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The Curbsiders Internal Medicine Podcast
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The Curbsiders Internal Medicine Podcast

Author: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD

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Supercharge your learning and enhance your practice with this Internal Medicine Podcast featuring board certified Internists as they interview the experts to bring you clinical pearls, practice changing knowledge and bad puns. Doctors Matthew Watto, Stuart Brigham, Paul Williams and friends (a national network of students, residents and clinician educators) deliver a little knowledge food for your brain hole. Yummy! No boring lectures here, just high value content and a healthy dose of humor. Fantastic for Internal Medicine, Family Medicine, Primary Care, and Hospital Medicine.
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This episode is Half COVID Cakes, Half Hotcakes, and entirely enlightening.  Our guest Dr. Utibe Essien MD, MPH @UREssien and Curbsider/epidemiologist, Dr. Rahul Ganatra MD, MPH @rbganatra discuss some Hot COVID Cakes including: racial differences in COVID-19 outcomes, why dogs and dexamethasone may hold the key to defeating COVID-19, how hormonal adjunctive therapies might be key for depression, and when to poo-poo probiotics versus when a side of Lactobacillus may be beneficial.    Listeners can claim Free CE credit through VCU Health at curbsiders.vcuhealth.org (CME goes live at 0900 ET on the episode’s release date).    Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME!   Credits Written and Produced by: Rahul Ganatra MD, MPH, Emi Okamoto MD; Sarah P. Roberts MPH; and Matthew Watto MD Show Notes and CME questions by: Deborah J. Gorth ScM Cover Art: Deborah J. Gorth ScM Hosts: Matthew Watto MD; Rahul Ganatra MD, MPH, Emi Okamoto MD, and Sarah P. Roberts MPH Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Utibe Essien MD, MPH   Sponsor VCU Health CE We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org and create your FREE account!   Time Stamps 00:00 Intro, disclaimer, guest bio 02:20 Silver Linings / Picks of the Week: Chicken Run (2000) and Chicken Run 2 on Hulu; Philly Inquirer story on COVID sniffing dogs; Buy some peaches! And check out their Wikipedia page! 07:33 Hospitalizations and Mortality Among Black and White patients with COVID-19 26:10 Dexamethasone for COVID-19 28:55 Hormonal therapy for depression 38:16 Probiotics 45:00 Outro   Goal Listeners will learn about the role of race in COVID-19 outcomes, possible hormonal adjunctive therapies for depression, and when to recommend probiotics.  Learning objectives After listening to this episode listeners will…   Learn the effect of race on COVID-19 outcomes. Know the indications for adjunctive hormonal treatment for depression. Discuss the role of probiotics for the treatment of common gastrointestinal illness.    Disclosures Dr. Utibe Essien reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.    Citation Essien UR, Ganatra RB, Okamoto E, Roberts SP, Gorth DJ, Watto MF. “#223 Hot COVID Cakes: COVID19 Disparities, Steroids, Hormones for Depression, Probiotics”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. Original air date July 2, 2020.
Listen as our esteemed guest Dr. Utibe Essien MD, MPH @UREssien walks us through key terminology and evidence necessary to understand anti-Black racism in medicine. Dr. Essien provides insights into ways that racism impacts our work in the clinical and academic settings and offers approaches for addressing anti-Black racism in these settings.    Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).  Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME!   Credits Producer and Writer: Joniqua Ceasar MD, Hannah Abrams MD Cover Art: Hannah Abrams MD Infographic: Beth Garbitelli Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Joniqua Ceasar MD    Editor: Paul Williams MD, Chris Chiu MD (written materials); Clair Morgan of nodderly.com Guest: Utibe Essien MD, MPH   Sponsor We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org and create your FREE account!   Time Stamps 00:00 Intro, disclaimer, guest bio
 02:40 Guest one-liner, Picks of the Week*: Just Mercy
 09:20 Statement from the show; Importance of discussing racism in medicine
 14:11 Definitions
 18:06 Identifying how racism manifests in the clinical setting
 37:46 Ideas for advocacy
 49:50 Take points and Outro   *The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.   Goal Listeners will understand the way that structural racism pervades medicine and develop approaches for addressing the effects of racism within their clinics and communities.   Learning objectives After listening to this episode listeners will…   Define common terms: race, structural racism, white supremacy, health disparities  Develop an approach to talking to patients about the effects of structural racism on health Develop an approach for advocating to colleagues and within institutions on the effects of structural racism Identify situations in which historical myths and structural racism in medicine may alter clinician judgment: race-based formulas, disparities in pain management, and disparities in screening and treatment of common conditions.   Disclosures Dr. Essien and Dr. Ceasar report no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.    Citation Essien UR, Ceasar JN, Abrams HR, Williams PN, Watto MF. “#222 Addressing Anti-Black Racism in Medicine”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list June 26, 2020.
Throw out your down pillows and join The Curbsiders for this lively discussion on interstitial lung disease. While the hundreds of interstitial lung disease types make this topic a bit overwhelming, breathe easy knowing that pulmonologist, Dr. Erin Narewski @erinnarewski (Temple), can boil things down to an easy to approach framework in less time than it takes to complete a few 6-minute walk tests. In this episode, we walk through the classification, relevant patient history, workup, and management of interstitial lung disease.    Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).    Credits Written and Produced by: Paul Williams, MD, FACP; Nicole Kus, David Madnick, and Peter Wikoff Infographic and Cover Art: Edison Jyang Show Notes: Deborah Gorth Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Paul Williams MD, FACP (written materials); Clair Morgan of nodderly.com Guest: Erin Narewski DO, FCCP Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME!   Sponsors   Join the ACP Community! Join the American College of Physicians today! Post-training physicians can take advantage of an exclusive limited-time $100 dues discount. Visit acponline.org/member and use the code ACPDISCOUNT. Discount is only available until June 30, 2020.   VCU Health CE We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org and create your FREE account!   Time Stamps 0:00  Sponsor - Join the ACP community! Be IM Proud Visit acponline.org/member and use the code ACPDISCOUNT 00:30 Intro, disclaimer, guest bio 03:14 Guest one-liner, career advice, favorite failure, Picks of the Week*: The Strain, FX Horror TV Show; One Hundred Years of Solitude (book) by Gabriel Garcia Marquez; Hypoallergenic pillows; Peanut butter whiskey  10:02 Sponsor - Join the ACP community! Be IM Proud Visit acponline.org/member and use the code ACPDISCOUNT 11:00 Case from Kashlak, Definitions 16:40 Buckets of ILD 32:06 Discussion of testing ILD: Labs and Imaging 44:20 Imaging findings in ILD 49:44 Basic Management of ILD 61:00 Take home points and Outro   *The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.   Goal Listeners will feel comfortable with the basic pathophysiology, diagnosis, and management of interstitial lung disease.    Learning objectives After listening to this episode listeners will…   Be able to define the lung interstitium.  Develop a mental framework for the basic subtypes of interstitial lung disease.  Learn with the types of questions necessary to elucidate the pathophysiology of their patient’s ILD.  Know the steps to initiate a workup for ILD. Become familiar with the treatment strategy for ILD.      Disclosures Dr Narewski reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.    Citation Narewski E, Gorth DJ, Kus N, Madnick D, Wikoff P, Williams PN, Jyang E, Brigham SK, Watto MF. “#221 Interstitial Lung Disease with Erin Narewski DO”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list . June 22, 2020.  
