content on the Education Portal: https://learning.rcpe.ac.uk/tag/index.php?tc=1&tag=Neurology

Recording date: 26 June 2023

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This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

In this episode Drs Dáire O'Shea and Sarah Clifford discuss what the acute medic needs to know about HIV (human immunodeficiency virus) with Dr Jonny Bardgett, including the patient journey following diagnosis, opportunistic infections, advances in diagnosis and management, treatment side effects, and use of PrEP (pre-exposure prophylaxis) and PEP (post-exposure prophylaxis) to reduce transmission and acquisition of HIV.

Dr Sarah Clifford recently completed training in Infectious Diseases and General Medicine, and is currently working as an acting consultant in the Regional Infectious Diseases Unit at the Western General Hospital in Edinburgh. Clinical interests include HIV medicine and tropical medicine. Dr Clifford is a graduate of the Liverpool School of Tropical Medicine & Hygiene, and the Gorgas Course in Tropical Medicine (Lima, Peru).

Dr Dáire O'Shea is a Consultant Physician in Infectious Disease at the Regional Infectious Diseases Unit Edinburgh and Honorary Clinical Senior Lecturer at University of Edinburgh. He is a graduate of Trinity College Dublin, Ireland and undertook Internal Medicine and specialist Infectious Diseases Training in Ireland. In 2011 Dr O'Shea was awarded a Transplant Infectious Diseases fellowship with the Alberta Transplant Institute in Canada continuing to take on a position with the Infectious Diseases Academic Faculty of the University of Alberta. In 2014 he took up his current position in Edinburgh. Subspecialist interests include infection in immunocompromised hosts, in particular infection post transplantation; HIV medicine, and Viral hepatitis. Research interests focus on immunopathogenesis and immune determinants of infection outcomes.

-- Link --

HIV drug interactions https://www.hiv-druginteractions.org/

Recording date: 31 May 2023

Sound issues: We apologise for some lower quality audio in this episode.

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This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

In this episode, Dr Libby Sampey interviews Dr Catriona Kyle about adrenal insufficiency and steroid replacement. They discuss the different types of adrenal insufficiency and relevant physiology before exploring recognition, investigations and diagnosis, and links to other autoimmune diseases. They go on to discuss management including ‘sick day rules’, and patient follow-up.

Dr Catriona Kyle is a Consultant Endocrinologist at the Western General Hospital in Edinburgh, and has a PhD in steroid physiology from the University of Edinburgh.

Dr Libby Sampey is a member of RCPE’s Trainees and Members’ Committee podcast team and a Foundation Year Doctor.

-- Links --

Society for Endocrinology - Adrenal Crisis Information

https://www.endocrinology.org/clinical-practice/clinical-guidance/adrenal-crisis/

Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline (Bornstein et al., 2016)

https://doi.org/10.1210/jc.2015-1710

Society for Endocrinology

https://www.endocrinology.org/

Recording date: 8 June 2023

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This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

Today Dr Marilena Giannoudi discusses treating diabetic patients on the wards with Dr Evgenia Foteinopoulou.

Dr Evgenia Foteinopoulou is a Consultant in Endocrinology & Diabetes at NHS Lothian with a special interest in Diabetic Nephropathy and Diabetes classification. Dr Foteinopoulou is also involved in Undergraduate and Postgraduate medical teaching.

Dr Marilena Giannoudi is the T&MC Podcast Lead and Vice-Chair for Careers and Communications, and a clinical academic trainee in cardiology in Yorkshire and Humber.

Recording Date: 21 April 2023

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This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).