Pomegranate Health

• [IMJ On-Air] DKA and insulin infusion protocols

  Diabetic ketoacidosis can be life-threatening but there’s some variability in the way it’s managed between health settings. Intervention involves intravenous insulin administration, hydration, electrolyte replacement and treatment of the underlying precipitant. In a survey of practitioners from 31 different hospitals in Australia there was an even split between those organisations which followed a fixed rate insulin infusion protocol, usually based on bodyweight, or a variable rate infusion protocol, titrated against blood glucose concentration. Three quarters of survey respondents had worked at another hospital that had different DKA management protocols raising concerns about the cognitive load on junior health staff moving between institutions. In Europe there has been some normalisation towards fixed rate protocols, despite there being no good quality evidence for superiority. In this podcast we hear some theories from two of the authors of the study published recently in the Internal Medicine Journal.12:40 SGLT2 inhbitor-associated ketoacidosis17:26 The cognitive burden of variation across settings25:11 the challenges of researching this questionsGuestsDr Lisa Raven FRACP PhD (St Vincent's Hospital, Sydney)Dr Mahesh Umapathysivam FRACP DPhil (Southern Adelaide Diabetes and Endocrine Service; Royal Adelaide Hospital) Guest HostDr Mervyn Kyi FRACP PhD (Royal Melbourne Hospital; Northern Hospital)ProductionProduced by Dr Mervyn Kyi and Mic Cavazzini DPhil. Music licenced from Epidemic Sound ‘Tree Tops’ by Autohacker and ‘Fugent’ by Lupus Nocte. Image created and copyrighted by RACP. Editorial feedback kindly provided by RACP physicians Aidan Tan, Hugh Murray, Stephen Bacchi and Aafreen Khalid. Key Reference“Heterogeneity in the management of diabetic ketoacidosis in Australia: a national survey”  [IMJ. 2025]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.

  --------  

  44:49

  --------

  44:49
• Ep135: “Wherefore a Pomegranate?” and other classics from the last ten years

  Pomegranate Health has been streaming since June 2015, so we’re going to share a few more classic eps from the last ten years. First up, presenter Mic Cavazzini digs deep to find the origins of the pomegranate, featured not just on this podcast but on the crest of the RACP. The journey starts 500 years ago at an unlikely place, the marriage of Henry VIII and the first of his six wives. You’ll find much of the pageantry reproduced at the web page. We then hear from the wonderful staff at Marrabinya, a support service in western NSW that helps connect Aboriginal patients to specialist consultations. As heard in episode 53, and a handful of others, healthy equity for First Nations people is a value embedded in the mission of the RACP. At Pomegranate Health we also try to support physician wellbeing and career development. One podcast towards that end was Episode 55: Starting out in Private Practice. We hear a pep talk from veteran rheumatologist Louis McGuigan about when and how to back yourself in such a business venture. Another episode with a practical theme was number 56 titled “Billing in Byzantium” where we heard how it is that a few billion dollars are inappropriately leaked from Medicare every year. Finally, in a sample from Episode 69. we hear about some of the structural bias in the health system that results in a gendered understanding of drug effects. All of these episodes and more, are now available on YouTube, as well as all the usual podcast browsing apps. Sampled in this retrospective episode: Desley Mason, Possum Swinton and Kym Lees from Ep53: Marrabinya Dr Louis McGuigan from Ep55: Starting out in private practice Margaret Faux PhD from  Ep56: Billing in ByzantiumProfessor Zoe Wainer from Ep69: Gendered Medicine 2- Funding and Research Production CreditsProduced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Fair Game’ by Mizlo, ‘Salat Alsabah’ by Feras Charestan, ‘Your Wave’ by Cospe, ‘Dusty Delta Day’ by Lennon Hutton, ‘Corn Candy’ by Guustavv and ‘After the Freak Show’ by Luella Gren. Music courtesy of FreeMusicArchive includes JS Bach's ‘March Fur Die Arche’ performed by The United States Army Old Guard Fife and Drum Corps and ‘Notre Dame’ by Jahzarr. Allegri’s ‘Miserere’ performed by Trinity College under Creative Commons licence from archive.org.  Editorial feedback kindly provided by RACP staff Kathryn Smith, Arnika Martus and Ruby Nelson.  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 

