Today 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 and Ane...
Feb 18, 2021•1 hr 6 min•Season 2Ep. 10
Today 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) paO2 ...
Feb 04, 2021•57 min•Season 2Ep. 9
Today 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://creativecommons.org...
Jan 20, 2021•36 min•Season 2Ep. 8
WARNING: 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 REMAP-CAP t...
Jan 14, 2021•55 min•Season 2Ep. 7
The 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://filmmusic.io "S...
Jan 07, 2021•35 min•Season 2Ep. 6
Today 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 Review Autop...
Dec 30, 2020•17 min•Season 2Ep. 5
Today 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 Asymptomatic Bacter...
Dec 16, 2020•47 min•Season 2Ep. 4
Today 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 Rapid Conv...
Dec 10, 2020•52 min•Season 2Ep. 3
We'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 for A fib and ...
Dec 03, 2020•38 min•Season 2Ep. 2
We'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 Snitch" by Kevin...
Nov 19, 2020•39 min•Season 2Ep. 1
Today 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/) Music from Uppbeat (free for Creators!): https://uppbeat.io/t/soundroll/dope License code: NP8HLP5WKGKXFW2R...
Jul 16, 2020•35 min•Season 1Ep. 22
Today 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/) Music from Uppbeat (free for Creators!): https://uppbeat.io/t/soundroll/dope...
Jul 10, 2020•30 min•Season 1Ep. 21
We'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 NT-pro-BNP ...
Jun 05, 2020•36 min•Season 1Ep. 20
We'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 Combination Therapy...
May 20, 2020•44 min•Season 1Ep. 19
It'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 COVID-19 Hydro...
Apr 30, 2020•40 min•Season 1Ep. 18
Seems 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 Caring for ...
Mar 18, 2020•30 min•Season 1Ep. 17
Austin finally returns to the podcast with harrowing tales of almost being eaten by a wolf. Today we discuss a new NEJM paper about long acting injectable therapy for HIV and a new JAMA paper about pregnenolone, a neurosteroid that may help treat the scourge of primary care: chronic low back pain. Long Acting Cabotegravir and Rilpivirine for HIV-1 Pregnenolone vs Placebo for Chronic Low Back Pain in Veterans Music from https://filmmusic.io "Sneaky Snitch" by Kevin MacLeod (https://incompetech.co...
Mar 10, 2020•25 min•Season 1Ep. 16
Today we had Dr. Dani Babbel back on the show to talk about the latest COVID-19 updates, whether gastric acid suppression increases your risk of MDRO colonization, and how to improve care to patients boarding in the emergency department. Check it out! Characteristics of Covid-19 in China Covid-19 Report from CDC of China Gastric Acid Suppression and MDRO Colonization Hospitalist Care of ED Boarders and Length of Stay Music from https://filmmusic.io "Sneaky Snitch" by Kevin MacLeod (https://incom...
Mar 04, 2020•33 min•Season 1Ep. 15
Today we had the pleasure of talking to Dr. Barbara Jones, first author on a new paper in JAMA IM about the outcomes in veterans treated with empirical anti-MRSA therapy vs standard therapy. She gives us a master class in propensity weighted analysis and instrumental variable analysis. We also look at whether outcomes are different in patients who are cared for by hospitalists who call more consults than their colleagues, and how much money we could save with a single payer system in the United ...
Feb 25, 2020•32 min•Season 1Ep. 14
Today we have the venerable EBM guru Dr. Brian Locke on the show to talk PLEX and DEX. Does plasma exchange for ANCA-vasculitis really work? Do steroids make any difference in patients with ARDS? Also, have you ever wondered which Hogwarts house your medical specialty belongs to? Plasma Exchange and Glucocorticoids for ANCA-Vasculitis Dexamethasone for Acute Respiratory Distress Syndrome The Sorting Hat of Medicine: Why Hufflepuffs Wear Stethoscopes and Slytherins Carry Scalpels Music from https...
Feb 19, 2020•31 min•Season 1Ep. 13
Today we are joined by the man, the myth, and the legend, Dr. Stacy Johnson, to talk about a new meta-analysis of using aspirin for DVT prophylaxis after a total hip or knee replacement. We also review a new retrospective cohort study from Cleveland Clinic on whether it's safe to give the recommended 30 ml/kg fluid bolus to patients with sepsis who also have CHF, cirrhosis or ESRD. Check it out! Aspirin for VTE Prophylaxis after THA or TKA Fluid Management for Sepsis in Patients with ESRD, Cirrh...
