Send us a text Kieran has officially finished his Royal College Exam to qualify as a General Internist; which means, this week is the first of two weeks of replay episodes while he takes a much deserved break! This replay episode features Kieran and Ashley Minuk in discussion on two studies examining therapies in people with diabetes. Diabetes research is ... The post REPLAY: Double Down – Liraglutide for the Prevention of Diabetes and Bariatric Surgery for the Treatment of Diabetes appeared fir...
May 26, 2017•32 min
Send us a text This week on The Rounds Table we’re back by popular demand with another rapid fire episode: just the salient points from FOUR articles instead of two. Same time spent listening, twice the take-home! Kieran Quinn and Mike Fralick tease out the bottom line for listeners. Both hyperglycemia and hypoglycemia are prevalent, real, concerns for patients ... The post Firing on All Cylinders! Hypothyroidism in Pregnancy, (Virtually) Managing Diabetes, and Anticoagulation Post Stroke appear...
May 19, 2017•31 min
Send us a text Overweight and obese patients are routinely counselled about weight loss since it is thought to improve numerous outcomes. However, as many of us know, achieving stable weight loss is easier said than done! In patients with existing coronary disease, is the weight fluctuation that is often associated with weight loss attempts harmful? Fahad takes listeners ... The post A VISION of Stability: Effects of Body Weight Fluctuation on Coronary Outcomes and Post-Operative Troponins on Mo...
May 12, 2017•31 min
Send us a text It is widely accepted that statin drugs reduce cardiovascular risk. However, how much of this risk reduction is attributable to LDL cholesterol reduction as opposed to something intrinsic in the statin drug has been a matter of debate. Paxton takes listeners through a randomized controlled trial that evaluated the efficacy of evolocumab (a biologic PCSK9 ... The post The Hurry for FOURIER & What’s New From HERDOO2 – Decision Making in VTE and Evolocumab for CVD Risk Reduction ...
May 05, 2017•30 min
Send us a text Migraine is a common presentation to primary care clinics. Current pharmacologic treatments offered by physicians have notable side effects and may be a financial burden. Understandably, patients are looking to alternative therapies. However, primary care providers may not be able to provide an educated opinion about whether these therapies are reasonable to pursue. Fraser provides ... The post Keep Calm and Get Your Analgesic On: Acupuncture for Migraine Prophylaxis and Pregabali...
Apr 28, 2017•29 min
Send us a text Foreign medical graduates are an important resource, and data on their proficiency is important to the public. Jay guides listeners through a study that answers the following: do patient outcomes differ between general internists who graduated from a medical school outside of the United States and those who graduated from a US medical school? Each ... The post Great Expectations: International Medical Graduates & MD Estimates of Benefits and Harms appeared first on Healthy Deb...
Apr 21, 2017•30 min
Send us a text Contrast-induced nephropathy is cited as the third most common cause of iatrogenic acute kidney injury. In the Emergency Department, physicians must balance diagnosing life-threatening conditions using emergent imaging with the risk of potential harm caused by exposure to IV contrast. Recent studies, including the one discussed by Lauren in this episode, challenge the proposed causal ... The post Emergent Realizations: Contrast-Induced Nephropathy & Opioid Prescribing Patterns...
Apr 14, 2017•30 min
Send us a text Kieran has officially finished half of his Royal College Exam to qualify as a General Internist; which means, we are back to new episodes every week to keep listeners up to date with the most recent and important medical research. This week, Kieran and Ashley Minuk delve into two studies examining therapies in people with ... The post Double Down: Liraglutide for the Prevention of Diabetes and Bariatric Surgery for the Treatment of Diabetes appeared first on Healthy Debate ....
Apr 07, 2017•32 min
Send us a text What if you could tell a woman about to undergo chemotherapy for breast cancer that you had an intervention that would significantly reduce her risk of hair loss during therapy? Or, tell an adult patient with physician diagnosed asthma that they could safely stop their asthma medications? This week on The Rounds Table we welcome ... The post Keeping a Cool Head – Reducing Hair Loss During Chemotherapy & Challenging Asthma Diagnoses appeared first on Healthy Debate ....
Mar 31, 2017•29 min
Send us a text This week on The Rounds Table we are trying something a little different: just the salient points from FOUR articles instead of two! Same time spent listening, twice the take-away! Dr. Michael Fralick, general internist at St. Michael’s Hospital, takes the lead on this rapid fire approach. Even in the post-SPRINT era optimal BP targets ... The post Rapid Fire to Keep the Blood Pumping – BP Management, Lung Cancer Screening, and Intubation During Cardiac Arrest appeared first on He...
