The Rounds Table

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Welcome back Rounds Table Listeners! Today we have a solo episode with Dr. Mike Fralick. This week, he discusses a recent systematic review and meta-analysis that looks at continuing versus withholding RAS inhibitors before noncardiac surgery. Here we go!

1. Evaluating the risks and benefits of continuing versus withholding renin–angiotensin system inhibitors: a systematic review and meta-analysis with trial sequential analysis (0:00 – 8:20).

The Good Stuff (8:21 – 9:44):

• NotebookLM

Questions? Comments? Feedback? We’d love to hear from you! @roundstable @InternAtWork @MedicinePods

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Welcome back Rounds Table Listeners! We are back today with a Classic Rapid Fire episode. This week, Drs. Mike and John Fralick discuss two recent papers: the effects of spironolactone on heart failure and cardiovascular death in patients undergoing maintenance dialysis, and antibiotic prophylaxis in patients with cirrhosis and upper gastrointestinal bleeding. Two papers, here we go!

1. Spironolactone versus placebo in patients undergoing maintenance dialysis (ACHIEVE): an international, parallel-group, randomised controlled trial (0:00 – 7:19)
2. Prophylactic Antibiotics for Upper Gastrointestinal Bleeding in Patients With Cirrhosis: A Systematic Review and Bayesian Meta-Analysis (7:20 – 15:08)

And for the Good Stuff (15:09 – 17:51):

• The $500m slugger who helped Canada get to the World Series
• Clinical practice guidelines one-pagers coming soon to Trial Files: https://trialfiles.substack.com/

Questions? Comments? Feedback? We’d love to hear from you! @roundstable @InternAtWork @MedicinePods

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Welcome back Rounds Table Listeners! In this throwback episode (initial release 14 Mar 2024), Dr. Mike Fralick and special guest, Dr. Laiya Carayannopoulos from the Intern at Work Podcast, discuss two papers: one exploring the role of non-invasive ventilation in comatose patients after acute poisoning, and and one on the use of the PEN-FAST Score in the point-of-care risk assessment of penicillin allergy. Two papers, here we go!

1. Effect of Noninvasive Airway Management of Comatose Patients With Acute Poisoning (0:00 – 16:25).
2. Efficacy of a Clinical Decision Rule to Enable Direct Oral Challenge in Patients With Low-Risk Penicillin Allergy (16:26 – 24:17).

And for the Good Stuff:

• Celebrating Research Success! (24:18 – 25:14).
• Non-inferiority results: everything you need know in 5 minutes! and Is Noninferior Not Inferior? (25:15 – 26:48).

Questions? Comments? Feedback? We’d love to hear from you! @roundstable @InternAtWork @MedicinePods

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Welcome back Rounds Table Listeners! Today we have a solo episode with Dr. Mike Fralick. This week, he discusses a recent trial examining whether amiloride is noninferior to spironolactone in reducing systolic blood pressure in patients with resistant hypertension. Here we go!

1. Spironolactone vs Amiloride for Resistant Hypertension: A Randomized Clinical Trial (0:00 – 8:10).

Run-in studies:

• Application and impact of run-in studies
• Application and Impact of Run-In Studies for the Evaluation of Statin Efficacy and Safety

The Good Stuff (8:11 - 9:14):

• Trial Files: https://trialfiles.substack.com/
• Heme Onc Trial Files: https://hemeonctrialfiles.substack.com/
• Allergy & Immunology Trial Files: https://allergyimmtrialfiles.substack.com/
• Critical Care Trial Files: https://criticalcaretrialfiles.substack.com/

Questions? Comments? Feedback? We’d love to hear from you! @roundstable @InternAtWork @MedicinePods

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Welcome back Rounds Table Listeners! Today we have a solo episode with Dr. Mike Fralick. This week, he discusses a recent phase 2 trial looking at the effects of once-weekly semaglutide on alcohol consumption and craving in adults with alcohol use disorder (AUD). Here we go!

