Hospital and Internal Medicine Podcast
136 episodes - English - Latest episode: about 2 years ago - ★★★★★ - 570 ratingsIntended for the medical professional who enjoys learning for the sake of it. Dr. Porat is a practicing Colorado Hospitalist and Board Certified in Internal Medicine.
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Episodes
Heart Failure with Preserved Ejection Fraction (Diastolic CHF) and SGLT-2 Inhibitor Therapy
January 27, 2022 21:23 - 11 minutes - 21.1 MBThe double-blind, randomized phase III EMPEROR-Preserved trial showed a benefit of the sodium-glucose cotransporter-2 (SGLT2) inhibitor empagliflozin in patients with heart failure with preserved ejection fraction (HFpEF). Now let us dig a bit more into those headlines.
Should You Postpone Interventions for INFECTED Necrotizing Pancreatitis?
October 18, 2021 19:45 - 10 minutes - 18.9 MBAn important recently published randomized control trial provides guidance on this controversy.
Spontaneous Bacterial Peritonitis - Unique Infections in Cirrhosis part 2
June 27, 2021 21:40 - 18 minutes - 33.3 MBUnique Infectious Considerations in Cirrhosis - part 1
June 15, 2021 02:00 - 7 minutes - 14.3 MBDiabetic Gastric Emptying Abnormalities (and sometimes normal) - Part 1
May 09, 2021 17:21 - 10 minutes - 18.4 MBAlmost nobody feels comfortable managing DELAYED gastric emptying (gastroparesis) and very few medical providers even think about RAPID gastric emptying in their diabetic patients. Even if you send these patients to GI specialists, your blood sugar co-management of these patients can be heavily impacted by these issues. Is delayed gastric emptying always a bad thing? When your patient has upper GI symptoms, how often is it a gastric emptying abnormality? Time for some answers.
Gastric Emptying Abnormalities - Part 2
May 08, 2021 20:10 - 9 minutes - 17.6 MBCan we trust a nuclear study to nail the diagnosis? Are motor abnormalities really the cause of symptoms? What is a POP procedure?
Morphine for later stage COPD patients not on hospice
April 09, 2021 19:44 - 8 minutes - 15.8 MBDoes regular, low-dose, oral sustained-release morphine improve disease-specific health status or cause respiratory adverse effects in patients with moderate to very severe chronic breathlessness due to advanced chronic obstructive pulmonary disease? Digging in on the latest study.
The JAMA controversy and loss of conversation in medicine
April 05, 2021 21:18 - 19 minutes - 34.8 MBMy take on what went down at the Journal of the American Medical Association. I disagree with the comment there isn't "structural racism in health care", but was the backlash against the Editor who didn't say it (and actually opposed the comment) an over-reaction? Can we have discussions about the controversial issues that affect healthcare (like gun violence or abortion) without cancel culture cancelling the people who want to have nuanced discussions? I fear we lost the ability to have dia...
Cows Milk - Healthy or Not?
March 06, 2021 17:00 - 11 minutes - 20.7 MBPsilocybin Mushrooms - will they become an accepted medicine?
February 19, 2021 22:00 - 28 minutes - 51.6 MBUnderstand Basic Epigenetic Changes in Medicine and Everyday Life
February 04, 2021 20:05 - 12 minutes - 22.9 MBThis lecture provides a basic understanding of how epigenetic changes influence infections/sepsis, vaccinations, cancer, future generations, your muscles, and (of course) those sweet tan-lines you are rocking. Every day you are living through epigenetic changes that have huge implications on your health and who you are.
Hyponatremia etiology by history and physical
December 23, 2020 16:53 - 29 minutes - 54.7 MBHyponatremia remains a challenging topic for many because they are trying to memorize algorithms and numbers. You can usually nail the etiology by history & physical and a brief chart review.
Cytokine Storm - part 1
December 02, 2020 00:35 - 5 minutes - 9.98 MBIf you use the term 'cytokine storm' and don't really know what you mean by it, you are far from unique. Let me help to try and clarify it for you just a bit.
Cytokine Storm - part 2
December 02, 2020 00:03 - 12 minutes - 22.6 MBDo you know what CRP is (other than saying it is an inflammatory marker)? Should we always shut down cytokines? If so, how? Why should we avoid giving a glucocorticoid to a COVID patient before they develop an elevated CRP or hypoxia? So many questions! A few answers are provided.
Covid Treatment (for Hospitalized Patients) Update
November 30, 2020 01:04 - 30 minutes - 55.6 MBDealing with hypoxia, anticoagulation, steroids, Remdesivir, VTE, self-proning, labs, plasma, etc. I do not get into the epidemic numbers or politics or vaccines or outpatient treatments (this is really a HOSPITALIZED TREATMENT discussion for frontline providers in hospitals). Some of what is discussed is likely going to change over the next months, as has often been the case with COVID19.