We’re going upstream! Dr. Karen DeSalvo (@KBDeSalvo) talks social determinants of health, arming us with a framework to consider this very challenging aspect of patient care. As Society for General Internal Medicine President and Chief Health Officer at Google Health, she shares her clinical and public health experience, including weathering Katrina in New Orleans. While our clinical care largely focuses on the downstream medical consequences, we must recognize the upstream social context to address the barriers to health and wellbeing.    Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME!   Credits Written and Produced by: Emi Okamoto MD Cover Art: Kate Grant MBChb, MRCGP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Emi Okamoto MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Karen DeSalvo MD, MPH, MSc   Sponsor We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org for and create your FREE account!   Time Stamps Intro, disclaimer, guest bio 0:44 Dr Desalvo’s one-liner 3:34 Picks of the Week*- The Great Influenza  5:01 Dr Desalvo’s advice and past experience 6:10 Case from Kashlak 10:30 What about the evidence for social determinants? 13:40 What to do about this in the clinic, and is it worth screening? 16:06 Approaching as a team and with the community 19:40 How do we affect the upstream, before the downstream consequences? 22:40 NAM recommendations and framework 26:00 The role of technology 30:00 What the SDOH are, and who they affect 34:00 Start paying attention to SDOH 37:00 Outro 38:49   *The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.   Goal Listeners will recognize the ubiquity of SDOH and their effects on individual well-being and disease.   Learning objectives After listening to this episode listeners will…   Recognize social determinants of health and the impact on health Give a framework for how to improve patient care by focusing on social determinants Recognize how to leverage care teams and technology in innovative ways to improve health of individuals   Disclosures Dr DeSalvo was a former board member of Humana. The Curbsiders report no relevant financial disclosures.    Citation DeSalvo KB, Okamoto EE, Williams PN, Watto MF. “#217 Social Determinants of Health with Karen DeSalvo MD”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list June 18, 2020.
Answers to common questions in post-op care with our Kashlak Chief of Perioperative Medicine Dr. Avital O’Glasser. She provides updates in delirium prevention, perioperative medication management, pain control, and even clarifies a lesson from Meredith Grey about causes of post-op fever.   Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).    Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME!   Credits Written: Hannah Abrams MD, Avital O’Glasser MD Produced by, Infographic and Cover Art by: Hannah Abrams MD Hosts: Hannah Abrams MD; Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Avital O’Glasser MD (written materials); Clair Morgan of nodderly.com Guest: Avital O’Glasser MD   Sponsors   Join the ACP Community! Join the American College of Physicians today! Post-training physicians can take advantage of an exclusive limited-time $100 dues discount. Visit acponline.org/member and use the code ACPDISCOUNT. Discount is only available until June 30, 2020.     VCU Health CE We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org and create your FREE account!   Time Stamps 00:00 Sponsors 00:30 Intro, disclaimer, guest bio 02:53 Guest one-liner, Picks of the Week*: 12 Angry Men 1957 Movie; Hedwig and the Angry Inch Cast Recording; PCSSNow Buprenorphine Waiver Training for Medical Students 09:28 Sponsor -Visit acponline.org/member 10:17 Kashlak case; How to collaborate with our surgical colleagues 13:45 Questions to ask at the time of transfer
 23:00 Routine Post-Op Care: Bowel regimen, pain control, delirium prevention, glucose, antihypertensives, and nausea 44:25 Comanaging Complications and Fever/Tachycardia; Brief discussion of VTE prophylaxis
 57:55 Outro   *The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.   Goal Listeners will effectively comanage perioperative patients with surgical colleagues.   Learning objectives After listening to this episode listeners will…   Identify effective strategies to improve safety at the time of transfer acceptance. Develop an approach for asking appropriate perioperative questions to the surgical team. Recognize common mistakes that hospitalists make when accepting a transfer. Become familiar with evidence based post-operative care to prevent and treat common post-op complications Develop a differential diagnosis and management approach for post-op fever Develop a differential diagnosis and management approach for delirium   Disclosures Dr O’Glasser reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.    Citation O’Glasser AY, Abrams HR, Williams PN, Watto MF. “#219 Post-Op Care and Complications with Avital O’Glasser MD”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list June 15, 2020.
