Send us a text This week, Amol, general internal medicine resident at the University of Toronto, and Fahad, staff internist at St. Michael’s Hospital in Toronto, discuss 2 recent papers: Is dementia in decline? A study using the well-characterized Framingham cohort found that dementia rates in the last four decades have declined by 20%. Fahad evaluate the quality of ... The post Proud to be Here: Declining Rates of Dementia and EPO-Agents for Anemia in Kidney Disease appeared first on Healthy De...
Feb 26, 2016•30 min
Send us a text This week, Amol, general internal medicine resident at the University of Toronto, and Nathan, general surgery resident also at the University of Toronto, discuss two recent papers: Resident duty hours have been a hotly debated topic for some time. A randomized control trial of United States residency programs compared conventional American duty hour regulations that ... The post At the Crack of Dawn: Resident Working Hours and Improving Antibiotic Prescribing appeared first on Hea...
Feb 19, 2016•36 min
Send us a text This week, Amol, general internal medicine resident at the University of Toronto, and Fahad, staff internist at St. Michael’s hospital in Toronto, discuss 3 papers: Where do physicians die? What is the intensity of the care they receive at the end of life? Fahad discusses 2 papers that attempted to answer these questions. The first ... The post Changing Gears Completely: How Physicians Die and Frozen Fecal Transplant for C. difficile appeared first on Healthy Debate ....
Feb 12, 2016•26 min
Send us a text This week, Amol, general internal medicine resident at the University of Toronto, discusses the GOLD 2016 COPD management guidelines, and compares it to the new Star Wars movie! While many clinicians will have a well-practiced approach to managing COPD exacerbations, Amol examines the evidence for why we do what we do. He talks about the ... The post Pure GOLD: Updated 2016 COPD Management Guidelines appeared first on Healthy Debate ....
Feb 05, 2016•22 min
Send us a text January is Alzheimer Awareness Month in Canada! To bring this to light, Amol and Nathan discuss three recent papers: The first is a systematic review and meta-analysis of risk factors for post-operative delirium. Among other findings, the study identified two nutritional-related variables, low BMI and low albumin, as delirium risk factors. Nathan relates this study to a ... The post Cognition Edition: Post-Operative Delirium and Healthcare Costs in Dementia appeared first on Healt...
Jan 29, 2016•36 min
Send us a text This week, we debut our new “Two Truths, One Lie” segment! Join us and put your knowledge to the test. As always, Amol, general internal medicine resident at the University of Toronto, and Reena, staff physician at St. Michael’s hospital, discuss 2 recent papers: A multi-centred cross over trial conducted in the UK tried to ... The post Old Questions, New Options: Spironolactone for Resistant Hypertension and Polymer-Free Stents appeared first on Healthy Debate ....
Jan 22, 2016•41 min
Send us a text Amol, general internal medicine resident at the University of Toronto, and Reena, staff physician in internal medicine at St. Michael’s hospital, discuss 2 recent papers: Opioid prescription is an increasing public health crisis. A retrospective cohort study found that patients who experience non-fatal opioid overdose almost always get re-prescribed opioids at large doses a month ... The post The Upbeat Episode: Opioid Prescription and High Sensitivity Troponin Assay appeared firs...
Jan 15, 2016•37 min
Send us a text Happy new year! In our first episode of 2016, Amol, general internal medicine resident at the University of Toronto, talk about his 10 favourite papers of 2015. Rate us on iTunes! Follow us on Twitter @roundstable. The Papers 1. Teixobactin, a new antibiotic: http://www.nature.com/nature/journal/v517/n7535/full/nature14098.html 2. Modified Valsalva manoeuvre: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2815%2961485-4/abstract 3. Prednisolone or pentoxifylline fo...
Jan 11, 2016•42 min
Send us a text This week, Amol, general internal medicine resident at the University of Toronto, and Fahad, general internist at St. Michael’s hospital in Toronto, discuss two recent papers: Fahad and colleagues recently published a study in JAMA that looks at severe adult undernutrition in low and middle income countries. Using 20-year health survey data collected by USAID, ... The post Fahad’s Work and Fahad Gets Worked Up: Prevalence of severely underweight women and peripheral arterial disea...
Dec 18, 2015•39 min
Send us a text This week we are replaying our first episode of the season. Originally aired on September 18, 2015, Amol and Fahad discuss: 1. A randomized controlled trial shows that a new approach to vagal maneuvers for supraventricular tachyarrhythmia was shown to be significantly more effective than traditional maneuvers. 2. A survey in California adolescents shows that there is ... The post Replay: Better Vagal Maneuvers for Arrhythmias and eCigarettes in Adolescents appeared first on Health...
