Last Week in Medicine
72 episodes - English - Latest episode: 10 months ago - ★★★★★ - 40 ratingsWouldn't it be nice if someone reviewed all the latest internal medicine literature and distilled it into a brief podcast you could listen to on your way to work? Get updates from the New England Journal of Medicine, JAMA Network, Annals of Internal Medicine, Journal of Hospital Medicine, Journal of General Internal Medicine, Lancet and more.
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Episodes
Metformin and Long COVID, Central Lines and Thrombocytopenia, DOACs vs LMWH in Cancer Associated Thrombosis, Early vs Late Anticoagulation after Stroke with Atrial Fibrillation
June 27, 2023 23:00 - 59 minutes - 40.7 MBToday we are joined by Dr. Brian Locke, recently graduated pulmonary-critical care fellow, who takes us on a journey of avoiding statistical fallacies. Does metformin reduce the likelihood of long COVID? Should we give platelet transfusions to thrombocytopenic patients before central line placement? Did the CANVAS trial change practice in cancer associated thrombosis? Should patients with a stroke due to atrial fibrillation start oral anticoagulation earlier or later? We discuss all these qu...
Osmotic Demyelination Syndrome and Hyponatremia, Apixaban vs Warfarin for On-X Aortic Valve, Perioperative Blood Pressure Strategies, Diagnostic Accuracy of CT Abdomen Without Contrast
May 25, 2023 03:00 - 1 hour - 46.9 MBToday we have a special guest, Dr. Joel Topf, board-certified nephrologist and medical educator extraordinaire. Our listeners will likely recognize Dr. Topf from his prolific tweeting @Kidney_boy, as well as his numerous appearances on the Curbsiders podcast. He is a co-founder of the NephJC on Twitter, and host and founder of the NephJC podcast Freely Filtered. He is also host of the podcast Channel Your Enthusiasm, a deep dive monthly recap of the nephrology textbook Clinical Physiology of...
Osmotic Demyelination Syndrome and Hyponatremia with Dr. Joel Topf, Apixaban vs Warfarin for On-X Aortic Valve, Perioperative Blood Pressure Strategies, Diagnostic Accuracy of CT Abdomen Without Contrast
May 25, 2023 03:00 - 1 hour - 46.9 MBToday we have a special guest, Dr. Joel Topf, board-certified nephrologist and medical educator extraordinaire. Our listeners will likely recognize Dr. Topf from his prolific tweeting @Kidney_boy, as well as his numerous appearances on the Curbsiders podcast. He is a co-founder of the NephJC on Twitter, and host and founder of the NephJC podcast Freely Filtered. He is also host of the podcast Channel Your Enthusiasm, a deep dive monthly recap of the nephrology textbook Clinical Physiology of...
Doxycycline Post-Exposure Prophylaxis for STIs (DoxyPEP), High Dose Prophylactic Anticoagulation for COVID-19 (ANTICOVID), Rates of Fracture Non-union and Bisphosphonates
April 27, 2023 17:00 - 46 minutes - 32.3 MBThis week we have special guest, Dr. Adam Spivak, to talk about the new study on doxycycline post-exposure prophylaxis for STIs. Dr. Spivak is an infectious disease expert and works in both an HIV clinic and a free PrEP clinic. I also review the latest COVID-19 anticoagulation trial and a paper looking at rates of fracture non-union in people who receive bisphosphonates. Check it out! Doxycycline Post-exposure Prophylaxis for STIs High dose prophylactic anticoagulation in COVID-19 Bispho...
Thiazides for Kidney Stones, Hydrocortisone for Severe Pneumonia (CAPE COD), 2023 GOLD COPD Guidelines, Real World Use of Oral Antibiotics for Infective Endocarditis
March 25, 2023 04:00 - 1 hour - 54.6 MBToday we have special guest, Dr. Sarah Gilligan, a nephrologist, to talk about the new study of thiazides for kidney stones. We all learn in medical school that thiazides reduce urinary excretion of calcium, but does that really translate to fewer kidney stones? We also have Dr. Brian Locke on to talk about the CAPE COD trial, a big new critical care paper on using hydrocortisone in severe pneumonia, as well as the latest COPD guidelines and a retrospective study of oral antibiotics for in...
Antibiotic Duration for Febrile UTI in Males, Lower GI Bleeding Guidelines, Intravenous Contrast in Patients with Acute Kidney Injury
February 25, 2023 04:00 - 45 minutes - 31.6 MBToday we welcome special guest and fellow EBM lover Dr. Mita Hoppenfeld to talk about a new randomized controlled trial evaluating the best duration of antibiotics for febrile UTI in men. Is 7 days as good as 14 days? We also review the latest guidelines for lower GI bleeding and a new retrospective study on renal outcomes in patients with AKI who receive IV contrast. 7 vs 14 days of antibiotics for Febrile UTI in Men Lower GI Bleeding Guidelines IV Contrast in patients with AKI Music fr...