Join us as we delve into the paradigm-shifting ethos of trauma-informed care with renowned expert Dr. Megan Gerber. Dr. Gerber is an Associate Professor of Medicine at Boston University School of Medicine and serves as Medical Director of Women’s Health for VA Boston where she directs the Women’s Health Fellowship. Dr. Gerber edited the textbook, “Trauma-informed Health Care Approaches: A Guide for Primary Care.”  We discuss the framework for trauma-informed universal precautions, as well as basics about the prevalence of trauma, strategies for integrating a trauma-sensitive approach into primary care, practical changes for the office environment,  modifications for physical exam methods, and more.   We recognize this topic may bring up upsetting thoughts or memories for some of our listeners. We will provide some self-care and trauma-informed resources in our show notes. The practice of medicine, especially during times of national crisis, can increase our exposure to traumatic events and reactivate difficult memories, predisoposing folks to depression and suicide risk. We just want to reiterate that you are not alone. If you are struggling with thoughts of harming yourself, the national suicide prevention lifeline number is 1-800-273-8255.    Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).    Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!   Credits Producer/Writer/Graphics: Beth Garbitelli Co-Producer: Paul Williams MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli  Editor: Molly Heublein MD (written materials); Clair Morgan of nodderly.com Guest: Megan Gerber MD, MPH, FACP   Sponsors Join the ACP Community! Join the American College of Physicians today! Post-training physicians can take advantage of an exclusive limited-time $100 dues discount. Visit acponline.org/member and use the code ACPDISCOUNT. Discount is only available until June 30, 2020.     VCU Health CE We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org and create your FREE account!   Time Stamps Intro, disclaimer, guest bio (0:00 - 4:09) Guest one-liner (4:24) Picks of the Week*: Keep Going: 10 Ways to Stay Creative in Good Times and Bad by Austin Kleon; Pilgrim at Tinker Creek by Annie Dillard; Molly’s Challah on King Arthur Flour website from cook/food writer Molly Yeh; OXO Good Grips Stainless Steel Food Scale with Pull-Out Display; Buffy the Vampire Slayer on Hulu, Amazon Prime; Devs on Hulu, Amazon Prime; Terry Pratchett’s Discworld series (Book 1 of 40: The Color of Magic, Night Watch) and The Wee Free Men; On Becoming a Healer by Saul J. Weiner MD (10:16)  Kashlak Cases (14:39) Epidemiology of trauma (16:11) Trauma and #MeToo (19:04) Defining Trauma-Informed Care (TIC) (19:56) Integrating TIC into primary care (23:42) Screening in TIC (25:56) Containment and retraumatization (29:56) Inquiring about trauma (31:39) Recap and Office Visit Mechanics (36:24) Building the Relationship (38:56) Common Inquiry Mishaps (39:46) TIC Physical Exam (41:14) Resources for Patients (45:24) Office Environment (48:56) Provider Burnout (50:56) TIC in Covid-19 (53:24) Take-home Points (57:14) Outro (65:44)   *The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.   Goal Listeners will gain fluency in trauma-informed care practices, methods, and perspectives in order to deliver compassionate care to patients who have experienced trauma and reduce the impacts of trauma in the healthcare setting.    Learning objectives After listening to this episode listeners will…   Define trauma-informed care and discuss the various forms of trauma.  Develop increased awareness of prevalence of adverse childhood experience, post-traumatic stress disorders, sexual violence, and intimate partner violence. Foster a safe, calm, welcoming clinical environment for patients who have experienced trauma.  Manage trauma disclosures and assess appropriate next steps for care and referrals. Cultivate advanced communication skills and strategies on the topics of sexual violence, intimate partner violence, and other trauma-related experiences.  Be able to engage in harm reduction strategies when caring for patients with trauma history.      Disclosures Dr. Gerber reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.    Citation Garbitelli EC, Gerber MR, Williams PN, Heublein M, Watto MF. “#218 Trauma-Informed Care with Megan Gerber MD”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list June 8, 2020.  
Stay current with the emerging COVID-19 research including: ACTT-1 (remdesivir), triple therapy with interferon, and conundrums  about SARS-CoV-2 PCR and serologic testing. We’re led by the one and only Curbsider/internist/epidemiologist, Rahul Ganatra MD MPH (@rbganatr). And...just in case you live outside of the habitat for murder hornets and your anxiety about the pandemic had begun to abate, we touch on the CDCs guidance to beware of hungry aggressive rats. Gross!   Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME!     Credits Written and Produced by: Rahul Ganatra MD, MPH, Deborah J. Gorth ScM, Emi Okamoto MD, Sarah P. Roberts MPH, and Matthew Watto MD Cover Art: Deborah J. Gorth ScM Hosts: Matthew Watto MD, Rahul Ganatra MD MPH, Emi Okamoto MD, and Sarah P. Roberts MPH Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com     Sponsors ACP Join the American College of Physicians today! Post-training physicians can take advantage of an exclusive limited-time $100 dues discount. Visit acponline.org/member and use the code ACPDISCOUNT. Discount is only available until June 30, 2020.   VCU Health CE We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org for more information.   Time Stamps 00:00 Sponsors 00:30 Intro, disclaimer 02:40 Fomites, groceries and killer rats 08:22 Sponsor 09:22 ACTT-1 trial of remdesivir 18:22 Triple therapy with lopinavir/ritonavir, ribavarin and interferon 33:10 Background on PCR testing for SARS-CoV-2; How common are false negative PCR tests? 44:25 Serologic testing for SARS-CoV-2; Utility of antibody testing; Test characteristics 50:30 Outro   Goal Listeners will practice their critical appraisal skills as they update themselves on the latest COVID-19 research.   Learning objectives After listening to this episode listeners will... Describe the quality of evidence put forth by and the implications of the recent Lancet paper on triple therapy for COVID-19 Be familiar with the results of the ACTT-1 trial or remdesivir for COVID-19 Appreciate the complexities of PCR in testing for SARS-CoV2 Gain insight into the role of serological testing for SARS-CoV2   Disclosures The Curbsiders report no relevant financial disclosures.    Citation  Gorth DJ, Ganatra RB, Okamoto E, Roberts SP, Watto MF. “#217 COVID Cakes 4 the Fourth”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. June 1, 2020.
Learn the nuances of caring for and building relationships with patients experiencing homelessness from expert internal medicine and addiction medicine physician, Stefan Kertesz MD, return guest from Episode 74 on Opioids and Health Policy (highly recommend a re-listen, y’all!).  To teach us the tricks of the trade, Dr. Kertesz draws on his many years of treating the underserved and researching homelessness, housing, and addiction in Birmingham, Alabama, where he currently serves as professor at UAB and Birmingham VA Medical Center.  In the course of this episode, we discuss the challenge of creating a welcoming and useful space for individuals experiencing homelessness (this is the preferred term, per Dr. Kertesz), how to meet patients where they’re at--both physically and mentally--the challenge of managing diuretics for those without stable access to a bathroom (avoid, if possible), and why the foot exam is of paramount importance.    Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).    Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME!   Credits Written and Produced by Nora Taranto MD Infographics by Nora Taranto MD Cover Art by Kate Grant MBChB, MRCGP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Nora Taranto MD     Editor: Carolyn Chan (written materials); Clair Morgan of nodderly.com Guest: Stefan Kertesz MD    Sponsor We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org for and create your FREE account!   Time Stamps 00:00 Intro, disclaimer, guest bio  3:17 Guest one-liner 8:55 Picks of the Week*: Dr. Kertesz’s Book Recommendation: Saul Weiner’s On Becoming A Healer; Nora’s Pick of the week: BackStory (especially their episode on dynamite!) https://www.backstoryradio.org/  10:07 Case from Kashlak  10:56 Language: How to ask where a patient lives?  13:25 Terminology: Persons Experiencing Homelessness:  14:35 The stats on prevalence of health and illness in the homeless population, and the importance of both medical and environmental factors 20:44 How to start the visit, and how to establish trust early on?  27:40 Why is the mortality rate higher?   35:15 Special conditions and Medication Considerations: Hypertension, Diuretics, Insulin and Food Insecurity, Substance Use Disorders, Feet, and Hepatitis C  54:15 COVID and homeless healthcare 57:00 Care Models 62:30 Take Home Points and Outro   Goal Listeners will learn the unique health challenges posed to individuals who are experiencing homelessness, and the best practices for addressing these challenges.    Learning objectives After listening to this episode listeners will… Screen for and identify patients experiencing homelessness Identify the unique challenges facing this population  Identify best practices in caring for this population Differentiate between different structures of healthcare delivery, and their advantages and disadvantages for the homeless population.     Disclosures Dr Kertesz reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.    Citation Kertesz S, Taranto NT, Williams PN, Brigham SK, Chan, Caroyn, Watto MF. “#216: Homeless Healthcare with Stefan Kertesz MD”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. May 28,2020.