The Most Important Person That Lived For Our Health and Wellbeing
November 28, 2020 00:10 - 31 minutes - 57 MBHint: That person died in 2017
An (old) New Weapon to Fight Leg Cellulitis
August 13, 2020 00:19 - 11 minutes - 20.6 MBAcute Severe Hypertension - part 1
April 28, 2020 16:30 - 14 minutes - 25.9 MBAcute Severe Hypertension - part 2
April 28, 2020 16:29 - 16 minutes - 30.9 MBMultiple treatment issues are discussed. This includes theoretical ideal blood pressure lowering rates, oral options (for hypertensive urgency and specific populations), intravenous options (for hypertensive emergency or NPO patients), specific issues with aortic dissection, coronary syndromes, acute pulmonary edema & heart failure, labetalol, esmolol, nitroglycerin, and nitroprusside.
Acute Severe Hypertension - part 3
April 27, 2020 16:46 - 14 minutes - 27.1 MBDid you know that intravenous labetalol and oral labetalol are not really similar? The great hydralazine debate. Things you must know about Clevidipine if you are going to use it.
Acute Severe Hypertension - part 4
April 25, 2020 04:39 - 17 minutes - 32.3 MBDid you know systolic and diastolic blood pressure are NOT measured by automated BP cuffs? PRES (Posterior Reversible Encephalopathy Syndrome), also known as RPLS (Reversible Posterior Leukoencephalopathy Syndrome), is something you should recognize when you see it. Brief mentions of esmolol, nitroprusside, and other topics are scattered somewhere in between musings.
A Plea For The Middle Ground With Covid19
April 24, 2020 22:29 - 14 minutes - 25.8 MBInteresting Studies, Facts, & Opinions - April 2020 edition
April 23, 2020 22:27 - 13 minutes - 25.4 MBIf you wonder why good food is more important than mortality and why ordering too many unnecessary consults worsens the food and doesn't impact mortality - this episode is for you. Tramadol is not well understood by many prescribers and there are some emerging facts we all need to know. A flashback to diuretic use in congestive heart failure with fluid overload and elevated creatinine is also discussed somewhere in the mix. Ohhh...and stop systematically prescribing nicotine replacement at h...
Balkan Reflections Forged By A Virus Lockdown
April 23, 2020 01:59 - 10 minutes - 14.1 MBWorld War I was partly triggered by powerful allies of various nationalities being dragged into a Balkan conflict (nationalism, of course, was another major factor). The more recent Balkan conflict is even more preposterous - and here is my attempt to humorously explain the unexplainable.
Recent Interesting Internal Medicine Studies and Facts - December 2019
December 10, 2019 21:11 - 18 minutes - 25 MBCorrecting Hypernatremia in adults (finally, a real study!). An option for that scary patient with hemoptysis. How many nephrons you have (and your patient has) - it matters.
Anemia of Inflammation - finally understand this common anemia that accomplished doctors often can't explain
September 30, 2019 19:08 - 9 minutes - 13.4 MBAnemia of Inflammation is also often referred to as Anemia of Chronic Disease. It is one of the most common anemias, yet often challenging to comprehend. This is an attempt is to try and simplify it.
Anemia of Inflammation - part 2
September 30, 2019 18:04 - 7 minutes - 9.87 MBIf you know why red blood cells survive less (and are made less) during inflammatory conditions, and already know why ferritin increases in inflammation, and don't want to hear a lousy Iron Man plot idea - then you are good to go on skipping this episode.
Anemia of Inflammation - part 3
September 30, 2019 12:58 - 8 minutes - 12.1 MBCreatine - part 1
August 20, 2019 23:41 - 12 minutes - 17.8 MBIt occurs naturally in the body (because we synthesize it), it is in meat, and it is frequently used as a supplement. Since it is in you, why not understand what it is and what it does? Advice is provided on which supplement labels to particularly avoid. A brief reflection upon creatine within our brains (and the potential memory impact seen in one study) is utilized to make the point that when it comes to a performance enhancer, like creatine, it's not solely about the ramifications on musc...
Creatine - part 2
August 06, 2019 22:11 - 9 minutes - 13.4 MBThe replenishing of muscle ATP is one (of the several) mechanisms that creatine helps with when it comes to heavy anaerobic exercise. Other topics discussed are things to know about lab testing the kidneys while taking creatine. Thoughts on why some don't respond to creatine supplementation.
Creatine - part 3
August 05, 2019 19:06 - 15 minutes - 21.8 MBIs there a specific type of creatine to buy? What is creatine monohydrate? What is Creapure? What do some professional organizations have to say about the safety of creatine? The loading dose debate. Also dives into the several mechanisms of action for how creatine helps build muscle.