Early Vasopressors and Restrictive Fluids in Septic Shock (CLOVERS), Furosemide vs Torsemide in Heart Failure (TRANSFORM-HF), Aspirin vs Enoxaparin after Extremity Fracture (PREVENT CLOT), Haloperidol for ICU Delirium (AID-ICU)
January 31, 2023 21:00 - 51 minutes - 35.1 MBWe're back with Season 4! Sorry for the unplanned hiatus. Today we talk about the CLOVERS trial, which tested the hypothesis that early vasopressors and restrictive fluid would be superior to liberal fluids plus rescue vasopressors. We also looked at the TRANSFORM-HF study, which compared torsemide and furosemide in congestive heart failure, the PREVENT CLOT study, which compared aspirin to enoxaparin for VTE prophylaxis after a traumatic fracture, and the AID-ICU study, which compared hal...
SGLT2 Inhibitors for Acute Heart Failure, SGLT2 Inhibitors vs Metformin, High Dose Dexamethasone for COVID-19 in ICU, Isolated Distal DVT, Monkeypox, Blood Donor Sex and Mortality, Outcomes in Surgeons Who Operate the Night Before
July 22, 2022 21:00 - 44 minutes - 30.6 MBToday we have a couple special guests under the age of 2. Birdie and Gus! Do SGLT2 inhibitors improve diuresis in acute heart failure? Are they better than metformin for reducing cardiovascular mortality? Is high dose dexamethasone better than standard dose in ICU patients with COVID? We also talk about outcomes in patients with isolated distal DVT compared to proximal DVT, a large case series of patients with monkeypox infection, blood donor outcomes and the outcomes for surgeons who op...
Restrictive Fluids in Septic Shock, Short vs Standard Antibiotics in Neutropenic Fever, IV Vitamin C for Septic Shock, Hospitalist Workload and Patient LOS, Fluid Bolus for Intubation, General Internist Practice Choices
June 24, 2022 20:00 - 54 minutes - 37.7 MBToday we are joined by Dr. Brian Locke to talk about multiple new critical care trials, including the CLASSIC trial of a restrictive vs standard fluid strategy, the LOVIT trial of vitamin C in septic shock, and the PREPARE-II trial of fluid bolus at the time of intubation to prevent cardiovascular collapse. We also look at whether 72 hours of antibiotics are safe in patients with neutropenic fever, whether hospitalist workload affects patient length of stay, and what kind of careers general ...
Inpatient Management of Opioid Use Disorder, Hep C Treatment in IVDU, Final SOLIDARITY Results for Remdesivir, TAVI for Moderate Risk Severe AS, Mediterranean Diet vs Low Fat Diet, Steroids for IgA Nephropathy, GLP-1s and Gallbladder Disease
May 25, 2022 03:00 - 58 minutes - 40.4 MBToday we had Dr. Patricia Liu to talk about a new study from Journal of Hospital Medicine on the management of opioid use disorder in the hospital. And then we got a little carried away covering way too many articles! Inpatient Management of Opioid Use Disorder Hepatitis C Care for People Who Inject Drugs Final SOLIDARITY trial results for Remdesivir TAVI for Moderate Risk Severe Aortic Stenosis Mediterranean Diet vs Low Fat Diet for Secondary Prevention of CVD Steroids for IgA Nephropath...
2022 AHA/ACC/HFSA Heart Failure Guidelines with Dr. James Fang, Guideline Committee Member
May 04, 2022 15:00 - 32 minutes - 22.6 MBToday, Dr. James Fang, Chief of Cardiovascular Medicine at the University of Utah, and AHA/ACC/HFSA Heart Failure Guideline Committee Member, joins us to talk about the new heart failure guidelines, published in April 2022. We talk about the new classifications, including HF with improved EF and HF with mildly reduced EF, and new recommendations for medical therapy for all the heart failure types. How do you start someone on GDMT? Who should get SGLT-2 inhibitors? How can we get more people...
Oral Carbapenem for Complicated UTIs, Awake Proning for COVID-19, 1-2 Months DAPT vs 12 Months DAPT, Low Sodium Diet for Heart Failure, Excess Mortality From COVID-19, IV Iron and Anaphylaxis, Pickle Juice for Cramps in Cirrhosis
April 23, 2022 03:00 - 50 minutes - 34.8 MBDr. Brian Locke is back to talk about that "nonrandomized" proning trial. We also talk about the new oral carbapenem for UTI trial, whether 1-2 months of DAPT is non-inferior to 12 months of DAPT, whether less than 1500 mg of sodium reduces heart failure hospitalizations, the risk of anaphylaxis from IV iron, and whether pickle juice is effective for treating cramps in cirrhosis. Check it out! Oral Tebipenem vs IV Ertapenem for Complicated UTI Awake Proning for Hospitalized COVID-19 Patie...