Chase that metronidazole with a beer! Pop some 30 year old pills! Retrain your brain as our esteemed guest Dr. Douglas Paauw goes over his popular annual ACP presentation on Medical Myths. Learn about how some common medical myths originate and continue in our practice. We discuss why it’s okay to drink on metronidazole, take expired medications, inject epinephrine into extremities and why recurrent sinusitis may not really exist.      Listeners can claim Free CME credit through VCU Health at curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).      Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME!     Credits Written and Produced by: Justin Berk, MD MPH MBA Infographic and Cover Art: Beth Garbitelli Hosts: Justin Berk, MD, MPH, MBA; Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com Guest: Douglas Paauw, MD     Sponsor We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org/ for more information.     Time Stamps 00:00 Intro, disclaimer, guest bio 02:22 Guest one-liner; Career Advice, Picks of the Week*: Being Mortal, book by Atul Gawande; The Band Played On, book by Randy Shilts; Lagunitas Hoppy Refresher: zero alcohol, zero calories! 06:15 Medical Myth Definitions 10:20 Dogma: Metronidazole and Alcohol; Healthy RCT Metronidazole and Alcohol 19:09 Expired Medications; Military Stockpiling Study 24:22 Aspirin and Nitroglycerin; Unopened eye drops; Epi-Pens; Expired Med Recap 31:13 Sinus Headaches; Trigeminal Nerve; Pearl: Recurrent headaches; Study showing Effectiveness of treatment (92%) 41:07 Epinephrine in extremity; RCT of Epi in Extremities Study showing Experts use it; Podiatry journal 48:39 Take home points and Outro   *The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.     Goal Listeners will challenge the dogma of specific medical practices that have been spread without evidence basis.     Learning objectives After listening to this episode listeners will... Counsel patients taking metronidazole on alcohol use Describe the risks associated with taking expired medications Diagnose and treat commonly defined “sinus headaches” Describe the risks associated with epinephrine injections in the extremities      Disclosures Dr Paauw reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.      Citation Pauuw D, Berk J, Williams PN, Watto MF. “#215 Medical Myths: Challenge Dogma with Dr. Douglas Paauw”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list May 25, 2020.
Elevate your critical appraisal skills as we review the first RCT of remdesivir and share the latest and greatest COVID-19 stories including: Llama antibodies, Stroke statistics, Future Waves, Exit Strategies and Awake Proning. We’re joined by everyone’s favorite Curbsider/internist/epidemiologist, Rahul Ganatra MD MPH (@rbganatra). Rahul provides critical appraisal of the newest randomized control trial (RCT) on remdesivir from the Lancet, and gives us a lesson on why statistical power is so important to consider. We also share updates on strokes, awake proning, pandemic predictions, and we reveal another reason to love llamas (besides those luscious lashes). Llama mia, here we go again!   Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME!     Credits Written and Produced by: Sarah P. Roberts MPH, Rahul Ganatra MD, MPH, Emi Okamoto MD, Paul Williams MD and Matthew Watto MD Cover Art: Beth Garbitelli Hosts: Sarah P. Roberts MPH, Matthew Watto MD, Paul Williams MD, Rahul Ganatra MD MPH, Emi Okamoto MD    Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com     Sponsors We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org for more information.   Time Stamps 00:00 Intro 02:10 Fun animal facts: Llama antibodies 09:10 Remdesivir RCT by Wang et al 12:40 Power and Sample Size 16:32 Baseline Characteristics, Results and Author’s conclusions 19:15 Rahul’s conclusions: How chance and bias effected the results 24:00 Right censoring; Viral load and timing of antivirals 30:30 Final thoughts on Remdesivir RCT by Wang et al; Looking ahead to the NIAID (ACTT) trial 33:53 Are patients really having less strokes and heart attacks? 38:20 Awake proning 43:30 Paul teaches us not to use the term “happy hypoxemic” 45:00 CIDRAP viewpoint on future waves and exit strategies 50:22 Outro   Goal Listeners will hone their skills in critical appraisal as they update themselves on all things COVID-19   Learning objectives After listening to this episode listeners will... Critically appraise recent research on remdesivir as a treatment for COVID-19 Recognize the consequences of COVID-19 on strokes Discuss the potential benefits of proning for COVID-19 patients Describe different scenarios likely for the pandemic’s future     Disclosures The Curbsiders report no relevant financial disclosures.      Citation Ganatra R, Okamoto E, Williams P, Roberts SP, Watto MF. “#214 COVID Cakes 3: Llamas, Remdesivir, Strokes, Predicting the Future, and More!”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list May 18, 2020.
Listen as our esteemed guest Dr. Nina Mingioni walks us through her approach to fatigue, from differential diagnosis, to the evidence behind physical exam, laboratory workup, and beyond!   Listeners can claim Free CME credit through VCU Health at curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).    Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!   Credits Writer, Producer, Infographic, and Cover Art: Hannah R. Abrams Hosts: Hannah R Abrams, Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com Guest: Nina Mingioni MD, FACP   Announcement Join in! We’re hosting a LIVE! COVID Cakes discussion of Remdesivir and other hot COVID-19 stories this coming Tuesday May 12, 2020 at 8:30 pm ET @thecurbsiders on Twitter and Periscope!   Sponsor We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org/ for more information.   Time Stamps 00:00 Intro, disclaimer, guest bio and a bad pun 03:00 Guest one-liner 07:10 Case from Kashlak, Defining fatigue; Taking a general history 11:36 Most common causes of fatigue and how to elicit them from the history 20:39 Physical exam for fatigue; Medications that cause fatigue; 25:25 Exam findings and LRs for anemia; Sleep apnea 30:55 Lab workup for fatigue; Expanded testing: Ferritin, Vitamins, EBV, Rheumatologic diseases, Celiac disease, Lyme 47:55 Spiel to the patient when no answer is found 51:14 Other diagnoses to consider: Fibromyalgia, Myalgic Encephalomyelitis 55:09 Take home points and Outro   Goal Listeners will develop an approach to caring for patients with fatigue symptoms.   Learning objectives After listening to this episode listeners will…   Identify top causes of fatigue Develop an evidence-based approach to assessing a patient with fatigue Describe evidence-based screening tools for fatigue   Disclosures Dr. Mingioni reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.    Citation Mingioni N, Abrams HR, Williams PN, Watto MF. “#213 Fatigue for Primary Care with Nina Mingioni MD”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. Air date May 11, 2020.