Mar 24, 2017•27 min
Send us a text It’s palliative care week on The Rounds Table! Kieran and Ariel guide listeners through two noteworthy new studies: interventions to clarify goals of care for individuals with advanced dementia; and a randomized trial of treatment for delirium in palliative care. Goals of care discussions are critical in ensuring treatments are aligned with patients expressed wishes. ... The post REPLAY – Clearing Confusion in Palliative Care: Goals of Care Interventions for Dementia and Antipsych...
Mar 17, 2017•30 min
Send us a text This week on The Rounds Table we are breaking the dogmas in clinical practice to find out if less is more. Does diverticulitis even require antibiotics in the age of antimicrobial stewardship? Next, how does casting compare to surgery for ankle fractures in older adults? Kieran and Lauren Lacroix discuss two thought-provoking new studies: Diverticulitis ... The post Breaking the Status Quo: Antimicrobial Stewardship in Diverticulitis & Casting vs. Surgery for Ankle Fractures a...
Mar 10, 2017•26 min
Send us a text “There is no comparable healthcare system in the world that does not ensure universal coverage of [at least] essential medicines.” – Dr. Steve Morgan on the need for Pharmacare in Canada What would a Canadian National Pharmacare Program look like? We break it down for you this week on a special episode of The Rounds ... The post REPLAY – Is Canada Ready for National Pharmacare? appeared first on Healthy Debate ....
Mar 03, 2017•33 min
Send us a text Here at The Rounds Table we aren’t quite over Valentine’s Day; it’s cardiac week! Kieran and Paxton take listeners through two exciting studies on the influence of genetic and lifestyle factors in coronary disease and “Triple Therapy” in patients with atrial fibrillation and recent percutaneous coronary intervention. It’s easy to feel helpless as a physician ... The post Mending a Broken Heart: Genetics & Lifestyle in Coronary Disease and Anticoagulation in Afib & Recent P...
Feb 24, 2017•34 min
Send us a text Kieran and Fraser are back this week to take listeners through two exciting new studies. What percentage of people that present to the Emergency Department have an adverse drug event (ADE)? How big does an abdominal aortic aneurysm (AAA) have to be to warrant surgical repair? Listen to find out! Emergency Department visits for ADEs ... The post REPLAY – Keeping a Pulse on Drug Reactions: Emergency Visits for Adverse Drug Events and Thresholds for AAA Repair appeared first on Healt...
Feb 17, 2017•25 min
Send us a text “There is no comparable healthcare system in the world that does not ensure universal coverage of [at least] essential medicines.” – Dr. Steve Morgan on the need for Pharmacare in Canada What would a Canadian National Pharmacare Program look like? We break it down for you this week on a special episode of The Rounds ... The post Is Canada Ready for National Pharmacare? appeared first on Healthy Debate ....
Feb 10, 2017•33 min
Send us a text It’s a new year, which means new theme music for The Rounds Table! This week, Kieran and Jay take listeners through alternatives to inpatient hospitalization and the effects of PPIs on community acquired pneumonia. Hospitals often operate at over 100% capacity, and inpatient care is expensive – it accounts for 32% of US healthcare dollars! ... The post REPLAY – New Year, New Medicine: Alternatives to Hospitalization & Association of PPIs with Pneumonia appeared first on Health...
Feb 03, 2017•25 min
Send us a text It’s palliative care week on The Rounds Table! Kieran and Ariel guide listeners through two noteworthy new studies: interventions to clarify goals of care for individuals with advanced dementia; and a randomized trial of treatment for delirium in palliative care. Goals of care discussions are critical in ensuring treatments are aligned with patients expressed wishes. ... The post Clearing Confusion in Palliative Care: Antipsychotics for Delirium and Goals of Care Interventions app...
Jan 27, 2017•30 min
Send us a text Kieran and Fraser are back this week to take listeners through two exciting new studies. What percentage of people that present to the Emergency Department have an adverse drug event (ADE)? How big does an abdominal aortic aneurysm (AAA) have to be to warrant surgical repair? Listen to find out! Emergency Department visits for ADEs ... The post Keeping a Pulse on Drug Reactions: Emergency Visits for Adverse Drug Events and Thresholds for AAA Repair appeared first on Healthy Debate...
Jan 20, 2017•25 min
Send us a text Is quitting cold turkey the best way to stop smoking? When should you transfuse a patient? How effective are current models of palliative care? We’re answering relevant and thought-provoking questions this week on The Rounds Table! Ashley, like many family physicians, makes a point of advising and supporting smoking cessation at most visits she has ... The post All Things Must End (Including Life and Smoking!): Gradual Versus Abrupt Smoking Cessation and Palliative Care Effectiven...