Reliever-Triggered ICS Therapy for Asthma, Methenamine for UTI Prevention, CT vs Invasive Coronary Angiography, Melatonin for Delirium Prevention, Interpretation of Home COVID Tests, Characteristics of Type 2 MI
March 22, 2022 04:00 - 1 hour - 45.2 MBToday we have Dr. Brian Locke back on to talk about asthma management and a new trial of reliever-triggered inhaled glucocorticoids for Black and Latinx patients with asthma. Other questions we try to answer: Does methenamine prevent recurrent UTIs in women? Should CT coronary scan be done before invasive coronary angiography? Does melatonin prevent delirium in ICU patients? How good are patients at interpreting home COVID tests? What is the most common cause of type 2 NSTEMI? Give it a lis...
Reliever-Triggered ICS Therapy for Asthma, Methenamine for UTI Prevention, CT vs Invasive Coronary Angiography, Melatonin for Delirium Prevention, Interpretation of Home COVID Tests, Characteristics of Type 2 MI
March 22, 2022 04:00 - 1 hour - 45.2 MBToday we have Dr. Brian Locke back on to talk about asthma management and a new trial of reliever-triggered inhaled glucocorticoids for Black and Latinx patients with asthma. Other questions we try to answer: Does methenamine prevent recurrent UTIs in women? Should CT coronary scan be done before invasive coronary angiography? Does melatonin prevent delirium in ICU patients? How good are patients at interpreting home COVID tests? What is the most common cause of type 2 NSTEMI? Give it a lis...
Paxlovid for COVID-19, Ivermectin Ineffective for COVID-19, One Year Outcomes for ICU COVID-19 Patients, Diagnostic Strategies for Ruling Out PE, Thiamine for Alcohol Use Disorder, Skin Color and Pulse Oximetry
February 25, 2022 01:00 - 42 minutes - 29.4 MBWe finally have the published trial results for Paxlovid! We also look at the latest trial showing the ivermectin is ineffective in treating COVID-19 and one year outcomes in ICU COVID-19 patients. We also look at a meta-analysis of trials looking at different diagnostic strategies for ruling out PE, a retrospective study of thiamine use in ICU patients with alcohol use disorder, and a new study on pulse oximetry in people with different skin color. Check it out! Paxlovid for High Risk, N...
Balanced Crystalloid vs Normal Saline (PLUS trial), Midline vs PICC, LOLA for Hepatic Encephalopathy, Eat-Walk-Engage Program for Older Inpatients, Post-Discharge Thromboprophylaxis for COVID-19, Mindfulness Training and Burnout
January 28, 2022 00:00 - 49 minutes - 33.8 MBToday we are joined by Dr. Brian Locke to talk about the newest big trial on IV fluids in critically ill patients and a meta-analysis that looks at all the similar trials. Is this question finally settled? We also look at PICC lines vs midlines, IV L-ornithine L-aspartate in acute treatment of hepatic encephalopathy, a new ward-based program for delirium prevention in older inpatients, post-discharge thromboprophylaxis for high risk COVID patients, and whether mindfulness training can help ...
Balanced Crystalloid vs Normal Saline (PLUS trial), Midline vs PICC, LOLA for Hepatic Encephalopathy, Eat-Walk-Engage Program for Older Inpatients, Post-Discharge Thromboprophylaxis for COVID-19, Mindfulness Training and Burnout
January 28, 2022 00:00 - 49 minutes - 33.8 MBToday we are joined by Dr. Brian Locke to talk about the newest big trial on IV fluids in critically ill patients and a meta-analysis that looks at all the similar trials. Is this question finally settled? We also look at PICC lines vs midlines, IV L-ornithine L-aspartate in acute treatment of hepatic encephalopathy, a new ward-based program for delirium prevention in older inpatients, post-discharge thromboprophylaxis for high risk COVID patients, and whether mindfulness training can help ...
Ultrasound JVP to Estimate CVP, IV Metoprolol vs Diltiazem for Atrial Fibrillation with RVR, Ischemic Stroke and Bleeding Risk with Apixaban vs Rivaroxaban, Reducing Sleep Interruptions in Hospital, Outpatient Remdesivir, Molnupiravir for COVID-19
December 31, 2021 01:00 - 1 hour - 49.2 MBIt's our last episode in 2021! This episode we have Dr. Libo Wang and Dr. Jon Harrison on to talk about their new paper in the Annals of Internal Medicine about ultrasound JVP for estimating CVP, validated with right heart catheterization. We also ask them their thoughts on a new meta-analysis looking at metoprolol vs diltiazem for atrial fibrillation with RVR. We also look at a new large retrospective study of apixaban vs rivaroxaban for stroke prevention, a study looking at reducing slee...