Summary Crush those 11 pm “STAT: Patient agitated” pages with this expert guide to assessing for and treating alcohol withdrawal!  Dr. Joji Suzuki MD, addiction psychiatrist extraordinaire at the Brigham and Women’s Hospital, walks us through how to think about the risk of severe withdrawal, the different ways to manage it, and how to engage with patients as they’re leaving the hospital. In the course of this Car-Talk (well, not exactly the same as the critically acclaimed radio show, but he did record in his car….), Dr. Suzuki demystifies withdrawal and debunks some common myths: that we must manage withdrawal inpatient, that banana bags are the cure to a hangover and alcoholic malnutrition, and that we tend to under-medicate with benzos (actually, it’s the opposite!).     Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME   Credits Written and Produced by Nora Taranto MD  Infographic and Cover Art by: Nora Taranto MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Cyrus Askin MD, Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Joji Suzuki MD    Announcement Join in! We’re hosting a LIVE! COVID Cakes discussion of Remdesivir and other hot COVID-19 stories this coming Tuesday May 12, 2020 at 8:30 pm ET @thecurbsiders on Twitter and Periscope!   Sponsor We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org for more information.   Time Stamps 00:00 Intro, disclaimer, guest bio 02:52 Guest one-liner; Career advice; Picks of the Week*: Why We Do What We Do (book); Fargo (film) 08:10 A Case from Kashlak and Screening for Alcohol Use and Severe Withdrawal Risk 17:32 Outpatient Versus Inpatient Treatment 25:27 Gabapentin for alcohol withdrawal 27:10 Indicators for ICU level Care 31:53 Symptom-Driven versus Fixed-Dose Protocols , Benzos vs. Barbs 36:55 And which benzo?   39:47 A Natural History of Withdrawal 44:10 Banana Bags and Thiamine Deficiency 48:17 The Transition Home: Naltrexone, Bridge Clinics, and Motivational Interviewing 56:36 Outro and Bonus clip   *The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.   Goal Listeners will be able to screen patients for risk of alcohol withdrawal and decide on management strategies that are individualized to the patient.    Learning objectives After listening to this episode listeners will… Screen and identify for patients at high risk of withdrawal  Identify who would benefit from inpatient withdrawal, and ICU vs floor level care   Identify the best withdrawal management protocol  List indications and contraindications of first line therapy for alcohol use disorder.   Disclosures Dr Suzuki reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.    Citation Suzuki J, Taranto NT, Williams PN, Askin C, Watto MF. “#212 Sober Talk: Managing Alcohol Withdrawal with Joji Suzuki, MD”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list May 7, 2020.
In this episode we tackle treatment with remdesivir, management with anticoagulation, and presymptomatic transmission. Welcome back to COVID Cakes, a rundown of recent COVID articles and news stories. What does the latest Gilead medication have to offer? Why should we wear masks? And if you thought 6 feet was THE safe distance…we’ve got some bad news about running. But it’s not all bad! We’re joined by everyone’s favorite Curbsider/Internist/Epidemiologist, Rahul Ganatra MD MPH (@rbganatra), who provides critical appraisal of the newest COVID-19 treatment article. Pull up a chair, bring your own syrup, and join us!    Listeners can claim Free CME credit through VCU Health at curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).    Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME!   Credits Producer: Sarah P. Roberts MPH, Rahul Ganatra MD MPH, Emi Okamoto MD    Writer: Emi Okamoto MD, Rahul Ganatra MD MPH,     Cover Art: Chris Chiu MD Hosts: Chris Chiu MD, Rahul Ganatra MD MPH, Emi Okamoto MD    Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com   Sponsors Apollo If you’re a healthcare worker looking for an opportunity to volunteer with the COVID relief efforts or you’ve been furloughed and are in need of work, please check out apollohct.com to see jobs and volunteer opportunities in your area and across the states. All you have to do is make a profile, input your preferences, and Apollo will do the searching for you.   VCU Health Continuing Education We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org for more information.   Time Stamps 00:00 Sponsors, Intro, disclaimer 02:30 Picks of the Week 6:36 Remdesivir trial rundown 21:52 Thrombosis in COVID-19 29:50 Asymptomatic/Presymptomatic transmission 41:42 Quick takes 49:00 Outro   Picks of the Week / Links You Bet Your Garden podcast with Mike McGrath Ologies podcast with Alie Ward Frosted Mini Wheats   Goal Listeners will hone their skills in critical appraisal as they update themselves on all things COVID-19   Learning objectives After listening to this episode listeners will... Critically appraise recent research on remdesivir as a treatment for COVID-19 Review emerging literature and guidelines on thrombotic complications of COVID-19  Interpret new data on asymptomatic transmission of COVID-19    Disclosures The Curbsiders report no relevant financial disclosures.    Citation Ganatra R, Chiu CJ, Okamoto E, Roberts SP, Watto MF. “COVID Cakes: Remdesivir, anticoagulation, and presymptomatic transmission”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list April 29, 2020.