Jan 13, 2017•33 min
Send us a text It’s a new year, which means new theme music for The Rounds Table! This week, Kieran and Jay take listeners through alternatives to inpatient hospitalization and the effects of PPIs on community acquired pneumonia. Hospitals often operate at over 100% capacity, and inpatient care is expensive – it accounts for 32% of US healthcare dollars! ... The post New Year, New Medicine: Alternatives to Hospitalization & Association of PPIs with Pneumonia appeared first on Healthy Debate ...
Jan 06, 2017•25 min
Send us a text Bugs, drugs, and optimal duration for antibiotic therapy? New frontiers in HIV treatment? Listen this week as Kieran and Jay Spiegel, a resident in General Internal Medicine in Toronto, discuss two studies: It’s hard to remember what the right drug is to treat a certain bug, let alone the correct duration of therapy. Further, for ... The post REPLAY: Bugs & Drugs – Duration of Antibiotic Therapy in Community-Acquired Pneumonia and Early Antiretroviral Treatment for HIV appeare...
Dec 30, 2016•39 min
Send us a text We’re back this week with Kieran and Ashley to take another look at diabetes and sweet treats. Should current practice guidelines be taken with a grain of salt – or should I say – sugar? Listen to find out! New drugs have popped up on the market for diabetes management, necessitating an update to practice ... The post REPLAY: Testing and Treatment in Diabetes – Taken with a Grain of Sugar! appeared first on Healthy Debate ....
Dec 23, 2016•31 min
Send us a text It’s big data week on The Rounds Table! When initiating pharmacotherapy for atrial fibrillation, which drug is best? How does frailty influence surgical outcomes? Kieran and Michael Fralick, General Internist at St. Michael’s Hospital, take listeners through two noteworthy studies: When a new medication is developed it is generally compared against standard of care or ... The post Big Data: Dabigatran vs. Rivaroxaban for Atrial Fibrillation and Association of Frailty with Post-Ope...
Dec 16, 2016•29 min
Send us a text This week’s episode is jam-packed with critical care medicine. What is the effect of conservative versus conventional oxygen therapy on mortality in patients in the ICU? Hydrocortisone on development of septic shock? Kieran and Laura take listeners through two important studies examining these questions. Prior research suggested excessive oxygenation in patients admitted to the ICU ... The post When Care is Critical: Conservative vs Conventional Oxygen Treatment in the ICU and the...
Dec 09, 2016•30 min
Send us a text It’s arrhythmia week on The Rounds Table! Should heart failure patients give up a caffeine jolt in the morning? How can we better identify appropriate patients for ICDs? Paxton Bach, fellow in General Internal Medicine at UBC, joins Kieran to discuss two exciting studies: Studies that inform practice toward the best medical treatments are of ... The post DANISH with your Coffee? ICDs for Non-Ischemic Cardiomyopathy and Effects of High Dose Caffeine on Cardiac Arrhythmias appeared ...
Dec 02, 2016•30 min
Send us a text Dr. Fraser Pollard, Family Physician in Trenton ON, discusses his frustration with the lack of effective treatments for osteoarthritis for long-term pain and disability in his patients. But there is hope! Fraser dips his toes into critically examining alternative medicine in leading listeners through a single blinded comparative effectiveness trial of Tai Chi versus physiotherapy ... The post Smoke & Mirrors? Tai Chi vs. Physiotherapy for Knee Osteoarthritis & Symptoms in ...
Nov 25, 2016•26 min
Send us a text It’s so hot you can barely touch it – the PESIT study! So what’s the buzz all about? Pulmonary embolism is one of those dreaded diagnoses – it can be life-threatening, but often elusive in its diagnosis since so many other conditions cause similar symptoms. Kieran takes listeners through the multi-centre cross sectional PESIT study ... The post PESIT and PATCH it! – Plugging ICH with platelets and quantifying the prevalence of PE in syncope appeared first on Healthy Debate ....
Nov 18, 2016•28 min
Send us a text Physician burnout is a work related syndrome involving emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment. The prevalence of burnout has reached a shocking 50% in both staff and resident physicians! Something needs to be done. Ariel Lefkowitz, Chief Medical Resident at Mount Sinai Hospital in Toronto, takes listeners through a systematic review ... The post We Need to Talk About It: Physician Burnout and Sex Differences in Salary appeared first...
Nov 11, 2016•29 min
Send us a text Ever wondered about when to mechanically ventilate patients with dementia in the ICU? Or how hospital quality predicts survival post MI? Tune in this week as Dr. Laura Walker, Chief Medical Resident at St. Michael’s Hospital, and Kieran discuss two intriguing studies! The prevalence of dementia is steadily rising across North America. Among hospitalized nursing ... The post If you build it, they will come! – ICU beds, dementia and quality of care in MI outcomes appeared first on H...
Nov 04, 2016•27 min