Chlorthalidone in CKD, Factor XI Inhibition for VTE Prevention, Untreated Subsegmental PE and Risk of Recurrent VTE, Rivaroxaban and GI Bleeding, Mental Stress Induced Ischemia, Depression and Residency, Patient Outcomes for Part Time Hospitalists
November 25, 2021 03:00 - 59 minutes - 40.6 MBSomehow we got through 7 articles today, and none of them are about COVID-19! Happy Thanksgiving! Chlorthalidone in CKD Milvexian for VTE Prevention Risk of Recurrent VTE in Subsegmental PE Rivaroxaban associated with higher rates of GI bleeding Depression and Residency Mental-Stress Induced Myocardial Ischemia Patient Outcomes for Part Time Hospitalists Music from Uppbeat (free for Creators!): https://uppbeat.io/t/soundroll/dope License code: NP8HLP5WKGKXFW2R
Chlorthalidone in CKD, Factor XI Inhibition for VTE Prevention, Untreated Subsegmental PE and Risk of Recurrent VTE, Rivaroxaban and GI Bleeding, Mental Stress Induced Ischemia, Depression and Residency, Patient Outcomes for Part Time Hospitalists
November 25, 2021 03:00 - 59 minutes - 40.6 MBSomehow we got through 7 articles today, and none of them are about COVID-19! Happy Thanksgiving! Chlorthalidone in CKD Milvexian for VTE Prevention Risk of Recurrent VTE in Subsegmental PE Rivaroxaban associated with higher rates of GI bleeding Depression and Residency Mental-Stress Induced Myocardial Ischemia Patient Outcomes for Part Time Hospitalists Music from Uppbeat (free for Creators!): https://uppbeat.io/t/soundroll/dope License code: NP8HLP5WKGKXFW2R
Race and Estimated GFR, Bleeding Risk in Oral Anticoagulation after First VTE, HEP-COVID trial, High Dose Dexamethasone for COVID-19
October 28, 2021 00:00 - 50 minutes - 34.7 MBToday we talk about the effect of eliminating the race coefficient from the estimated GFR calculators, the risk of bleeding from anticoagulation after first unprovoked VTE, another trial looking at therapeutic anticoagulation in COVID-19, and whether 12 mg of dexamethasone is better than 6 mg for severe COVID-19 infections. New GFR Equations without Race Race, Genetic Ancestry and Estimating Kidney Function Long Term Bleeding Risk from Oral AC after First Unprovoked VTE Therapeutic Hepa...
Empagliflozin for HFpEF, Antibiotic Duration for UTIs in Men, Targeted Temperature after Cardiac Arrest, Normal Saline vs Balanced Solution in ICU Patients, Baricitinib and Therapeutic Anticoagulation for Hospitalized COVID-19 Patients
September 30, 2021 23:00 - 1 hour - 42.5 MBWe're back after a nice relaxing summer taking care of a surge of COVID-19 patients. To start off season 3 we decided to do a rapid review of some of the best articles over the last three months. Dr. Brian Locke returns to help us break down some critical care papers, we talk about the miracle of SGLT-2 inhibitors, the treatment of UTIs in men, and the latest in COVID-19 literature. Hypothermia vs Normothermia after Cardiac Arrest Empagliflozin for Heart Failure with Preserved EF Anti...
Antibiotic Duration for Prosthetic Joint Infections, Colorectal Cancer Screening Guidelines, Hospital Observation after ACS Ruled Out in ED, Morning Discharges, Personalized Steroid Regimen for COPD Exacerbation
June 03, 2021 01:00 - 1 hour - 43.6 MBToday is our season 2 finale, and we have a master class on prosthetic joint infections from Dr. Laura Certain. Is 6 weeks as good as 12 weeks for prevent recurrent infections? How does the surgeon decide what kind of surgery to do? Should we use oral or IV antibiotics? When should you use rifampin?? Dr. Certain answers all these questions and more. We also talk about the new colon cancer screening guidelines from USPSTF, hospital admission for chest pain after ACS ruled out in the ED...
