General Medicine and Primary Care

Host: Matt Birnholz, MD

Guest: Wes Ely, MD, MPH

After surviving a critical illness, many patients look forward to their lives returning to normal, but unfortunately, that’s not always possible.

To uncover the far-reaching impacts of delirium, Dr. Matt Birnholz is joined by Dr. Wes Ely, Professor of Medicine and Co-Director of the Center for Critical Illness, Brain Dysfunction and Survivorship Center at Vanderbilt University’s School of Medicine which focuses on improving the lives and care of patients in the intensive care unit to ensure both physical and cognitive rehabilitation.

Guest: Shail M. Govani, MD, MSc

Incidence and Predictors of Success of Adalimumab Dose Escalation and De-escalation in Ulcerative Colitis: a Real-World Belgian Cohort Study.

Saartje Van de Vondel, MD, Filip Baert, MD, PhD, Christine Reenaers, MD, PhD, Stijn Vanden Branden, MD, Leila Amininejad, MD, Pieter Dewint, MD, PhD, Wouter Van Moerkercke, MD, Jean-François Rahier, MD, PhD, Pieter Hindryckx, MD, PhD, Peter Bossuyt, MD, Marc Ferrante, MD, PhD, and Belgian IBD Research and Development (BIRD)

BACKGROUND:

Adalimumab (ADM) has been shown efficacious in ulcerative colitis (UC). In randomized controlled trials, dose escalation from 40 mg ADM every other week to 40 mg every week was required in 20%–25% of patients within 1 year. Real-life data suggest higher escalation rates. Attempts for dose de-escalation have not been studied yet. We assessed the need for, outcome of, and predictors of dose escalation and de-escalation in a large retrospective cohort of UC patients treated with ADM.

METHODS:

We included 231 consecutive patients from 10 Belgian centers initiating ADM treatment for active UC before September 1, 2015 (follow-up ≥1 year in each patient). We performed detailed chart review to identify variables associated with short-term clinical benefit (based on physician global assessment and absence of rectal bleeding at week 10), success …

Guest: Yash Mittal, MD

Reliability of Measuring Ileo-Colonic Disease Activity in Crohn's Disease by Magnetic Resonance Enterography.

Vipul Jairath, MD, PhD, Ingrid Ordas, MD, PhD, Guangyong Zou, PhD, Julian Panes, MD, Jaap Stoker, MD, PhD, Stuart A Taylor, MD, Cynthia Santillan, MD, Karin Horsthuis, MD, Mark A Samaan, MD, Lisa M Shackelton, PhD, Larry W Stitt, MSc, Pieter Hindryckx, MD, PhD, Reena Khanna, MD, William J Sandborn, MD ,Geert D'Haens, MD, PhD, Brian G Feagan, MD, Barrett G Levesque, MD, and Jordi Rimola, MD, PhD

BACKGROUND:

Magnetic resonance enterography is increasingly utilized for assessment of luminal Crohn's disease activity. The Magnetic Resonance Index of Activity and the London Index are the most commonly used outcome measures in clinical trials. We assessed the reliability of these indices and several additional items.

METHODS:

A consensus process clarified scoring conventions and identified additional items based on face validity. Four experienced radiologists evaluated 50 images in triplicate, in random order, at least 1 month apart, using a central image management system. Intra- and interrater reliability were assessed by calculating and comparing intraclass correlation coefficients.

RESULTS:

Intrarater intraclass correlation coefficients (95% confidence intervals) for the Magnetic Resonance Index of Activity, London, and London "extended" indices and a visual analogue …

Host: Brian P. McDonough, MD, FAAFP

Guest: Kenneth Davin Fine, MD

Dr. Brian McDonough brings up an age-old question: can listening to music cure your ailments? In an attempt to put this long-lived discussion to rest, Dr. McDonough welcomes Dr. Kenny Fine, a physician-musician of 15 years.

Host: Brian P. McDonough, MD, FAAFP

Guest: Daryl Gioffre, DC

Are our diets helping or hurting us? To examine the link between your gut and your overall health, Dr. Brian McDonough is joined by nutritionist Daryl Gioffre, who suggests that an unhealthy gut could very well be the root cause of significant health issues.

Host: Brian P. McDonough, MD, FAAFP

Guest: David Neagle

Is it possible that our environment and experiences have subconsciously programmed our emotional response to the world around us? Joining Dr. Brian McDonough is David Neagle, author of The Millions Within: Tips to Improve Emotional Intelligence, to offer advice on what impacts our emotional intelligence and the changes we can implement to strengthen our own.

Produced in cooperation with:

Host: Brian P. McDonough, MD, FAAFP

Guest: Jorge Garcia, MD

Even though people have gained immunity to the Zika virus in certain parts of the world, Zika outbreaks can—and do—still occur. Tune in as Dr. Jorge Garcia joins Dr. Brian McDonough to discuss the who, what, where, why, and how of the Zika virus, the once headline-dominating epidemic.

Host: Brian P. McDonough, MD, FAAFP

Guest: Patricia (Tia) Powell, MD

Since dementia is one of the most common health problems in the United States, it's hard not to know at least one person who is impacted by it. Proof of this is Dr. Tia Powell, who discusses the far-reaching impacts of dementia with Dr. Brian McDonough.

Guest: David J. Portman, MD

For the one in eight women who will develop breast cancer in their lifetime and for the three million breast cancer survivors, what’s the best way to manage genitourinary syndrome of menopause (GSM)? Founder and Director Emeritus of the Columbus Center for Women’s Health Research Dr. David Portman explains the rationale behind his approach.

Host: Matt Birnholz, MD

Guest: David J. Portman, MD

Recorded live during ReachMD's Innovation Theater in Chicago, Illinois, Founder and Director Emeritus of the Columbus Center for Women’s Health Research Dr. David Portman joins Dr. Matt Birnholz to share his tips for getting past the taboo and providing sexual health counseling and treatment to your patients.