Get inside the black box of transplant medicine as we discuss: Kidney transplant for the internist. Join Dr. Cyrus Askin, @askins_razor, one of our Curbsiders Correspondents, as he teams up with the fine folks from freely Filtered in this NephMadness episode exploring topics in kidney transplant! On this show, the gang turns to Dr. Samira Farouq, @ssfarouk, a Mount Sinai transplant nephrologist, to take the reins during this guided tour of concepts in transplant medicine that internists should be familiar with. During this episode, you’ll learn about indications for kidney transplant, immunosuppressive agents, what to watch out for in your post-transplant patients and so much more! And of course, we will talk a little NephMadness as we wrap things up. So maybe you need to learn about kidney transplant or perhaps you’re still mourning the loss of March Madness 2020 - either way, we encourage you to take a listen and hope you’ll enjoy!   Listeners can claim free CE credit for this episode at curbsiders.vcuhealth.org (goes live at 1200 ET on the episode’s release date).    Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME   It's time for NephMadness 2020! Fill out your bracket before the April 30, 2020 deadline and be sure to list The Curbsiders as your team.  Read this year’s region posts here. Submit an individual or team bracket here. Discuss your picks with #NephTwitter!   Credits Written and Produced by: Cyrus Askin MD, Matthew Watto MD and the Freely Filtered Crew Infographic: Cyrus Askin MD Cover Art: Kate Grant MBChB DipGUMed Hosts: Cyrus Askin MD, Joel Topf MD, Samira Farouk MD, Swapnil Hiremath MD, Jennie Lin MD & Matt Sparks MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com   Sponsor We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org for more information.   Time Stamps 00:00 Announcement, Intro to Freely Filtered and NephMadness 04:00 Case of advanced CKD; Who/when to refer for transplant 12:05 Benefits of renal transplant 16:22 Counseling patients with advanced CKD about transplant and a bit on living donors 20:40 Medications after transplant; Drug-drug interactions 25:50 Dr. Sparks’ 30 second exam for the transplant patient; Diarrheal illness 32:07 Calcineurin inhibitor levels 36:42 Prophylaxis for long term complications 40:21 Allograft rejection; BAMF criteria 50:40 Cardiovascular risk; Statins 56:11 Malignancy after kidney transplant 60:00 NephMadness Transplant Region: Biomarkers vs Biopsy 72:23 Outro   Goal Listeners will learn valuable skills to assist in the management and counseling of pre- and post- kidney transplant patients.   Learning objectives After listening to this episode listeners will…   Recognize the criteria for kidney transplant referral and evaluation, as well as the importance of referring a patient as soon as they are eligible.  Be able to counsel a patient regarding what to expect before, during and after the transplant process. Know the main classes of medication used after patients have received transplants, to include their side effects and any relevant monitoring.  Be familiar with the different types of rejection, the clinical signs/symptoms of rejection and the utility / limitations of kidney biopsy. Be able to discuss the post-transplant complications of kidney transplantation (cardiovascular, malignancy, etc.) as well as what type of prophylactic medications should be considered in these patients.   Disclosures Drs. Cyrus Askin MD, Samira Farouk MD, Swapnil Hiremath MD, Jennie Lin MD & Matt Sparks MD report no relevant financial disclosures. Dr. Topf has received honoraria from Astra Zeneca and Cara Therapeutics. He is joint venture partner in Davita Dialysis centers receiving dividends. The Curbsiders report no relevant financial disclosures.    Citation Cyrus A, Topf J, Farouk S, Swapnil H, Lin J, Sparks M, Watto MF. “#210 NephMadness: Kidney Transplant for the Internist”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. April 27, 2020
LIVE! from VCU, we discuss why and how to use Twitter and other Social Media platforms as a clinician educator. Guest Michelle Brooks MD (@michellebrooksMD, VCU) shares her Twitter origin story along with pearls on how to use Twitter for digital scholarship #meded, networking and how to stay out of trouble on social media.     Check out this recent paper on Twitter in #Meded by Dr. Brooks and friends [Drs. Rebecca Jaffe, Tony Breu, Charlie Wray, Margaret Chapman and Avital O’Glasser (Kashlak Chief of Periop Medicine)]!   Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!   Credits Written and Produced by: Matthew Watto MD, FACP Infographic: Michelle Brooks MD Cover Art: Matthew Watto MD, FACP Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Clair Morgan of nodderly.com Guest: Michelle Brooks MD   Sponsor We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out https://curbsiders.vcuhealth.org/ for more information.   Time Stamps 00:00 Guest one liner, favorite failure, career advice,  08:08 Picks of the week*: Culture Code (book) by Daniel Coyle; Crucial Conversations (book); Teaching Naked (book); Dark Crystal (Netflix series); The Outsider (HBO series) 11:23 Case of Sosh Al Media; Landscape of social media; Control your digital footprint; Public vs Private profiles 23:04 Negative aspects of social media 26:44 How to utilize Twitter for medical education; Twitter basics; Milton Packer 37:14 Pros and Cons of #medtwitter 42:02 Tweetorials 44:28 Audience questions: Repercussions from posting on social media; Social Media fellowships; Advocacy on social media 51:34 Outro    *The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.   Goals Listeners will develop a framework on how Twitter can be used for scholarship and medical education.   Learning objectives After listening to this episode listeners will... Define the landscape of digital media platforms available to the modern medical educator Discuss how digital platforms can be used to promote career development through digital scholarship Explain how Twitter is being used to disseminate medical education, future directions and concerns that have been raised.    Disclosures Dr Brooks reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.    Citation Brooks M, Williams PN, Brigham SK, Watto MF. “#209 LIVE! Twitter, Social Media and Digital Scholarship”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date April 23, 2020.
Fall in love with the thyroid all over again, as we deconstruct hypothyroidism with thyroid expert, Susan Mandel MD, MPH (PENN). We review common causes, symptoms, diagnosis and treatment and how these may differ for those who are Pregnant, over age 65, or have existing Heart disease. Plus, Dr Mandel schools us on her approach to treatment with levothyroxine (T4), and even explains when she trials liothyronine (T3) replacement! Warm up those thumbs for the thyroid exam...it’s on!   Listeners can claim Free CME credit through VCU Health at https://vcu.cloud-cme.com/default.aspx?P=0&EID=18031 (CME goes live at 1200 PM ET on the episode’s release date).    Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com |   Credits Written and Produced by: Elena Gibson MD  Cover art and Infographic by: Dr Kate Grant MBChb MRCGP Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Emi Okamoto (written materials); Clair Morgan of nodderly.com Guest: Susan Mandel MD, MPH   Sponsor We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer continuing education credits for physicians and check out https://vcu.cloud-cme.com/default.aspx?P=0&EID=18031  for more information.   Time Stamps 00:00 Intro, disclaimer, guest bio
 02:43 Guest one-liner; Pick of the week: Waiting for Godot (Play); Favorite Failure; Career Advice
 09:40 Case from Kashlak Part one; Hypothyroidism signs and symptoms
 13:20 When to Test for Hypothyroidism 
 17:43 Biotin interaction
 19:49 Which thyroid tests should we order?
 26:15 Subclinical hypothyroidism
 29:00 Etiology/Types of hypothyroidism 
 33:30 Case from Kashlak Part two; Initial Medication dosing; Physical Exam
 37:10 Levothyroxine replacement time of administration
 42:10 TSH goal 
 46:00 Levothyroxine manufacturers
 48:33 Dosing in older adults
 50:27 T3 treatment
 56:52 Pregnancy
 59:42 Dose adjustments
 61:43 Estrogen and thyroid binding protein 
 63:33 Who needs a referral?