Antibiotic Duration for Prosthetic Joint Infections, Colorectal Cancer Screening Guidelines, Hospital Observation after ACS Ruled Out in ED, Morning Discharges, Personalized Steroid Regimen for COPD Exacerbation
June 03, 2021 01:00 - 1 hour - 43.6 MBToday is our season 2 finale, and we have a master class on prosthetic joint infections from Dr. Laura Certain. Is 6 weeks as good as 12 weeks for prevent recurrent infections? How does the surgeon decide what kind of surgery to do? Should we use oral or IV antibiotics? When should you use rifampin?? Dr. Certain answers all these questions and more. We also talk about the new colon cancer screening guidelines from USPSTF, hospital admission for chest pain after ACS ruled out in the ED...
Antibiotic Delay Intervals and Hospital Mortality for Patients with Suspected Sepsis, Guidelines for High Flow Nasal Oxygen and Point of Care Ultrasound for Acute Dyspnea, Screening for Atrial Fibrillation in Older Patients
May 13, 2021 05:00 - 45 minutes - 31.2 MBHow long can you delay antibiotics in patients with suspected sepsis before the risk of hospital mortality increases? What proportion of patients with suspected sepsis end up having actual sepsis? Dr. Devin Horton joins us to review a paper in Critical Care Medicine that tries to answer these questions. Antibiotic Delay Intervals and Hospital Mortality for Patients with Suspected Sepsis High Flow Nasal Oxygen POCUS for Acute Dyspnea Screening of Atrial Fibrillation in Older Patients Mus...
Hospital at Home for Geriatric Patients, RAAS Inhibition and Pulmonary Hypertension, Vaccine Induced Immune Thrombotic Thrombocytopenia (VITT)
April 28, 2021 20:00 - 59 minutes - 40.9 MBToday we have special guest Dr. Natalie Como to talk about Hospital at Home and what it's like to practice hospital medicine at a rural critical access hospital. We also look at a retrospective paper on ACE/ARBs in veterans with pulmonary hypertension and talk about vaccine-induced immune thrombotic thrombocytopenia (VITT). Check it out! Hospital at Home with Comprehensive Geriatric Assessment RAAS Inhibition and Pulmonary Hypertension Vaccine-Induced Immune Thrombotic Thrombocytopenia ...
Three Days of Antibiotics for Pneumonia, IV Contrast and Kidney Function, DOACs for Valvular Atrial Fibrillation
April 08, 2021 03:00 - 51 minutes - 35.2 MBToday we are joined by heavy hitter Dr. Brian Locke to talk about the new paper on 3 vs 8 days of antibiotics for pneumonia, a clever new paper looking at whether there is any association between IV contrast and kidney function, and a new retrospective study on DOAC use for valvular atrial fibrillation. Check it out! Three Days of Antibiotics for Pneumonia IV Contrast and Kidney Function DOACs for Valvular Atrial Fibrillation Music from https://filmmusic.io "Sneaky Snitch" by Kevin MacLe...
Weekly Semaglutide for Weight Loss (STEP 1, 2 and 3 Trials), 4PEPS Rule for Pulmonary Embolism, Nafcillin vs Cefazolin for Epidural Abscess, Ferritin/Procalcitonin Ratio for COVID19, Intermediate Thromboprophylaxis for COVID19
March 24, 2021 01:00 - 50 minutes - 34.9 MBToday we are doing double duty: podcasting and parenting. Fortunately our babies were well-behaved. We talk about three trials for semaglutide and weight loss and a new 4 level pre-test probability rule for diagnosing PE. We also talk about a retrospective study of cefazolin vs nafcillin for epidural abscess, a ferritin/procalcitonin ratio for differentiating bacterial from COVID pneumonia, and a new randomized controlled trial of intermediate thromboprophylaxis for ICU patients with COVI...
Weekly Semaglutide for Weight Loss (STEP 1, 2 and 3 Trials), 4PEPS Rule for Pulmonary Embolism, Nafcillin vs Cefazolin for Epidural Abscess, Ferritin/Procalcitonin Ratio for COVID19, Intermediate Thromboprophylaxis for COVID19
March 24, 2021 01:00 - 50 minutes - 34.9 MBToday we are doing double duty: podcasting and parenting. Fortunately our babies were well-behaved. We talk about three trials for semaglutide and weight loss and a new 4 level pre-test probability rule for diagnosing PE. We also talk about a retrospective study of cefazolin vs nafcillin for epidural abscess, a ferritin/procalcitonin ratio for differentiating bacterial from COVID pneumonia, and a new randomized controlled trial of intermediate thromboprophylaxis for ICU patients with COVI...
