Last Week in Medicine

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 hypertension and talk about vaccine-induced immune thrombotic thrombocytopenia (VITT).  Check it out!

Hospital at Home with Comprehensive Geriatric Assessment
RAAS Inhibition and Pulmonary Hypertension
Vaccine-Induced Immune Thrombotic Thrombocytopenia 










Music from https://filmmusic.io
"Sneaky Snitch" by Kevin MacLeod (https://incompetech.com)
License: CC BY (http://creativecommons.org/licenses/by/4.0/)

Music from Uppbeat (free for Creators!):

https://uppbeat.io/t/soundroll/dope

License code: NP8HLP5WKGKXFW2R

Today we are joined by heavy hitter Dr. Brian Locke to talk about the new paper on 3 vs 8 days of antibiotics for pneumonia, a clever new paper looking at whether there is any association between IV contrast and kidney function, and a new retrospective study on DOAC use for valvular atrial fibrillation.  Check it out!


Three Days of Antibiotics for Pneumonia
IV Contrast and Kidney Function
DOACs for Valvular Atrial Fibrillation





Music from https://filmmusic.io
"Sneaky Snitch" by Kevin MacLeod (https://incompetech.com)
License: CC BY (http://creativecommons.org/licenses/by/4.0/)

Music from Uppbeat (free for Creators!):

https://uppbeat.io/t/soundroll/dope

License code: NP8HLP5WKGKXFW2R

Today we are doing double duty: podcasting and parenting.  Fortunately our babies were well-behaved.  We talk about three trials for semaglutide and weight loss and a new 4 level pre-test probability rule for diagnosing PE.  We also talk about a retrospective study of cefazolin vs nafcillin for epidural abscess, a ferritin/procalcitonin ratio for differentiating bacterial from COVID pneumonia, and a new randomized controlled trial of intermediate thromboprophylaxis for ICU patients with COVID19.  Check it out!


Semaglutide for Weight Loss (STEP 1)
Semaglutide for Weight Loss in Diabetics (STEP 2)
Semaglutide + Intensive Calorie Restriction for Weight Loss (STEP 3)

4PEPS for Pulmonary Embolism
Nafcillin vs Cefazolin for Epidural Abscess
Ferritin/Procalcitonin Ratio for COVID-19 vs Bacterial Pneumonia
Intermediate Thromboprophylaxis for COVID-19 (INSPIRATION)








Music from https://filmmusic.io
"Sneaky Snitch" by Kevin MacLeod (https://incompetech.com)
License: CC BY (http://creativecommons.org/licenses/by/4.0/)

Hall of the Mountain King Kevin MacLeod (incompetech.com)
Licensed under Creative Commons: By Attribution 3.0 License
http://creativecommons.org/licenses/by/3.0/

Music from Uppbeat (free for Creators!):

https://uppbeat.io/t/soundroll/dope

License code: NP8HLP5WKGKXFW2R

Today has a nice liver disease theme.  Does targeting a serum albumin above 3 g/dL reduce death, infections and kidney failure in patients with decompensated cirrhosis?  Does terlipressin work in hepatorenal syndrome? 


Albumin Infusion for Decompensated Cirrhosis
Terlipressin for Type 1 Hepatorenal Syndrome 







Music from https://filmmusic.io
"Sneaky Snitch" by Kevin MacLeod (https://incompetech.com)
License: CC BY (http://creativecommons.org/licenses/by/4.0/)

Music from Uppbeat (free for Creators!):

https://uppbeat.io/t/soundroll/dope

License code: NP8HLP5WKGKXFW2R

Today I am joined by Infectious Disease expert Dr. Emily Spivak to talk about the latest batch of tocilizumab trials for COVID-19 and a meta-analysis of all the convalescent plasma trials.  Check it out!


Tocilizumab in Hospitalized Patients with COVID-19 (COVACTA)
IL-6 Receptor Antagonists in Critically Ill Patients with COVID-19 (REMAP-CAP)
RECOVERY Tocilizumab pre-print
Meta-analysis of Convalescent Plasma for COVID-19










Music from https://filmmusic.io
"Sneaky Snitch" by Kevin MacLeod (https://incompetech.com)
License: CC BY (http://creativecommons.org/licenses/by/4.0/)

Music from Uppbeat (free for Creators!):

https://uppbeat.io/t/soundroll/dope

License code: NP8HLP5WKGKXFW2R

Today we have special guests Dr. Emily Signor and Dr. Amanda Breviu, two hospitalists, to talk about a survey published in JHM on gender-based discrimination among hospitalists.  We also discuss a survey published in JGIM on educational resources used by internal medicine residents.  Check it out!


