Ep124: Pleural medicine comes of age

Professor Gary Lee established the first dedicated pleural service in the southern hemisphere in 2009, at the Sir Charles Gairdner Hospital in Perth. He says that pleural disease has finally come to be regarded as an area of subspeciality interest in its own right, not just a complication of other comorbidities. In this podcast he presents a potted history of key developments in the management of pleural effusion in particular. This is diagnosed in about 60,000 people every year in Australia, mainly as a result of infection or malignancy. With mentors in the UK, Professor Lee conducted some of the earliest trials on fibrinolytics and DNAses to break down purulent effusions. They also put to the test protocols for pleurodesis via talcum insufflation that date back to the 1930s. Professor Lee’s more recent clinical research has focused on the use of indwelling pleural catheters that a patient can use to drain pleural effusate when feeling breathless. He has also a made an important contribution to conservative management guidelines for primary spontaneous pneumothorax. This story is great example of how clinical practice emerges imperfectly from a soup of evidence, accidents, human biases and system. Guest Prof Gary Lee PhD FRACP FRCP FCCP (Pleural Service, Sir Charles Gairdner Hospital in Perth; University of Western Australia).Co-hostDr Marion Leighton FRACP (Wellington Hospital).ProductionProduced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Reconstruct’ by Amaranth Cove, ‘Nagba Algooah’ by Ebo Krdum. ‘Vittoro’ by Borrtex provided courtesy of FreeMusicArchive. Image by ilbusca licenced through Getty Images.   Editorial feedback kindly provided by RACP physicians Aidan Tan, Maansi Arora, Simeon Wong, Hugh Murray and Vanessa Wong.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.