Albumin Infusion for Decompensated Cirrhosis (ATTIRE trial), Terlipressin for Type 1 Hepatorenal Syndrome (CONFIRM trial)
March 11, 2021 00:00 - 39 minutes - 26.8 MBToday has a nice liver disease theme. Does targeting a serum albumin above 3 g/dL reduce death, infections and kidney failure in patients with decompensated cirrhosis? Does terlipressin work in hepatorenal syndrome? Albumin Infusion for Decompensated Cirrhosis Terlipressin for Type 1 Hepatorenal Syndrome Music from https://filmmusic.io "Sneaky Snitch" by Kevin MacLeod (https://incompetech.com) License: CC BY (http://creativecommons.org/licenses/by/4.0/)
IL-6 Receptor Antagonists Reduce Mortality in Critically Ill COVID-19 Patients (REMAP-CAP, RECOVERY), Convalescent Plasma Fails to Improve Mortality
March 04, 2021 01:00 - 42 minutes - 29.3 MBToday I am joined by Infectious Disease expert Dr. Emily Spivak to talk about the latest batch of tocilizumab trials for COVID-19 and a meta-analysis of all the convalescent plasma trials. Check it out! Tocilizumab in Hospitalized Patients with COVID-19 (COVACTA) IL-6 Receptor Antagonists in Critically Ill Patients with COVID-19 (REMAP-CAP) RECOVERY Tocilizumab pre-print Meta-analysis of Convalescent Plasma for COVID-19 Music from https://filmmusic.io "Sneaky Snitch" by Kevin MacLeod (ht...
Gender-Based Discrimination and Harassment Among Hospitalists, Educational Resource Utilization in Internal Medicine Residents, Transfusion Thresholds for ACS, DOACs for VTE prevention in CKD
February 18, 2021 05:00 - 1 hour - 45.3 MBToday we have special guests Dr. Emily Signor and Dr. Amanda Breviu, two hospitalists, to talk about a survey published in JHM on gender-based discrimination among hospitalists. We also discuss a survey published in JGIM on educational resources used by internal medicine residents. Check it out! Gender Based Discrimination and Harassment Among Hospitalists Educational Resource Utilization Among Internal Medicine Residents Liberal vs Restrictive Transfusion Threshold for Patients with ACS...
Early Ablation vs Medications for Atrial Fibrillation (STOP-AF First, EARLY-AF), ACEi and ARBs in COVID-19, IV vs Oral Antibiotics for Appendicitis, Rifaximin after TIPS, Low vs High Oxygen Targets
February 04, 2021 03:00 - 57 minutes - 39.4 MBToday we have a special guest, Dr. Jared Bunch, an international expert in atrial fibrillation and ablation, to talk about the state of atrial fibrillation and which patients benefit from early catheter ablation based on two new trials published last week in the NEJM. We also talk about whether you should stop ACEi or ARBs in patients admitted with COVID-19, whether oral antibiotics are adequate for uncomplicated appendicitis, and whether you should target a high (90 mmHg) or low (60 mmHg) ...
Inhaled Treprostinil for Pulmonary Hypertension due to Interstitial Lung Disease, Omecamtiv Mecarbil for Systolic Heart Failure (HFrEF)
January 20, 2021 23:00 - 35 minutes - 24.5 MBToday I am joined by pulmonary hypertension and heart failure expert, Dr. John Ryan, to talk about inhaled treprostinil for pulmonary hypertension due to ILD, and a new cardiac myosin activator, omecamtiv mecarbil, for treatment of systolic heart failure. Check it out! Treprostinil for Pulmonary Hypertension due to ILD Omecamtiv Mecarbil for Systolic Heart Failure Music from https://filmmusic.io "Sneaky Snitch" by Kevin MacLeod (https://incompetech.com) License: CC BY (http://creativecom...
Prevalence of Pulmonary Embolism in Acute COPD Exacerbation, Tocilizumab for COVID-19 Round 3
January 14, 2021 02:00 - 54 minutes - 37.7 MBWARNING: This episode is long on banter. If you would like to skip the intro conversation and get right to the articles, skip ahead to 12:13. Today we are joined by Dr. Jason Carr, pulmonary-critical care all-star, to talk about how often PE is present in patients with acute COPD exacerbations. We also review more tocilizumab RCTs because they just keep coming. Prevalence of Pulmonary Embolism in Acute COPD Exacerbation STOP-IT COVID trial RCT-TCZ-COVID-19 trial CORIMUNO-TOCI-1 trial ...
Treatment of Inpatient Hypertension, Testing and Treatment of Primary Aldosteronism in Patients with Resistant Hypertension, Tocilizumab for COVID-19 Round 2
January 07, 2021 02:00 - 35 minutes - 24.1 MBThe president's supporters may have stormed the capitol and attempted a coup today, but the show must go on. Today I'm joined by Dr. Dani Babbel to talk about treatment of hypertension in the hospital, as well as testing for primary aldosteronism in patients with resistant hypertension. Check it out! Treatment and Outcomes in Inpatient Hypertension Testing for Primary Aldosteronism and MRA Use Among US Veterans Tocilizumab in Hospitalized Patients with COVID-19 Music from https://film...