Gender Based Discrimination and Harassment Among Hospitalists
Educational Resource Utilization Among Internal Medicine Residents
Liberal vs Restrictive Transfusion Threshold for Patients with ACS and Anemia
DOACs for VTE prevention in CKD







Music from https://filmmusic.io
"Sneaky Snitch" by Kevin MacLeod (https://incompetech.com)
License: CC BY (http://creativecommons.org/licenses/by/4.0/)

Music from Uppbeat (free for Creators!):

https://uppbeat.io/t/soundroll/dope

License code: NP8HLP5WKGKXFW2R

Today we have a special guest, Dr. Jared Bunch, an international expert in atrial fibrillation and ablation, to talk about the state of atrial fibrillation and which patients benefit from early catheter ablation based on two new trials published last week in the NEJM.  We also talk about whether you should stop ACEi or ARBs in patients admitted with COVID-19, whether oral antibiotics are adequate for uncomplicated appendicitis, and whether you should target a high (90 mmHg) or low (60 mmHg) paO2 in patients with respiratory failure.

STOP-AF First trial
EARLY-AF trial
ACEi and ARBs in COVID-19
IV vs Oral Antibiotics for Appendicitis
Rifaximin after TIPS to Prevent HE
Reimagining Endocarditis Care in an Opioid Epidemic
Lower vs Higher Oxygen Targets











Music from https://filmmusic.io
"Sneaky Snitch" by Kevin MacLeod (https://incompetech.com)
License: CC BY (http://creativecommons.org/licenses/by/4.0/)

Music from Uppbeat (free for Creators!):

https://uppbeat.io/t/soundroll/dope

License code: NP8HLP5WKGKXFW2R

Today I am joined by pulmonary hypertension and heart failure expert, Dr. John Ryan, to talk about inhaled treprostinil for pulmonary hypertension due to ILD, and a new cardiac myosin activator, omecamtiv mecarbil, for treatment of systolic heart failure.  Check it out!


Treprostinil for Pulmonary Hypertension due to ILD
Omecamtiv Mecarbil for Systolic Heart Failure












Music from https://filmmusic.io
"Sneaky Snitch" by Kevin MacLeod (https://incompetech.com)
License: CC BY (http://creativecommons.org/licenses/by/4.0/)

Music from Uppbeat (free for Creators!):

https://uppbeat.io/t/soundroll/dope

License code: NP8HLP5WKGKXFW2R

WARNING: This episode is long on banter.  If you would like to skip the intro conversation and get right to the articles, skip ahead to 12:13. 

Today we are joined by Dr. Jason Carr, pulmonary-critical care all-star, to talk about how often PE is present in patients with acute COPD exacerbations.  We also review more tocilizumab RCTs because they just keep coming.

Prevalence of Pulmonary Embolism in Acute COPD Exacerbation
STOP-IT COVID trial
RCT-TCZ-COVID-19 trial
CORIMUNO-TOCI-1 trial
REMAP-CAP trial pre-print









Music from https://filmmusic.io
"Sneaky Snitch" by Kevin MacLeod (https://incompetech.com)
License: CC BY (http://creativecommons.org/licenses/by/4.0/)

Music from Uppbeat (free for Creators!):

https://uppbeat.io/t/soundroll/dope

License code: NP8HLP5WKGKXFW2R

The president's supporters may have stormed the capitol and attempted a coup today, but the show must go on.  Today I'm joined by Dr. Dani Babbel to talk about treatment of hypertension in the hospital, as well as testing for primary aldosteronism in patients with resistant hypertension.  Check it out! 


Treatment and Outcomes in Inpatient Hypertension
Testing for Primary Aldosteronism and MRA Use Among US Veterans
Tocilizumab in Hospitalized Patients with COVID-19














Music from https://filmmusic.io
"Sneaky Snitch" by Kevin MacLeod (https://incompetech.com)
License: CC BY (http://creativecommons.org/licenses/by/4.0/)

Music from Uppbeat (free for Creators!):

https://uppbeat.io/t/soundroll/dope

License code: NP8HLP5WKGKXFW2R