 65:40 Plugs, Outro
   Goal Listeners will develop an approach to the diagnosis and management of patients with hypothyroidism.   Learning objectives After listening to this episode listeners will…   Recognize the different etiologies of hypothyroidism. Identify signs and symptoms of hypothyroidism. Develop an approach to diagnosing and treating hypothyroidism. Define subclinical hypothyroidism and when to treat it.  Recognize how pregnancy influences hypothyroidism management. Be able to counsel patients on treatment for hypothyroidism.   Disclosures Dr. Mandel reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.    Citation Mandel S, Gibson EG, Grant K, Williams PN, Brigham SK, Okamoto E, Watto MF. “Hypothyroidism”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list April 20, 2020.
Welcome to The Curbsiders tutorial on how to create your own medical podcast. @doctorwatto and @paulnwilliamz walk you through how to conceptualize your podcast, build your team, choose your equipment and the basics of how to setup hardware and software recording. Be sure to browse the accompanying show notes for a true step-by-step guide complete with links to videos, web pages, and blog posts that we found helpful when starting our show. If it’s not in this document, then it can easily be found on YouTube, or via a Google search.   Credits Written and produced by: Matthew Watto MD Cover art and Infographic by Matthew Watto MD Hosts: Matthew Watto MD and Paul Williams MD Editor: Clair Morgan of Nodderly.com   Time Stamps 00:00 Announcement, Intro, Disclaimer 02:53 Our top podcasting pearls 07:01 Find your niche 09:46 Logistics 13:25 Business, finances and legal matters 14:40 Equipment 21:48 Recording and editing 24:56 Website, web and media hosting 28:53 How to setup and record your podcast 35:08 Editing software 35:58 Search engine optimization 37:45 Post-processing 39:49 Take home points and outro   Disclosures The Curbsiders report no relevant financial disclosures.    Goals Listeners will develop a framework for how to create a medical podcast from the original idea to software, equipment, recording and a bit about editing.   Learning objectives After listening to this episode listeners will...    Define your podcast’s content, and who it's for   Conceptualize the logistics of recording a podcast Recall the necessary equipment and software for a medical podcast BRIEFLY discuss podcast editing Talk about how to disseminate a medical podcast (website, media host) Review the potential pitfalls and nuances, like intellectual property considerations, SEO, branding, etc.   Citation Watto MF, Williams PN. "#207 How to create a medical podcast: Tales from The Curbside". The Curbsiders Internal Medicine Podcast https://thecurbsiders.com/episode-list. Air date April 16, 2020.  
Breathe easy with these airway management principles and expert tips for managing the patient with COVID-19 related lung disease (i.e. pneumonia, hypoxemia, ARDS). In the COVID-19 era, non-intensivists are being called upon to care for critically ill patients across the globe. At the Curbsiders, we understand that this can be a stressful proposition! Therefore, we’ve enlisted the help of the renowned medical intensivist & USUHS Chair of Medicine, Dr. Kevin Chung (@chungk1031) to teach us what we need to know about airway management  in these challenging times.   Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com    Credits Written and Produced by: Cyrus Askin MD, Michael Rose MD, Kathleen Hiltz MD Show Notes: Cyrus Askin MD Infographic: Elena Gibson, MD Cover Art: Dr. Kate Grant MBChB DipGUMed Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Cyrus Askin, MD    Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com Guest: COL Kevin Chung, MD, FACP   Sponsor AccessMedicine is the acclaimed online medical resource that features Harrison's Principles of Internal Medicine and more trusted content from the best minds in medicine. Visit  AccessMedicine to learn more: http://bit.ly/MHCurbsiders.   Time Stamps 00:00 Sponsor - AccessMedicine by McGraw Hill http://bit.ly/MHCurbsiders  00:15 Disclaimer, intro, guest bio 03:15 Guest one liner, chicken wings (Miller Lite marinade), career advice 07:40 Sponsor - AccessMedicine by McGraw Hill http://bit.ly/MHCurbsiders  08:20 Case of hypoxemic respiratory failure; Rapid evaluation, initial labs 16:03 Initial assessment of a COVID-PUI; HFNC and non-invasive ventilation 23:40 Proning patients for hypoxemia 29:15 ARDS basics: diagnostic criteria, Brief Recap 33:22 Mechanical ventilation: Initial settings, following the blood gas 40:55 Peak and plateau pressure, Lung compliance and  Troubleshooting a high pressures 51:30 Ventilator dyssynchrony; Lung compliance and traditional ARDS vs COVID-19 lungs 62:55 Advanced ARDS - The 5 Ps of therapy and differences with COVID-19 68:10 Take home points; Plugs; Outro   Links Internet Book of Critical Care (IBCC) Podcast by Dr. Josh Farkas - COVID-19 Dr. Jessica Bunin’s Video Lecture on Vent Basics for Non-Intensivists COVID-19 Toolbox One-Stop for some COVID-19 video content, also on the COVID-19 Toolbox Site   Goal Listeners will be equipped with the basics to provide ventilatory support, to include the use of mechanical ventilation, for critically ill patients in the COVID-19 era.   Learning objectives After listening to this episode listeners will…   Appreciate the unique challenges faced by the medical community as pertaining to the current COVID-19 pandemic. Be familiar with fundamentals of critical care as pertaining to airway management. Define the diagnostic criteria of ARDS and appreciate early clinical signs that may indicate a patient is developing ARDS. Review the various non-invasive methods of assisting with oxygenating & ventilating a patient (NC, NRB, HFNC, NIPPV, etc.) and any key contraindications. Recognize signs suggestive of impending respiratory failure requiring invasive mechanical ventilation (i.e. indications for intubation). Be familiar with basic ventilator parameters, basic terminology / modes. Know initial vent settings for a patient with resp failure / ARDS based on ARDSnet data. Have an approach to titrating vent settings based on physiologic parameters & the blood gas. Know special considerations for management of ARDS in a patient with COVID-19. Be familiar with advanced management strategies for patients with ARDS such as proning and paralysis   Disclosures Dr. Chung reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.    Citation Chung, K, Askin C, Rose M, Hiltz K, Gibson E, Williams PN, Watto MF. “206 Airway Management for the Non-Intensivist”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list 04/13/2020.\
