Special Episode 16. Interventional Radiology with Dr Yen Chieng
Interventional radiology is an innovative and rapidly growing medical profession that enables radiologists to blend clinical interaction, procedural work, and imaging. It stands as an exciting domain within modern medicine, offering precise, targeted treatments for complex diseases and conditions throughout the body. Interventional radiologists seamlessly integrate various specialty interests, including gastroenterology, vascular surgery, neurosurgery, oncology, pain management, gynecology, and more. Moreover, they've pioneered treatment techniques using state-of-the-art technology like MRI, CT scans, fluoroscopy, ultrasound, and plain X-rays.
Their scope of practice encompasses a broad range of procedures such as biliary intervention, cholecystostomy, chemo and radioembolization of tumors, Radiofrequency ablation, Cryoablation and microwave ablation, balloon angioplasty, vascular stenting, aneurysm repair, embolization (e.g., of the uterine artery, fibroids, and pulmonary arteriovenous malformations), catheter-directed thrombolysis, placement of IVC filters, dialysis-related interventions, central venous catheter placement, percutaneous nephrostomy placement, ureteral stent placement, coeliac axis nerve blocks, spinal blocks, and more.
Interventional radiology is poised to play an increasingly significant role in the future of modern medicine. It offers cost-effective, minimally invasive treatments with shorter procedural and recovery times, sometimes yielding better patient-focused outcomes compared to many surgical alternatives.
In this podcast, my goal was to expand my knowledge about the remarkable world of IR. I am delighted to welcome interventional radiologist Dr. Yen Chieng to join us, covering many of the areas mentioned above. Yen has skillfully navigated challenging clinical scenarios, bailing many of us out more than once with his incredible yet measured skills and enthusiasm. Please welcome Yen to the podcast."
References:
Dr. Yen Chieng: i-med.com.au
Royal Australian and New Zealand College of Radiologists: www.ranzcr.com
Interventional Radiology Society of Australasia: www.irsa.com.au
Inside radiology: www.insideradiology.com.au
Episode 32. Lung Cancer with Mr Cliff Choong
Lung cancer is a major problem facing Australian doctors representing 9% of all cancer diagnoses and with 12,200 new cases of lung cancer diagnosed each year it is the fifth most commonly diagnosed cancer, but the most common cause of cancer death in this country for both men and for women. The early presentation of lung cancer may be as subtle as a small coin lesion or nodule seen on chest imaging and there are a multitude of ways in which such nodules may be interrogated further. Whilst a wait and watch approach may be appropriate, further evaluation by VATS with a tissue diagnosis maybe required.
Lung cancer is a major problem facing Australian doctors representing 9% of all cancer diagnoses and with 12,200 new cases of lung cancer diagnosed each year it is the fifth most commonly diagnosed cancer, but the most common cause of cancer death in this country for both men and for women. The early presentation of lung cancer may be as subtle as a small coin lesion or nodule seen on chest imaging and there are a multitude of ways in which such nodules may be interrogated further. Whilst a wait and watch approach may be appropriate, further evaluation by VATS with a tissue diagnosis maybe required.
In this podcast episode we are joined by expert thoracic surgeon Mr Cliff Choong who discuss:
· Lung nodules and coin lesions
· Appropriate follow-up and review when a lung nodule or coin lesion is found on imaging
· Surgical approaches to diagnosis and management including VATS (video assisted thoracic surgery)
This is an excellent conversation with Cliff who generously guides us through a logical approach to management. Please join me.
Useful references include:
- www.sjog.org.au
- my.clevelandclinic.org
To be a guest on the show or provide some feedback, I’d love to hear from you: manager@gihealth.com.au
Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.
Episode 14. Faecal Microbiota Transplant with Dr Darcy Holt
The transfer of stool from a healthy donor into the gastrointestinal tract of a recipient (FMT) at first consideration does not seem like a reasonable or scientific approach to the treatment of gastrointestinal diseases. Historically however, it has been used by communities for over 3,000 years, gaining credibility in 1958 after a paper by Eisemen in Denver who described treating pseudomembranous colitis this way.