Medicare for All? (or maybe you call it Universal Healthcare or Single-Payer)
July 01, 2019 23:24 - 47 minutes - 65.9 MBAre you surprised that GoFundMe and crowdfunding are not the solution to a family healthcare crisis? How about Medicare for All? Hmmmm.....
Part 5 of Muscle and Strength Gaining Tips - The Emotional Connection and Overcoming Temporary Pain
April 08, 2019 20:22 - 20 minutes - 28.3 MBClostridium Difficile - part 1
January 25, 2019 20:40 - 13 minutes - 19.1 MBA deceivingly difficult topic. Not so obvious points are made about asymptomatic carriers, transmission, and who to test.
Clostridium Difficile - part 2
January 23, 2019 20:32 - 10 minutes - 14.9 MBSpecific initial treatment regimens are discussed. Topics include fulminant disease, Vancomycin, Fidaxomicin, Metronidazole, and recurrence rates/regimens.
Clostridium Difficile - part 3
January 23, 2019 18:59 - 13 minutes - 18.2 MBMany of the latest studies in the 2017-2018 timeframe are reviewed. The importance of looking at the eosinophil count on the CBC, probiotic future directions, microbiome transplant options, antibody treatment (bezlotoxumab), "penicillin allergic" patients, and a brief mention of available testing.
Live From My Basement Bathroom
December 24, 2018 00:27 - 16 minutes - 22.6 MBExperiences that taught me some lessons.
Type 2 Diabetes Treatment - Part 7 - GLP-1 Agonists and DPP-4 Inhibitors
December 17, 2018 21:57 - 16 minutes - 23 MBGlucagon-Like Peptide 1 (GLP-1) mimetics are also referred to as the GLP-1 receptor agonists. While this talk mostly focuses on GLP-1 mechanisms and actions, the hope is you will also better understand The Dipeptidyl Peptidase-4 (DPP-4) inhibitors The current GLP-1 Agonists include Exenatide (Byetta), Liraglutide (Victoza), Dulaglutide (Trulicity), Abiglutide (Tanzeum), Lixisenatide (Adlyxin), Semaglutide (Ozempic). The current DPP-4 Inhibitors include Alogliptin (Nesina), Linagliptin (Tr...
Type 2 Diabetes Treatment - Part 6 - SGLT2 Inhibitors
September 26, 2018 19:23 - 20 minutes - 27.6 MBSodium-Glucose Transporter 2 Inhibitors decrease glucose re-absorbtion. The diuretic effect, weight loss, DKA, cardiac outcomes, blood pressure, genital infections and a whole bunch of other information is discussed. SGLT2s include Canagliflozin (Invokana), Dapagliflozin (Farxiga), Empagliflozin (Jardiance), Ertagliflozin (Steglatro), with more to be released in the future.
Type 2 Diabetes Treatment - Part 5 - HgA1C
August 26, 2018 17:56 - 19 minutes - 26.5 MBThere is a lot more to understanding HgA1C then most realize (particularly the quality industry and big corporations).
Type 2 Diabetes Treatment - Part 4 - Metformin
May 27, 2018 23:28 - 25 minutes - 34.7 MBTackles - Vitamin B12, kidney disease, CHF, cancer, Impaired Glucose Tolerance (IGT), dosing, side-effects, lactic acidosis, cost, drinkers, hypoxic patients, glucose lowering, and a few other moments of erudation.
Type 2 Diabetes Treatment - Part 3 Glucagon
May 16, 2018 17:16 - 8 minutes - 12.4 MBIf you want to understand drug classes like DPP-4 inhibitors, GLP-1 (GLUCAGON-like peptide) therapies, treating hypoglycemia, and an important player among the many etiologies of Type 2 diabetes - then you must understand the basics about glucoagon.
Type 2 Diabetes Treatment - Part 2 - Reversing The Disease With Lifestyle Changes
May 01, 2018 21:30 - 13 minutes - 17.9 MBType 2 Diabetes Treatment - Part 1
May 01, 2018 17:23 - 8 minutes - 12.2 MBInternal Medicine Pearls #5
April 03, 2018 21:57 - 33 minutes - 45.7 MBDiuretic therapy for congestive heart failure treatment, antibiotics for diabetic osteomyelitis after foot surgery, and practical tips with new-onset seizures - is among the knowledge dropped (because, after all, school can't teach us everything).
Some Recent Studies Worth Knowing About - February 2018
February 01, 2018 18:49 - 11 minutes - 15.5 MBSome new stuff about Vitamin D & Calcium supplementation, another about the timing of hip fracture surgery, etc
Forcing Atheist Doctors to Play With God
December 22, 2017 04:32 - 34 minutes - 47.1 MBInternal Medicine Pearls #4
November 14, 2017 18:36 - 14 minutes - 19.8 MBChecking glucose levels in Type 2 Diabetes, ACE Inhibitors for women, and using Azithromycin in Asthma.