Rundown of recent COVID articles and news stories including: Hydroxychloroquine and azithromycin, serologic testing, use of convalescent plasma, economic inequality / health disparities... and COVID in cats?! We’re joined by Curbsider/Internist/Epidemiologist, Rahul Ganatra MD, @rbganatra (VA Boston) who provides critical appraisal of the article that inspired Trump’s infamous hydroxychloroquine and azithromycin comment. Plus, @Paulnwilliamz and @cjchiu give us  some telehealth along with the usual antics.    Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com    Credits Written, Produced by: Rahul Ganatra MD, Chris Chiu MD, FACP, FAAP; Matthew Watto MD, FACP; Paul Williams MD, FACP Cover Art and Show Notes by: Matthew Watto MD, FACP Hosts: Chris Chiu MD, FACP, FAAP; Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Matthew Watto MD  Guest: Rahul Ganatra MD   Time Stamps 00:00 Intro, COVID-19 and cats by Shi J Science Apr 2020; Picks of the week: Kimberly Manning thread Frontline-ish; Steak Umm thread; Some Good News YouTube Channel by John Krazinski 07:08 Telehealth (Greenhalgh BMJ 2020), Breathlessness (Roth score calculator), ACP COVID-19 resource site 11:50 Telehealth best practices: Postpone routine therapy, Choose therapy that doesn’t require monitoring Treat empirically, Only order tests that will change management, Keep people out of the ED (see attached); Doximity dialer for video calls is in Beta testing 16:42 Convalescent plasma and Serology (Chenguang JAMA “Trial” of Convalescent Plasma; Nat’l Academy Sciences 10 pt study; COVID-19 Insights Blog by Bill Rodriguez; FDA Press Release re: SARS-CoV-2 Serologic Testing; FDA Emergency Auth for Rapid IgG/IgM  21:45 Chris discusses the decontamination of N95 masks using CCDS (CCDS, Battele news Report) 23:45 Inequality during the pandemic VOX and NYTimes articles on inequality 25:30 Hydroxychloroquine background; Rahul provides critical appraisal for HCQ + azithromycin article from France (Gautret et al IJAA 2020) and Rahul’s tweetorial  49:18 Pre-print data; Rahul discusses a newer HCQ randomized clinical trial article (Chen medRxiv 2020) 43:05 Outro   Goals Listeners will hone their skills in critical appraisal as they update themselves on all things COVID-19   Learning objectives After listening to this episode listeners will... Discuss the limitations in the evidence for hydroxychloroquine and azithromycin as treatment for COVID-19 Discuss some challenges of telehealth during the COVID-19 pandemic Be aware of racial disparities during the COVID-19 pandemic Explain the rationale for serologic testing and the use of convalescent plasma in COVID-19 disease   Disclosures Dr Ganatra reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.    Citation Ganatra R, Williams PN, Chiu CJ, Watto MF. “#205 COVID Cakes and Hotakes with Rahul Ganatra MD”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list April 10, 2020.
Get under the hood of SGLT2 inhibitors! Listen as our guests Dr. Harish Seethapathy, Dr. Matt Sparks, and Dr. Joel Topf give us a tour through the NephMadness 2020 SGLT2i region! How do these promising drugs work, and what evidence is there for using them in non-diabetic kidney disease or kidney transplant patients.   Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com   Credits Written and Produced by: Hannah R. Abrams Cover Art and Infographic by: Hannah R. Abrams Hosts: Hannah R Abrams, Matthew Watto MD, FACP    Editor: Clair Morgan of Nodderly.com (audio), Emi Okamoto MD (written) Guests: Harish Seethapathy MD; Matthew Sparks MD; Joel Topf MD   Sponsors AccessMedicine is the acclaimed online medical resource that features Harrison's Principles of Internal Medicine and more trusted content from the best minds in medicine. Visit  AccessMedicine to learn more: http://bit.ly/MHCurbsiders.   Join The Curbsiders!  Pre-med and medical students, we need your help with production of the show! You’ll learn all aspects of podcasting, get to network with national thought leaders and join an amazing global team of Curbsiders. We are especially in need of folks with experience creating video content, developing websites and using social media tools. Application deadline is Friday April 10, 2020. Send an email to thecurbsiders@gmail.com and include the following:   [  ] A half page on why you’d make a great Curbsider [  ] A copy of your CV [  ] Your social media handles on Instagram, Twitter, etc.  [  ] Samples of prior work (e.g. videos, websites, etc.)   Time Stamps 00:00 Sponsor 00:26 Intro, disclaimer, guest bio 02:57 Guest one-liner and Pick of the Week: Michael Pollan audiobook on Coffee and Caffeine Addiction 03:52 SGLT2i definition, background, and why we now consider CV endpoints in diabetes 11:16 Sponsor 12:00 Tubuloglomerular feedback; Balloon analogy 17:40 Other mechanisms for SGLT2i 23:05 Back to the case; Risks from SGLT2i; Counseling and Monitoring 34:18 SGLT2i for non-diabetic kidney disease; Possible mechanisms: Joel’s caution against early adoption 41:42 SGLT2 inhibitors in kidney transplant 45:20 Take home points and picks for the SGLT2 inhibitor region 49:50 Outro   #NephMadness 2020: SGLT2i Region – AJKD Blog   Goal Listeners will recognize the different potential mechanisms for SGLT2i mechanisms and the different populations which may derive benefit from treatment.    Learning objectives After listening to this episode listeners will…   Identify the theorized mechanism by which SGLT2i improve outcomes through their effect on tubuloglomerular feedback and other theorized mechanisms for SGLT2i effects Develop a pathophysiological understanding of SGLT2i adverse effects, including acute decrease in GFR and genital infections Recognize the potential benefit of using SGLT2i in non-diabetic patients, including for kidney disease, heart failure, and kidney transplant   Disclosures The Curbsiders report no relevant financial disclosures. Drs. Seethapathy and Sparks report no relevant financial disclosures. Joel Topf lists the following on his blog “I have an ownership stake in a few Davita run dialysis clinics and a vascular access center. Takeda Oncology made a donation to MM4MM the program that is taking me to Mount Everest in 2018.”   Citation Seethapathy H, Abrams HR, Okamoto E, Sparks M, Topf J, Watto MF. “#204 NephMadness 2020: SGLT2 Inhibitors”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list April 6, 2020.
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Comments (4)

David Clements

Thanks for info about the Abbott SARS-cov-2 IgG blood test. Note that Labcorp exclusively uses this test. Quest uses this test for some samples.

Jun 10th
Reply

setareh abdoli

very good but please attach algorithm and link

Dec 20th
Reply

Daniel B

Amazing podcast for medical students. Highly recommend!

Sep 29th
Reply

Aman Kaur

Internal medicine

Jun 21st
Reply
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