Dec 11, 2015•27 min
Send us a text This week, Amol, resident in General Internal Medicine at University of Toronto, and Mike Fralick, chief medical resident at St. Michael’s Hospital in Toronto, talk about 2 blood pressure studies: A meta-analysis and systematic review found that more intensive blood pressure lowering was associated with improved cardiovascular outcomes and albuminuria. Amol discusses the trade-offs of ... The post The SPRINT to lower blood pressure appeared first on Healthy Debate ....
Dec 04, 2015•33 min
Send us a text Amol, general internal medicine resident at the University of Toronto, and Nathan, general surgery resident at the University of Toronto, discuss 2 recent studies: Does it matter which hospital patients return to after surgery? A large retrospective cohort study showed that when post-operative patients are re-admitted to the same hospital where they had their surgery, ... The post Changing the Tune: Post-operative Readmission and Music as Perioperative Therapy appeared first on He...
Nov 27, 2015•33 min
Send us a text This week, Amol, general internal resident at the University of Toronto, and Reena, General Internist at St. Michael’s Hospital in Toronto, discuss two papers: Reena shares a large registry-based study that found adult patients with Type 2 Diabetes in Sweden had a 15% higher mortality rate than the general population. Amol and Reena wonder why this ... The post Diabetes Week: Mortality in Diabetes and DPP-4 Inhibitors Compared to Sulfonylureas appeared first on Healthy Debate ....
Nov 20, 2015•30 min
Send us a text This week we are replaying one of our favourite episodes from earlier this season: Originally aired on October 3, 2015, Amol, general internal resident at the University of Toronto, and Fahad, Staff Internist at St. Michael’s Hospital in Toronto, discuss two papers. It’s phototherapy without the need for electricity. Fahad discusses how filtered sunlight is found to ... The post Replay: Filtered Sunlight for Jaundice and Text Messages for Healthy Lifestyle appeared first on Health...
Nov 12, 2015•28 min
Send us a text Amol, general internal resident at the University of Toronto, and Raed Joundi, neurology resident at the University of Toronto, discuss 2 recent studies: Is early mobilization helpful for stroke patients? A randomized control trial showed that early aggressive rehabilitation for acute stroke patients resulted in worse outcomes. Amol and Raed speculate reasons behind this counter-intuitive ... The post Brain Week: Early Rehab for Stroke and Drug Interaction Increases Bleeding in Br...
Nov 06, 2015•25 min
Send us a text Amol, general internal resident at the University of Toronto, and Janice, general internist at the Mount Sinai Hospital in Toronto, discuss 2 recent studies: Dying with dignity is not easy, especially in a highly charged environment like the Intensive Care Unit. Janice talks about a mixed methods study that examined the impact of soliciting and fulfilling ... The post Wishes and Pills: Fulfilling Wishes for Dying Patients and Medications for Back Pain appeared first on Healthy Deb...
Oct 30, 2015•24 min
Send us a text This week we are replaying one of our favourite old episodes, due to many of our team members being away at the Canadian Society of Internal Medicine Conference. Originally aired on April 17, 2015, Nathan and Amol want you to understand the following: 1. There was no significant difference between three different call schedules in ... The post Replay: Resident Call Schedules in the ICU and Thyroid Nodules appeared first on Healthy Debate ....
Oct 23, 2015•24 min
Send us a text Amol and Janice, general internal medicine residents at the University of Toronto, discuss 2 recent studies that challenge 2 widely accepted medical practices. Does using acetaminophen to treat fever improve outcomes? A randomized control trial found that giving acetaminophen to critically ill patients did lower their fever, but did not affect the number of ICU ... The post Questioning Convention: Acetaminophen for Fever and Calcium for Fractures appeared first on Healthy Debate ....
Oct 16, 2015•26 min
Send us a text The “broken heart syndrome” – not always caused by a broken heart? A multi-national, multi-centered observational study on takotsubo cardiomyopathy found that physical triggers are more common than emotional triggers, patients present predominantly with chest pain, ECG changes, and troponin elevation. The study also generated surprising hypotheses about what medications have long-term benefit for these ... The post What the Heart Wants: Takotsubo Cardiomyopathy and Cardiovascular ...
Oct 09, 2015•28 min
Send us a text It’s phototherapy without the need for electricity. Fahad discusses how filtered sunlight is found to be equivalent to conventional phototherapy in treating infants with elevated bilirubin levels. The film that filters the sunlight is low cost and low-tech, yet has the potential for global impact. Amol discusses using text messages to battle cardiovascular disease. Semi-personalized motivational ... The post Brave New World: Filtered Sunlight for Jaundice and Text Messages for Hea...
Oct 03, 2015•27 min
Send us a text Nathan discusses a randomized trial about breast cancer screening that found that sending women information about both the risks and the benefits of breast cancer screening resulted in more women making an “informed choice” and fewer wanting to undergo screening mammography. Amol discusses the BRIDGE trial, which found that not bridging patients’ anticoagulation around the ... The post Arithmetic Operations: Breast Cancer Screening Choices and Anticoagulation Bridging appeared fir...