The transfer of stool from a healthy donor into the gastrointestinal tract of a recipient (FMT) at first consideration does not seem like a reasonable or scientific approach to the treatment of gastrointestinal diseases. Historically however, it has been used by communities for over 3,000 years, gaining credibility in 1958 after a paper by Eisemen in Denver who described treating pseudomembranous colitis this way. More recently double-blind randomised control trials have demonstrated the efficacy of FMT in the treatment of severe clostridium difficile enterocolitis. To discuss this subject in more detail we are joined in a conversation with Dr Darcy Holt, senior consultant at Monash Health, who also works at the Centre for GI Health, as he leads us through –
· The indications for FMT
· Therapeutic advantages
· Practical aspects of FMT
With his typical academic flare and clarity of dialogue, please enjoy this interesting conversation with Darcy.
Useful references include –
To be a guest on the show or provide some feedback, I’d love to hear from you: manager@gihealth.com.au
Episode 13. Biologics and Small Molecules in IBD with Dr Darcy Holt
DARCY HOLT - BIOLOGICS AND SMALL MOLECULES FOR INFLAMMATORY BOWEL DISEASE Biologic agents (produced in living organisms or containing components of living organisms) coupled with a variety of new small molecules (acting in novel ways to influence the human immune system) have dramatically improved medical management of inflammatory bowel disease.
DARCY HOLT - BIOLOGICS AND SMALL MOLECULES FOR INFLAMMATORY BOWEL DISEASE Biologic agents (produced in living organisms or containing components of living organisms) coupled with a variety of new small molecules (acting in novel ways to influence the human immune system) have dramatically improved medical management of inflammatory bowel disease.
Biologic agents (produced in living organisms or containing components of living organisms) coupled with a variety of new small molecules (acting in novel ways to influence the human immune system) have dramatically improved medical management of inflammatory bowel disease. In this podcast episode, we are joined by Dr Darcy Holt, a senior gastroenterologist at Monash Health, with a special interest in inflammatory bowel disease and body composition to discuss -
· TNF inhibitors including the chimeric infliximab, fully humanised recombinant adalimumab, fully humanised monoclonal antibody golimumab
· Anti-integrins which regulate lymphocyte trafficking to the gut including the gut selective vedolizumab
· Interleukin inhibitors including ustekinumab which inhibits interleukin 12 and 23 as well as
· JAK inhibitors which decrease signalling by cytokines growth factor receptors including Tofacitinib
Darcy covers appropriate indications, screening for tuberculosis and viral hepatitides before therapy commencement, relative contraindications and the use of biosimilars. I found this a very interesting discussion on a group of therapies that have brought significant improvement to the quality of life of many patients with inflammatory bowel disease.
The useful references include:
To be a guest on the show or provide some feedback, I’d love to hear from you: manager@gihealth.com.au
Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.
Episode 10. Barrett's Oesophagus with Dr Puneet Mahindra
In this episode I have a conversation with Dr Puneet Mahindra on the subject of Barrett's oesophagus. Puneet not only discusses the origins of this condition, named after Australian born thoracic surgeon Mr Norman Barrett, but also discusses - · Its relationship to chronic reflux disease · Adenocarcinoma risk · Surveillance guidelines · Appropriate medical management Puneet makes the point that Barrett's oesophagus is an important reason why we should all take gastro-oesophageal reflux disease seriously.
In this episode I have a conversation with Dr Puneet Mahindra on the subject of Barrett’s oesophagus. Puneet not only discusses the origins of this condition, named after Australian born thoracic surgeon Mr Norman Barrett, but also discusses –
· Its relationship to chronic reflux disease
· Adenocarcinoma risk
· Surveillance guidelines
· Appropriate medical management
Puneet makes the point that Barrett’s oesophagus is an important reason why we should all take gastro-oesophageal reflux disease seriously. This is an excellent introduction and overview to the subject; I hope you enjoy the conversation.
References include –
pubmed.ncbi.nlm.nih.gov
ASGE guidelines
wiki.cancer.org.au
To be a guest on the show or provide some feedback, I’d love to hear from you: manager@gihealth.com.au
Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.
Episode 9. Gastro-Oesophageal Reflux Disease with Dr Puneet Mahindra
In this episode I interview experienced gastroenterologist Dr Puneet Mahindra on the common clinical problem of gastro-oesophageal reflux disease. Puneet details - · Risk factors · Complications · Approaches to management He provides personal tips drawn from experience and the literature outlining an approach that should be helpful to everyone practicing clinical medicine.