Thrombosis and COVID-19
December 30, 2020 03:00 - 17 minutes - 11.8 MBToday I do a quick review of the COVID-19 thrombosis literature from the last year to try to answer some of the following questions: Why does COVID-19 cause thrombosis? How many patients with COVID-19 develop thrombotic complications? Why do patients with COVID-19 on VTE prophylaxis still develop blood clots? Should we use intermediate dosing of anticoagulation for prophylaxis? What about full dose therapeutic anticoagulation (no!) What do the guidelines say? Lots of papers: JAMA IM Re...
Inappropriate Testing and Treating of Asymptomatic Bacteriuria, Baricitinib Plus Remdesivir for COVID-19 (ACTT-2), COVID-19 Vaccine, Noninvasive Respiratory Protocol for COVID-19, Iron Supplementation in Acute Heart Failure
December 16, 2020 18:00 - 47 minutes - 32.5 MBToday we have special guest Dr. Valerie Vaughn to talk about her new paper in Open Forum Infectious Diseases about inappropriate treatment and testing for asymptomatic bacteriuria. Then we talk about the new ACTT-2 trial results of baricitinib plus remdesivir for COVID-19. We also review the BioNTech/Pfizer vaccine safety and efficacy results, a noninvasive respiratory protocol to reduce intubations in COVID-19, and iron deficiency in acute heart failure. Testing and Treating Asymptomati...
Patient Outcomes in Resident, APC and Solo Hospitalist Teams, Rapid Conversion to Oral Antibiotics in Pneumonia, SOLIDARITY trial for COVID-19
December 10, 2020 19:00 - 52 minutes - 35.8 MBToday we have special guests Dr. Claire Ciarkowski and Dr. Stacy Johnson to talk about two recent papers they published, as well as the new SOLIDARITY trial results. Are patient outcomes the same for resident, APC and solo hospitalist teams? How do you get doctors to switch to oral antibiotics faster when treating pneumonia? And with the new SOLIDARITY results showing no benefits for remdesivir, should we still be using it for COVID-19? Resident, APC and Solo Hospitalist Team Outcomes ...
Danish Mask Study, Rivaroxaban for Atrial Fibrillation and Bioprosthetic Mitral Valve, Convalescent Plasma Fails, Semaglutide in NASH, Once Weekly Insulin, Statin Nocebo Effect
December 03, 2020 03:00 - 38 minutes - 26.2 MBWe're back with our second episode of the new season. Dr. Rupp is sporting a new mustache, and we discuss the mysterious monolith discovered in the Utah desert. If you want to skip the banter, go to 6:56. This week we try to figure out what that Danish Mask Study really showed. Is it safe to use rivaroxaban in patients with a bioprosthetic mitral valve and A fib? Does convalescent plasma improve outcomes in COVID-19? Danish Mask Study CDC Report on Kansas Mask Mandates Rivaroxaban ...
Remdesivir Redux, Tocilizumab Fails, Bamlanivimab gets EUA and mRNA Vaccines for COVID-19
November 19, 2020 02:00 - 39 minutes - 26.9 MBWe're back after a prolonged hiatus, ready to break down the latest and greatest in the medical literature. Today's episode will get you caught up on the newest treatments for COVID-19. We promise to talk about something else next time :) If you want to skip all the banter about Baby Yoda and politics, go to 8:36. Remdesivir for COVID-19 Final Report Tocilizumab for Hospitalized COVID-19 Patients Bamlanivimab Pfizer Vaccine Moderna Vaccine Music from https://filmmusic.io "Sneaky S...