Sep 25, 2015•32 min
Send us a text Amol and Fahad discuss: 1. A randomized controlled trial shows that a new approach to vagal maneuvers for supraventricular tachyarrhythmia was shown to be significantly more effective than traditional maneuvers. 2. A survey in California adolescents shows that there is an association between eCigarette use and subsequent tobacco use, raising concerns about a ‘gateway’ effect. The ... The post New Beginnings: Better Vagal Maneuvers for Arrhythmias and eCigarettes in Adolescents app...
Sep 18, 2015•27 min
Send us a text Season 2 of The Rounds Table kicks off next week. To get things started, here’s a short episode with ‘good stuff’ recommendations from our excellent new team: Jennifer Peng, Anthony Maher, and Annie Wang. Good Stuff Jennifer: http://www.theatlantic.com/health/archive/2014/11/the-dutch-village-where-everyone-has-dementia/382195/ Anthony: http://blogs.plos.org/globalhealth/2013/11/jojewell2/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+plos%2Fblogs%2Fblogospher...
Sep 11, 2015•8 min
Send us a text Amol and Reena want you to understand the following: 1. When added to moderate dose statin, the IMPROVE-IT randomized trial showed that ezetimibe improved clinical outcomes in patients after acute coronary syndrome. 2. A network meta-analysis showed that no blood pressure lowering therapy improved mortality in patients with diabetes and chronic kidney disease. The combination of ACE-inhibitors and ... The post Summer Replay 4: Ezetimibe and clinical outcomes, BP lowering in diabet...
Aug 24, 2015•30 min
Send us a text Originally aired May 22, 2015. Amol and Janice want you to understand the following: 1. Several RCTs and observational studies suggest that Transcatheter Aortic Valve Replacement reduces mortality and improves symptoms in frail, elderly patients. 2. A historical analysis demonstrates that the sugar industry had heavy influence in setting national dental research priorities in the 1970s, which ... The post Summer Replay 3: Transcatheter Aortic Valve Replacements and Sugar Industry ...
Aug 07, 2015•29 min
Send us a text Amol and Nathan want you to understand the following: 1. A large randomized evaulation of a quality improvement intervention demonstrated a modest but significant reduction in rates of cesarean-section in Quebec. 2. A large double-blind randomized-controlled-trial of over 1100 patients showed that pentoxifylline is not beneficial in the treatment of alcoholic hepatitis and prednisolone may have mild ... The post Summer Replay 2: Reducing c-sections and prednisolone vs. pentoxifyll...
Jul 26, 2015•28 min
Send us a text Aired April 23: Empiric antibiotic choices for community acquired pnuemonia and clindamycin versus trimethoprim-sulfamethoxazole for skin and soft tissue infections. Fahad and Amol want you to understand the following: 1. A large, high quality RCT showed that there was no significant difference between an empiric treatment strategy of beta-lactam vs beta-lactam plus macrolide vs respiratory fluoroquinolone for ... The post Summer Replay: Community Acquired Pneumonia and Skin Infec...
Jul 18, 2015•36 min
Send us a text Fahad and Amol want you to recognize that: 1. Idarucizumab as an agent that specifically reverses the hemostatic effects of dabigatran. 2. A post-hoc analysis of the ROCKET-AF study showed that digoxin is associated with increased mortality in patients with atrial fibrillation. The papers Idaracizumab for Dabigatran reversal. Digoxin use and mortality in ROCKET-AF. Good stuff http://www.smacc.net.au/about-us/welcome/ http://emupdates.com/wp-content/uploads/2015/06/Strayer-Opioid-M...
Jul 03, 2015•26 min
Send us a text Amol wants you to: 1. Consider how the evidence helps us decide whether to prescribe a patient warfarin or a novel oral anticoagulant for stroke prevention in atrial fibrillation. Continuing Medical Education Internists can receive 0.5 hours of Continuing Medical Education credit for each podcast they listen to through the Canadian Society of Internal Medicine (MOC Category 1) ... The post Flying Solo: Warfarin vs. New Oral Anticoagulants, what does the evidence say? appeared firs...
Jun 28, 2015•18 min
Send us a text Originally Published December 5, 2014: Travis and Amol want you to recognize that: 1. Recognize whole exome sequencing is an important new method of identifying genetic mutations associated with disease. 2. Understand that the 4-year follow-up of the PROTECT AF study showed that left atrial appendage closure devices may be superior to warfarin in preventing strokes in patients ... The post Repeat: Value Judgments – Whole exome sequencing and left atrial appendage closure devices a...
Jun 19, 2015•24 min