In this episode I interview experienced gastroenterologist Dr Puneet Mahindra on the common clinical problem of gastro-oesophageal reflux disease. Puneet details –
· Risk factors
· Complications
· Approaches to management
He provides personal tips drawn from experience and the literature outlining an approach that should be helpful to everyone practicing clinical medicine.
Puneet also walks us through his journey to becoming a gastroenterologist, growing up in India, working and studying in the United Kingdom and then Australia. I hope you enjoy the conversation.
Useful references include –
www.gesa.org.au (Clinical update and Management guidelines)
To be a guest on the show or provide some feedback, I’d love to hear from you: manager@gihealth.com.au
Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.
Episode 8. Heart Failure with Dr James Sapontis
It is estimated that at least 300,000 Australians have chronic heart failure imposing a significant impact on the quality of life and mortality. In this podcast episode, we are joined by an experienced interventional cardiologist, Dr James Sapontis, as we explore heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF).
It is estimated that at least 300,000 Australians have chronic heart failure imposing a significant impact on the quality of life and mortality. In this podcast episode, we are joined by an experienced interventional cardiologist, Dr James Sapontis, as we explore heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF). James carefully dissects and describes these two forms of heart failure by discussing –
· Diagnosis
· Risk factors
· Treatment approaches
This was a very interesting conversation that I am delighted to share with you.
Useful references include –
www.jamessapontis.com
To be a guest on the show or provide some feedback, I’d love to hear from you: manager@gihealth.com.au
Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.
Episode 7. Coronary CT Angiography (CCTA) with Dr James Sapontis
It is estimated that 1 in 4 Australian deaths relate to cardiovascular disease and that there are over 60,000 acute coronary events, including either angina or myocardial infarctions, recorded each year in Australia. In an attempt to reduce morbidity and mortality medical efforts have been directed to primary prevention and improving the selection of patients likely to require coronary intervention, such as cardiac stenting or revascularisation.
It is estimated that 1 in 4 Australian deaths relate to cardiovascular disease and that there are over 60,000 acute coronary events, including either angina or myocardial infarctions, recorded each year in Australia. In an attempt to reduce morbidity and mortality medical efforts have been directed to primary prevention and improving the selection of patients likely to require coronary intervention, such as cardiac stenting or revascularisation. To discuss the place of coronary CT angiography in the investigation and work up of a patient suspected to have coronary disease we are joined by the very impressive and knowledgeable interventional cardiologist, Dr James Sapontis as he explains –
· CCTA
· Explores the appropriate place of CCTA in the workup and management of coronary artery disease.
I found this conversation very interesting and I am very pleased to share the episode with you.
Useful references include –
Jamessapontis.com
To be a guest on the show or provide some feedback, I’d love to hear from you: manager@gihealth.com.au
Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.
Episode 6. Bariatric Surgery with Mr Ray McHenry
In this episode we have a very interesting conversation with one of Australia's leading bariatric surgeons, Mr Raymond McHenry, on surgical approaches to weight loss, focussing particularly on the gastric sleeve and roux-en-y gastric bypass operations.
In this episode we have a very interesting conversation with one of Australia’s leading bariatric surgeons, Mr Raymond McHenry, on surgical approaches to weight loss, focussing particularly on the gastric sleeve and roux-en-y gastric bypass operations.
Ray discusses –
· patient selection
· psychological profiling
· choice of operation and outcomes and
· covers some of the early experiences with other bariatric approaches
This conversation provided a very insightful discussion from one of our surgical masters.
Useful references include -
www.lapsurgeryaustralia.com.au
To be a guest on the show or provide some feedback, I’d love to hear from you: manager@gihealth.com.au
Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.
Episode 5. COVID-19 with Dr Babak Rad
Covid 19 has brought forth upon the world a pandemic unrivalled since the Spanish flu (1918 - 1920) caused by H1N1 influenza A. Described by Australian Treasurer Josh Frydenberg as the "new and invisible enemy", every doctor has had to avail themselves of knowledge regarding this highly contagious virus.
Covid-19 has brought forth upon the world a pandemic unrivalled since the Spanish flu (1918 – 1920) caused by H1N1 influenza A. Described by Australian Treasurer Josh Frydenberg as the “new and invisible enemy”, every doctor has had to avail themselves of knowledge regarding this highly contagious virus.