1. Once-Weekly Semaglutide in Adults With Alcohol Use Disorder (0:00 – 10:28).

Questions? Comments? Feedback? We’d love to hear from you! @roundstable @InternAtWork @MedicinePods

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Welcome back Rounds Table Listeners! This week, Dr. Mike Fralick sits down with Mihir Pandya, a third-year medical student at Western University. Mihir picks Mike’s brain for advice on preparing for internal medicine clerkship: What’s the best approach to acquire knowledge on the varying conditions seen in internal medicine? How can you foster better rapport with patients? What’s the best way to ask your staff physician for a reference letter? Answers to these questions and more—here we go!

Questions? Comments? Feedback? We’d love to hear from you! @roundstable @InternAtWork @MedicinePods

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Welcome back Rounds Table Listeners! We are back today with a solo episode with Dr. John Fralick. This week, he discusses a recently published trial examining fecal microbiota transplantation (FMT) in primary C. difficile infection. Here we go!

1. Fecal Microbiota Transplantation Versus Vancomycin for Primary Clostridioides difficile Infection: A Randomized Controlled Trial (0:00 – 4:47).

The Good Stuff (4:48 – 5:36):

• The I'm Pharmacy podcast, now featured on https://medicinepods.com/im-pharmacy/.

Questions? Comments? Feedback? We’d love to hear from you! @roundstable @InternAtWork @MedicinePods

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Welcome back Rounds Table Listeners! Today we have a solo episode with Dr. Mike Fralick. This week, he discusses a recently published trial looking at aspirin in patients with chronic coronary syndrome receiving oral anticoagulation. Here we go!

1. Aspirin in Patients with Chronic Coronary Syndrome Receiving Oral Anticoagulation (0:00 – 9:43).

Throwback to EPIC-CAD: 

• The Rounds Table Episode 94: Top Papers from the 2024 European Society of Cardiology Congress 

The Good Stuff:

• Trial Files is a free monthly newsletter on practice-changing trials, delivered straight to your inbox (https://trialfiles.substack.com/).
• Guidelines summaries coming to Trial Files soon!

Questions? Comments? Feedback? We’d love to hear from you! @roundstable @InternAtWork @MedicinePods

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Welcome back Rounds Table Listeners! We are back today with a special Rapid Fire Podcast. This week, Drs. Mike and John Fralick discuss some of the top papers from the 2025 European Society of Cardiology (ESC) Congress. Hot off the presses, here we go!

1. Increasing the Potassium Level in Patients at High Risk for Ventricular Arrhythmias (0:00 - 5:23)
2. Digitoxin in Patients with Heart Failure and Reduced Ejection Fraction (5:24 - 10:23)
3. RSV Prefusion F Vaccine for Prevention of Hospitalization in Older Adults (10:24 - 16:09)
4. Apixaban for Extended Treatment of Provoked Venous Thromboembolism (16:10 - 20:55)

The Good Stuff (20:56 - 22:53):

• Thrombo Trial Files (https://thrombotrialfiles.substack.com/)
• John Candy: I Like Me at the Toronto International Film Festival 
• The I'm Pharmacy podcast is now live on www.medicinepods.com 

Questions? Comments? Feedback? We’d love to hear from you! @roundstable @InternAtWork @MedicinePods

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Welcome back Rounds Table Listeners! This week, Dr. Mike Fralick sits down with Dr. Mina Tadrous, a pharmacist, researcher, Assistant Professor at the University of Toronto's Leslie Dan Faculty of Pharmacy, and host of the I'm Pharmacy podcast. If you're curious about what it takes to run a podcast, musings on the future of AI and drug discovery, and whether Mike can hold his own in a 90's-style rap battle, this is a conversation you don't want to miss. Here we go!

Check out the I'm Pharmacy podcast (new season begins 17 Sep 2025), now on https://medicinepods.com/.

Questions? Comments? Feedback? We’d love to hear from you! @roundstable @InternAtWork @MedicinePods