Last Week in Medicine
Wouldn'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.
Episodes
61 episodes
Hydrocortisone for Severe Pneumonia (REMAP-CAP), Intensive BP Control in Diabetes (BPROAD), Aldosterone Synthase Inhibitors for Hypertension (ADVANCE-HTN), Reduced-dose Apixaban for Cancer Associated Thrombosis (API-CAT)
What do you do when most trials suggest benefit for an intervention, but then a new trial suggests harm? We thought steroids in pneumonia was a settled question, but REMAP-CAP had other plans!We also review a new RCT for BP targets in pa...
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Episode 61
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56:43
Half Dose DOAC for Long Term VTE Prevention, Biomarker Guided Antibiotics for Sepsis, GPT-4 Assistance for Physicians, Optimal Vasopressin Initiation for Shock, DOAC vs No AC for A fib After Intracerebral Hemorrhage, HFNC vs NIV for Respiratory Failure
For this episode we are joined by EBM guru, Dr. Brian Locke, who deftly breaks down all of our statistics questions. Is half dose DOAC as good as full dose DOAC for preventing VTE, and does it reduce bleeding risk? Can procalcitonin...
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Episode 60
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1:32:52
7 vs 14 Days of Antibiotics for Bacteremia, Factor XI Inhibition for Atrial Fibrillation, ACEi or ARB Before Elective Surgery, GLP-1 Agonist for HFpEF and Obesity
We're back, after a brief hiatus! Today we talk about duration of therapy for bacteremia, Factor XI inhibition for atrial fibrillation, whether to stop ACEi or ARB before elective surgery, and whether GLP-1 agonists are beneficial i...
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Episode 59
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1:06:04
Anticoagulation in AF with Cirrhosis, Trends in Anticoagulation for Acute PE, Beta Blockers for Acute MI with Normal EF, Finerenone for HFpEF, Continuous vs Intermittent Infusion for Antibiotics, Cefepime vs Piperacillin-Tazobactam for Sepsis
It's been a long time, but we are back!Apologies on the audio quality from Dr. Jenkins. Apparently he was recording from inside a cardboard box.Today we talk about important, practice changing studies in internal medicine from t...
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Episode 58
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1:05:23
Metformin and Long COVID, Central Lines and Thrombocytopenia, DOACs vs LMWH in Cancer Associated Thrombosis, Early vs Late Anticoagulation after Stroke with Atrial Fibrillation
Today 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 ...
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Episode 57
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59:11
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
Today 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 Curb...
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Episode 56
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1:08:12
Doxycycline Post-Exposure Prophylaxis for STIs (DoxyPEP), High Dose Prophylactic Anticoagulation for COVID-19 (ANTICOVID), Rates of Fracture Non-union and Bisphosphonates
This 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 r...
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Season 4
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Episode 4
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46:57
Thiazides for Kidney Stones, Hydrocortisone for Severe Pneumonia (CAPE COD), 2023 GOLD COPD Guidelines, Real World Use of Oral Antibiotics for Infective Endocarditis
Today 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 fe...
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Season 4
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Episode 3
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1:19:31
Antibiotic Duration for Febrile UTI in Males, Lower GI Bleeding Guidelines, Intravenous Contrast in Patients with Acute Kidney Injury
Today 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 ...
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Season 4
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Episode 2
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45:58
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)
We'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 ...
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Season 4
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Episode 1
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51:05
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
Today 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 bett...
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Season 3
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Episode 12
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44:36
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
Today 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 bol...
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Season 3
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Episode 11
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54:50
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
Today 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!
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Season 3
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Episode 10
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58:45
2022 AHA/ACC/HFSA Heart Failure Guidelines with Dr. James Fang, Guideline Committee Member
Today, 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 ...
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Season 3
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Episode 9
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32:50
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
Dr. 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 reduc...
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Season 3
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Episode 8
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50:39
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
Today 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 recu...
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Season 3
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Episode 7
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1:05:44
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
We 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 trial...
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Season 3
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Episode 6
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42:46
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
Today 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 m...
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Season 3
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Episode 5
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49:09
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
It'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 a...
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Season 3
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Episode 4
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1:11:36
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
Somehow we got through 7 articles today, and none of them are about COVID-19! Happy Thanksgiving! Chlorthalidone in CKD
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Season 3
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Episode 3
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59:07
Race and Estimated GFR, Bleeding Risk in Oral Anticoagulation after First VTE, HEP-COVID trial, High Dose Dexamethasone for COVID-19
Today 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 w...
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Season 3
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Episode 2
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50:33
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
We'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...
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Season 3
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Episode 1
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1:01:52
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
Today 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?...
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Season 2
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Episode 17
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1:03:27
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
How 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...
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Season 2
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Episode 16
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45:22
Hospital at Home for Geriatric Patients, RAAS Inhibition and Pulmonary Hypertension, Vaccine Induced Immune Thrombotic Thrombocytopenia (VITT)
Today 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...
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Season 2
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Episode 15
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59:28