Feb 11, 2020•29 min•Season 1Ep. 12
Today we are joined by the very smart Dr. Jason Carr, a pulmonary/critical care fellow, to talk about two big papers from the wonderful world of lungs. Does CT screening for lung cancer save lives? Do you have to put a chest tube in every patient with a spontaneous pneumothorax? Check it out! CT Screening for Lung Cancer, AKA NELSON Conservative vs Interventional Treatment for Spontaneous Pneumothorax Music from https://filmmusic.io "Sneaky Snitch" by Kevin MacLeod (https://incompetech.com) Lice...
Feb 04, 2020•29 min•Season 1Ep. 11
It's our tenth episode! Thanks for getting us this far. Today we discuss the new coronavirus outbreak, what to do with high sensitivity troponins, whether hydroxyethyl starch should be used in abdominal surgery (spoiler alert: it shouldn't) and the appropriate use of testosterone therapy. Novel Coronavirus in China High Sensitivity Troponins and the Fourth Universal Definition of MI Hydroxyethyl Starch versus Saline in Major Abdominal Surgery Efficacy and Safety of Testosterone Treatment in Men ...
Jan 28, 2020•28 min•Season 1Ep. 10
Today we are joined by the wonderful Dr. Emily Signor to talk about new therapeutic approaches to DVT prophylaxis, how much time physicians spend using the EHR in clinic, and whether that Vitamin C cocktail works for septic shock. Check it out! Effect of Osocimab in Preventing VTE in Patients Undergoing TKA Physician Time Spent Using the EHR During Outpatient Encounters Vitamin C, Thiamine and Hydrocortisone for Septic Shock Music from https://filmmusic.io "Sneaky Snitch" by Kevin MacLeod (https...
Jan 22, 2020•31 min•Season 1Ep. 9
Today we try something a little different -- three co-hosts! Dr. Dani Babbel joins Jenkins and Rupp for some lively discussion about hotspotting, very severe aortic stenosis and whether adherence improves when medications are free. Check it out! Health Care Hotspotting Early Surgery for Asymptomatic Aortic Stenosis Effect on Treatment Adherence of Distributing Essential Medicines at No Charge Music from https://filmmusic.io "Sneaky Snitch" by Kevin MacLeod (https://incompetech.com) License: CC B...
Jan 14, 2020•32 min•Season 1Ep. 8
Happy New Year and welcome to the first episode of 2020! We've got some great articles to review today. Can we save money by taking care of some acutely ill patients in their own homes? Are patients admitted for "social" reasons at the same risk for adverse events as acutely ill patients? Can NT-ProBNP level predict cardiovascular death and myocardial injury after non-cardiac surgery? Does limiting alcohol intake reduce atrial fibrillation recurrence? Listen to find out! Hospital Level Care at H...
Jan 07, 2020•35 min•Season 1Ep. 7
Dr. Rupp is back! Today we talk about whether it's safe to give group 2 gadolinium based contrast agents to patients with CKD stage 4 and 5 and whether metoprolol can be used to prevent COPD exacerbations. We also shine some more sunlight on the sunshine vitamin's inability to change any meaningful outcomes, and discuss some interesting data from the Intern Health Study. Risk of Nephrogenic Systemic Fibrosis in Patients with Stage 4 or 5 CKD Receiving Group II Gadolinium Based Contrast Agent Met...
Dec 17, 2019•25 min•Season 1Ep. 6
This week we have a special guest host, Dr. Dani Babbel. We talk about the new guidelines on upper GI bleeding, a new study on E-VALI, and the possible association of beta blockers with heart failure hospitalizations in heart failure with EF > 50%. Management of Upper GI Bleeding Guidelines Clinical presentation, treatment and short term outcomes of E-VALI Association of Beta-Blocker Use with Heart Failure Hospitalizations in HFpEF Music from https://filmmusic.io "Sneaky Snitch" by Kevin MacL...
Dec 10, 2019•30 min•Season 1Ep. 5
Can you get away with a higher d-dimer value in patients with a low pre-test probability for PE? Does working more days in a row improve patient outcomes? How often are people inappropriately prescribing fluoroquinolones? How often are people using systemic lytics vs catheter directed lytics in acute PE, and what are the outcomes? Music from https://filmmusic.io "Sneaky Snitch" by Kevin MacLeod (https://incompetech.com) License: CC BY (http://creativecommons.org/licenses/by/4.0/) Music from Uppb...
Dec 02, 2019•24 min•Season 1Ep. 4
Today we talk about the effects of vitamin D in progression of CKD in people with diabetes, and whether SGLT-2 inhibitors like dapagliflozin can be used to treat heart failure with reduced ejection fraction in people without diabetes. We also talk about ticagrelor monotherapy after three months of DAPT, rivaroxaban for the treatment of APS (don't do it!) and LDL targets for stroke prevention. Music from https://filmmusic.io "Sneaky Snitch" by Kevin MacLeod (https://incompetech.com) License: CC B...
Nov 26, 2019•24 min•Season 1Ep. 3