Today we are joined by expert infectious disease specialist Dr Babak Rad who will discuss:
· Our knowledge regarding the incubation period of Covid 19
· Virulence
· Quality of testing
· Asymptomatic spreaders
· The immunocompromised patients
· Medical therapies
· Vaccines
Much of our knowledge continues to be a work in progress, by the time this pandemic passes Covid 19 may be the best-known pathogen ever studied by humankind. Please join me in this interesting conservation with Dr Babak Rad.
Useful references include:
To be a guest on the show or provide some feedback, I’d love to hear from you: manager@gihealth.com.au
Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.
Episode 4. Hepatitis C with Dr Ferry Rusli
In this episode I have a conversation with hepatologist and gastroenterologist Dr Ferry Rusli in a four-part series on liver disease where we explore chronic hepatitis C, its population reservoirs in Australia and approaches to treatment. In particular, Ferry points out - · The need to increase our effectiveness at treating hepatitis C in at risk populations.
In this episode I have a conversation with hepatologist and gastroenterologist Dr Ferry Rusli in a four-part series on liver disease where we explore chronic hepatitis C, its population reservoirs in Australia and approaches to treatment. In particular, Ferry points out - · The need to increase our effectiveness at treating hepatitis C in at risk populations.
In this episode I have a conversation with hepatologist and gastroenterologist Dr Ferry Rusli in a four-part series on liver disease where we explore chronic hepatitis C, its population reservoirs in Australia and approaches to treatment.
In particular, Ferry points out –
· The need to increase our effectiveness at treating hepatitis C in at risk populations (e.g. prison population)
· Discusses the impressive breakthrough with new antiviral therapies and their effectiveness in curing hepatitis C
· Surveillance for hepatocellular carcinoma
I really hope you find this conversation as interesting as I did.
Useful references include -
To be a guest on the show or provide some feedback, I’d love to hear from you: manager@gihealth.com.au
Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.
Episode 3. Hepatitis B with Dr Ferry Rusli
In this episode I talk with experienced gastroenterologist and hepatologist Dr Ferry Rusli on the subject of hepatitis B in a four-part series on liver disease. Ferry discusses - · the prevalence of hepatitis B in the Asia Pacific region · the long-term complications and consequences of hepatitis B · treatment options including pharmacological therapies which are currently falling short of the national target for patients receiving treatment.
In this episode I talk with experienced gastroenterologist and hepatologist Dr Ferry Rusli on the subject of hepatitis B in a four-part series on liver disease. Ferry discusses -
· the prevalence of hepatitis B in the Asia Pacific region
· the long-term complications and consequences of hepatitis B
· treatment options including pharmacological therapies which are currently falling short of the national target for patients receiving treatment.
This conversation provides a great introduction to current approaches to hepatitis B management. I hope you enjoy the conversation.
Useful reference are -
To be a guest on the show or provide some feedback, I’d love to hear from you: manager@gihealth.com.au
Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.
Episode 1. Abnormal Liver functions with Dr Ferry Rusli
In this episode I interview gastroenterologist and hepatologist Dr Ferry Rusli in the first of a four-part series on liver disease. Ferry discusses his approach to a patient presenting with abnormal liver function tests and navigates us through - · Obstructive liver patterns · Hepatitic patterns Ferry will address in broad terms common aetiologies such as non-alcoholic fatty liver disease, chronic hepatitides, acute viral infections, biliary obstruction, malignancy and the possibility of drug side-effects.
In this episode I interview gastroenterologist and hepatologist Dr Ferry Rusli in the first of a four-part series on liver disease. Ferry discusses his approach to a patient presenting with abnormal liver function tests and navigates us through -
· Obstructive liver patterns
· Hepatitic patterns
Ferry will address in broad terms common aetiologies such as non-alcoholic fatty liver disease, chronic hepatitides, acute viral infections, biliary obstruction, malignancy and the possibility of drug side-effects. There are some great insights to be gained here. We also find out about Ferry’s journey into medicine growing up in Indonesia, completing schooling in Melbourne and being awarded the travel scholarship in hepatology from the Gastroenterological Society of Australia. I hope you enjoy the show.
Useful reference -
www.gihealth.com.au
To be a guest on the show or provide some feedback, I’d love to hear from you: manager@gihealth.com.au
Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne Australia and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.