Should your patients be reaching for albuterol when their asthma flares up? Some of us may have been treating asthma exacerbations incorrectly for many years… What is the right approach? Tune in to the fifth episode of Beyond Journal Club, a new series brought to you by Core IM in collaboration with NEJM Group, to learn about the latest asthma management trials and guidelines, and how to translate them into better patient care.

Show Notes & Transcript

Timestamps:

(01:47) | Evolving story of asthma management

(03:26) | Pathophysiology of asthma management

(06:01) | Key players & terms

(08:56) | Story of asthma through the decades

(17:55) | MANDALA Trial

Tags: IMCore, CoreIM, primary care, pulmonary, nurse practitioner, pharmacist, physician assistant, inhalers

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How do you choose btw PO vs. IV iron? What is the best counseling for oral iron formulations? How do you choose between different IV iron formulations? Should you use the Ganzoni formula?  What is a Fishbane reaction? And how is it different from anaphylaxis?

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Behind the Scenes YouTube Interview

Transcript and Show Notes

Time stamps:

(02:09) | Spaced repetition from the last Gray Matters Episode

(05:29) | Choosing between oral and IV iron

(11:17) | Considerations with oral iron repletion

(24:02) |Considerations with IV iron repletion

(32:36) | Complications and side effects of IV iron

Tags: hematology, primary care, CoreIM, IMcore, nurse practitioner, physician assistant

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What do the different iron labs mean?! How to interpret iron labs in the setting of inflammation? How to take a good menstrual history?

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Behind The Scenes YouTube Videos

Transcript and Show Notes

Time stamps:

(03:43) | Iron deficiency labs and interpretation in inflammation

(16:08) | Heavy menstrual bleeding evaluation

(27:04) | When should a premenopausal woman with iron deficiency have endoscopy?

(35:15) | Recap

Tags: hematology, women's health, gastroenterology, heavy menstrual bleeding, primary care, CoreIM, IMcore, nurse practitioner, physician assistant, iron deficiency diagnosis

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Uncover many blind spots on tube feeds!

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Behind the Scenes Youtube Interviews: 

• Short-term enteral access
• Durable enteral access
• What is venting aka decompression?

Show Notes & Transcript

Timestamps:

(02:21) | Indications for tube feeds

(09:36) | Routes of enteral access

(19:20) | Components of tube feeds

(27:03) | Tube feeds complications

(34:50) | Counseling patients before discharge and medication interactions

Tags: IMCore, CoreIM, nursing home, primary care, dietician, nutrition support, hospital medicine, interprofessional education, enteral feeds

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How do you manage GDMT in a frail older adult? When is a guardian needed and what is the process for obtaining guardianship?

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Behind The Scenes YouTube Interview

Show Notes & Transcript

Timestamps:

(04:03) | Deep Dive 1: How do you approach guideline-directed medical therapy of heart failure with reduced ejection fraction in a frail older adult?

(11:55) | Deep Dive 2: When is a guardian needed and what is the process for obtaining guardianship?

(28:30) | Deep Dive 3: How do you re-evaluate GDMT in a frail older adult once an adverse event has occurred?

(33:27) | Reflections

(37:06) | Recap

Tags: IMCore, CoreIM, nursing home, primary care, cardiology, palliative care hospital medicine, interprofessional education, social work, case management

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How do you counsel patients eligible for the RSV vaccines? What do the results of the RENOIR and AReSVi trials tell us and how do they compare? How should we interpret vaccine trials in the first place? Tune in to the fourth episode of Beyond Journal Club, a new series brought to you by Core IM in collaboration with NEJM Group.

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Show Notes & Transcript

Time Stamps:

(02:30) | Epidemiology of RSV

(03:46) | Development of RSV vaccine

(05:55) | Vaccine trial design

(12:22) | ARESVI and RENOIR Trials

(18:18) | Who should we recommend the RSV vaccine to?

(19:50) | What don’t we know?

Tags: IMCore, CoreIM, primary care, infectious disease, nurse practitioner, pharmacist, physician assistant

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When you see a low mag or a low phos, what are you thinking about? And do PPIs effect magnesium absorption? How much sodium and potassium are found in a typical oral phosphorus supplement?

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Youtube interview on key points on magnesium

Youtube interview on key points on phosphate

CME : http://bit.ly/CIMCME || Show Notes & Transcript

Timestamps:

(01:37) | Pearl 1: Magnesium

(09:39) | Pearl 2: Framework for hypomagnesemia

(16:53) | Pearl 3: Magnesium repletion

(22:39) | Pearl 4: Phosphorous

(28:36) | Pearl 5: Phosphorous repletion

Tags: IMCore, CoreIM, nephrology, hospital medicine, interprofessional education, renal

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Sharpen your de-escalation skills!

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Timestamps:

• 02:26 Difficult Patients
• 10:25 Mediation Toolkit
• 17:20 Maxims of Mediation
• 26:46 When the Conversation Still Breaks Down
• 35:11 Conclusion

Tags: IMCore, CoreIM, ethics, humanities, nurse practitioner, pharmacist, physician assistant, burnout

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In community-acquired pneumonia, can steroids improve mortality? Past studies of steroids in CAP have been conflicting, with some showing a mortality benefit and others showing no difference. How does the CAPE COD trial change how we think about patients hospitalized with severe CAP? To find out, tune into the third episode of Beyond Journal Club, a new series brought to you by Core IM in collaboration with NEJM Group.

Show Notes & Transcript

• 01:50 Pathophysiology of Steroids and Infection
• 03:50 Steroids in PNA Studies
• 08:56 CAPE COD Trial
• 14:13 Discussion of CAPE COD Trial
• 18:36 Takeaways/Discussion

Tags: IMCore, CoreIM, primary care, cardiology, nurse practitioner, pharmacist, physician assistant

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Syncope history, PPM/ICD prior to MRI or surgery, anticoagulation for pacemaker or ICD procedures and new cardiac devices and how they may look different on EKG or chest x-ray!

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Show Notes & Transcript

Timestamps:

• 01:13 Pearl 1: Should we approach syncope history differently in our patients with pacemakers and ICDs?
• 06:31 Pearl 2: Considerations for patients with implantable devices before surgery.
• 12:26 Pearl 3: Considerations for patients with implantable devices before MRI.
• 14:45 Pearl 4: Anticoagulation in patients undergoing pacemaker or ICD procedures. 
• 18:17 Timestamp 5: Emerging cardiac device technology and how they might look different on EKG or chest x-ray

Tags: IM Core, CoreIM, cardiology, prodromal symptoms, CRT, biventricular pacing

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