  --------  

  32:05

  --------

  32:05
• [IMJ On-Air] Microbleeds and Memory

  Cerebral microbleeds are a finding on MRI that are usually asymptomatic. There are two main aetiological pathways, one occurring as a result of uncontrolled hypertension and the other from the accumulation of amyloid-beta peptide. The link between cerebral amyloid angiopathy and Alzheimer’s Disease is not understood and even the impact that cerebral microbleeds more generally have on cognition. For the study discussed today, clients of an Australian memory clinic were retrospectively assessed for prevalence of cerebral microbleeds and how this correlates to performance on cognitive tests and formal diagnosis categories. Prevalence of multiple cerebral microbleeds was associated with poorer cognitive performance and more severe diagnoses. And there are suggestions of a shared instigator between Alzheimer’s Disease cerebral amyloid angiopathy. But novel anti-amyloid therapies can also cause increased bleeding risk, meaning that multiple microbleeds are a contraindication for these drugs. We hear how clinicians in the memory clinic balance therapeutic outcomes and potential risks.  Guest Associate Professor Paul Yates FRACP PhD (Austin Health; University of Melbourne) Co-HostDr Duncan Austin FRACP PhD (Alfred Health; Cabrini Health)ProductionProduced by Dr Duncan Austin and Mic Cavazzini. Music licenced from Epidemic Sound includes ‘Tree Tops’ by Autohacker and ‘Fugent’ by Lupus Nocte. Image created and copyrighted by RACP. Editorial feedback kindly provided by RACP physicians Stephen Bacchi, Joseph Lee and Aidan Tan.Key ReferencePrevalence and Associations of Cerebral Microbleeds in an Australian Memory Clinic Cohort [IMJ. 2025]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.

  --------  

  46:44

  --------

  46:44
• [Case Report] 46yo with psychosis and cold intolerance

  A 46-year old man is admitted to hospital following a first time presentation of psychosis that involved barricading himself inside a neighbour’s home. At admission he appears disorganised with slow movements and speech. His rambling reveals bizarre delusional beliefs of a paranoid and persecutory nature. At moments he shows aggression towards staff but when examines reports occasional dizziness and an intolerance of cold. Physical examination reveals cool peripheries, sparse axillary and pubic hair, and soft adult-sized testicles. The investigating team suspect hypothyroidism and a complex series of investigations and therapies follows.Guests Dr Peak Man Mah FRACP  (Lyell McEwin Hospital, University of Adelaide) Dr Malcolm Borg (Royal Adelaide Hospital) HostsAssociate Professor Stephen Bacchi FRACP (Lyell McEwin Hospital; University of Adelaide)Mic Cavazzini DPhilProductionProduced by Stephen Bacchi and Mic Cavazzini. Music licenced from Epidemic Sound includes ‘Rockin’ for Decades’ by Blue Texas and ‘Brighton Breakdown’ by BDBs. Image created and copyrighted by RACP. Editorial feedback kindly provided by RACP physician Simeon Wong and medical student Cindy Shi.  Key Reference (Spoiler Alert)* * * * *Panhypopituitarism and psychosis in a male patient [Aust N Z J Psychiatry. 2010] 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. 

  --------  

  23:10

  --------

  23:10
• Ep132: Ten Years of Pomegranate Health

  Pomegranate Health marks ten years of podcasting since its launch in June 2015. This episode will be one of two samplers that dip into the back catalogue of 131 episodes to showcase some of the most compelling stories. You’ll hear how podcast themes are identified from all the domains of medicine and professionalism. And a little bit about the motivations of long-time producer and presenter, Mic Cavazzini.Pomegranate Health has several thousand listeners in over 150 countries. Three quarters of listeners are, predictably, in Australia and Aotearoa-New Zealand, but a full 14 per cent are located outside the traditional anglosphere. RACP is proud to provide this platform to showcase the great work and dedication of its members. It’s also a place where physicians can learn from the other professionals and patient advocates that make up the health system. Sampled in this retrospective episode:Prof Meera Agar from ​Ep33: Early days for medicinal cannabisDr Paul Drury and Prof Sophia Zoungas from Ep41: Targeting DiabetesProf Rinaldo Bellomo from Ep70: Zeroing in on “the renal troponin”Dr Nic Szecket and Dr Art Nahill from Ep32: Cognitive biases in diagnostic thinkingProf Ian Harris and Assoc Prof Louise Stone from Ep25: Dealing with Uncertainty Part 1Dr Danielle Ofri from Ep38: Making a ConnectionMichael Pooley as Dr David Hilfiker from Ep75: Feeling guilty- Medical Injury Part 2 CreditsProduced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Le Hustle’ by Polyrhythmics, ‘Your Wave’ by Cospe, ‘Soul Single Serenade’ by Dusty Decks, ‘Hollow Head’ by Kenzo Almond and ‘Illusory Motion’ by Gavin Luke. Music courtesy of FreeMusicArchive includes ‘I got 99 broadswords but this one isn't one’ and ‘Friends’ by Komiku and ‘Cree’ by Satellite Ensemble. Thumbnail image is the copyright of RACP. Editorial feedback kindly provided by RACP physicians Zac Fuller and Simeon Wong. Thanks also to RACP staff Kathryn Smith, Michael Davidson and Anne Fredrickson.  Please visit the Pomegranate Health web page for a list of thankyous over the ten years. Subscribe to new episode email alerts or search for ‘Pomegranate Health’ in Apple Podcasts, Spotify, Castbox or any podcasting app.

  --------  

  33:42

  --------

  33:42

More Health & Wellness podcasts

Trending Health & Wellness podcasts

About Pomegranate Health