Caring for COVID-19 Patients in the Navajo Nation
July 16, 2020 21:00 - 34 minutes - 23.9 MBToday we are joined by a special guest, Dr. Lawanda Jim, chief of internal medicine at Northern Navajo Medical Center, to talk about what it's been like taking care of patients during the pandemic in Shiprock, NM. Check it out! Music from https://filmmusic.io "Sneaky Snitch" by Kevin MacLeod (https://incompetech.com) License: CC BY (http://creativecommons.org/licenses/by/4.0/)
Caring for COVID-19 Patients in the Navajo Nation
July 16, 2020 21:00 - 34 minutes - 23.9 MBToday we are joined by a special guest, Dr. Lawanda Jim, chief of internal medicine at Northern Navajo Medical Center, to talk about what it's been like taking care of patients during the pandemic in Shiprock, NM. Check it out! Music from https://filmmusic.io "Sneaky Snitch" by Kevin MacLeod (https://incompetech.com) License: CC BY (http://creativecommons.org/licenses/by/4.0/)
Dexamethasone Reduces Mortality in COVID-19: The RECOVERY Trial
July 10, 2020 00:00 - 30 minutes - 21 MBToday we're back with a spirited discussion of a pre-print publication for the dexamethasone arm of the RECOVERY trial. Should hospitalized COVID19 patients receive dexamethasone? Take a listen and decide for yourself. Dexamethasone in Hospitalized Patients with COVID-19 Music from https://filmmusic.io "Sneaky Snitch" by Kevin MacLeod (https://incompetech.com) License: CC BY (http://creativecommons.org/licenses/by/4.0/)
Remdesivir Shortens Time to Recovery in COVID19 (ACTT-1), CRP-Guided Antibiotics for Gram Negative Bacteremia, NT-pro-BNP in Syncope
June 05, 2020 01:00 - 36 minutes - 25 MBWe're back with another episode. We cover the latest highlights in COVID, including the exciting new results on remdesivir from the ACTT-1 trial. We also talk about whether you can use CRP to guide duration of antibiotic therapy in patients with gram negative bacteremia, and whether NT-pro-BNP can help you risk-stratify patients with syncope. Check it out! Remdesivir Shortens Time to Recovery in COVID19 (ACTT-1) CRP Guided Antibiotics or 7 Days vs 14 Days for Gram Negative Bacteremia ...
Remdesivir Shortens Time to Recovery in COVID19 (ACTT-1), CRP-Guided Antibiotics for Gram Negative Bacteremia, NT-pro-BNP in Syncope
June 05, 2020 01:00 - 36 minutes - 25 MBWe're back with another episode. We cover the latest highlights in COVID, including the exciting new results on remdesivir from the ACTT-1 trial. We also talk about whether you can use CRP to guide duration of antibiotic therapy in patients with gram negative bacteremia, and whether NT-pro-BNP can help you risk-stratify patients with syncope. Check it out! Remdesivir Shortens Time to Recovery in COVID19 (ACTT-1) CRP Guided Antibiotics or 7 Days vs 14 Days for Gram Negative Bacteremia ...
Triple Antiviral Therapy for COVID-19, Remdesivir for Severe COVID-19, Convalescent Plasma, Hydroxychloroquine and Azithromycin in New York
May 20, 2020 03:00 - 43 minutes - 30.2 MBWe're back with some of the latest updates on COVID-19! Are hydroxychloroquine or azithromycin associated with increased risk of mortality or cardiac arrest? Does triple combination antiviral therapy shorten time to a negative viral swab? Does remdesivir shorten time to clinical improvement? Should we be giving patients convalescent plasma? If you were the patient with severe COVID-19, which therapies would you want? Hydroxychloroquine and Azithromycin in New York City Triple Combinat...
Last Month in COVID-19
April 30, 2020 03:00 - 40 minutes - 27.6 MBIt's been a while! We took a short hiatus while our lives were upended by the pandemic. But we couldn't stay away forever. Today we review some of the big trials published in the last month on Covid-19. We look at the large case series on New York patients published in JAMA, three hydroxychloroquine studies, the lopinavir-ritonavir study and the compassionate use of remdesivir study. Buckle up! 5700 Patients Hospitalized with COVID-19 in New York City Lopinavir-Ritonavir in Severe CO...
COVID-19 in New York City, Lopinavir-Ritonavir in Severe COVID-19, The French Hydroxychloroquine Study, Chinese Hydroxychloroquine RCT, VA Hydroxychloroquine Study, Compassionate Use of Remdesivir
April 30, 2020 03:00 - 40 minutes - 27.6 MBIt's been a while! We took a short hiatus while our lives were upended by the pandemic. But we couldn't stay away forever. Today we review some of the big trials published in the last month on Covid-19. We look at the large case series on New York patients published in JAMA, three hydroxychloroquine studies, the lopinavir-ritonavir study and the compassionate use of remdesivir study. Buckle up! 5700 Patients Hospitalized with COVID-19 in New York City Lopinavir-Ritonavir in Severe CO...
COVID-19 Update, Gabapentin for Alcohol Use Disorder, Apixaban versus Rivaroxaban for Atrial Fibrillation
March 18, 2020 03:00 - 29 minutes - 20.6 MBSeems like a lot has happened in just one week! The whole world is different. Today we talk about some of the most recent articles published about the ongoing COVID-19 pandemic. We also discuss whether gabapentin can be used to treat people with alcohol use disorder, and whether apixaban is better than rivaroxaban for preventing strokes in people with atrial fibrillation. Incubation Period for COVID-19 Risk Factors for Mortality in COVID-19 Risk Factors for ARDS and Death in COVID-19 Car...