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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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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.
Create your own online curriculum for #meded with this Step-by-Step guide for medical educators by Drs. Kat Zechar MD, @inked_caduceus and Amreet Sidhu MD, @Brosencephalon. They teach us how to identify learner’s needs and develop an online curriculum complete with self assessment tools, remote lectures, audio & video content and interactive cases. We discuss specific software tools and the basic hardware that you’ll need to get your online meded curriculum up and running. You should also check out this guide to building your online curriculum at https://www.brosencephalon.com/onlinecurriculum.    Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com    Credits Written and Produced by: Paul Williams MD, FACP Cover art and Show notes by: Matthew Watto MD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Kat Zechar MD and Amreet Sidhu MD   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 Announcement: We’re looking for pre-med and medical Student members. Send applications to thecurbsiders@gmail.com by deadline April 10, 2020. 01:22 Intro, disclaimer and guest bios 03:38 Guest one-liners, Picks of the week*: Gumption (book) by Nick Offerman; Man Search for Meaning (book) by Viktor Frankl; Death Stranding (videogame); Alita: Battle Angel (film) 09:30 Why you might need an online meded curriculum 16:33 Overview of Amreet and Kat’s online curriculum 21:15 Website, domain name, media hosting, software (Vimeo, Zoom meeting software) and WordPress plugins; Zoom can record audio, video or screen recording (i.e. for a speaker going through slides) and equipment 36:35 How to generate self-assessment tools: ABIM blueprint, quiz questions and interactive cases (from twinery.org) 46:35 Time commitment 50:55 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.   Goals Listeners will learn the basic tools needed to develop their own online curriculum and educational model.   Learning objectives After listening to this episode listeners will... Outline the benefits of creating an online curriculum. Identify the necessary tools to create an online curriculum. Recognize the potential benefits and pitfalls of asynchronous education. Discuss the learning theory that supports asynchronous learning. Explain how an existing curriculum can be quickly modified to adapt to evolving learner needs.   Disclosures Drs. Sidhu and Zechar report no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.    Citation Sidhu A, Zechar K, Williams PN, Watto MF. “#203 How to Create an Online Curriculum for Medical Education”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. April 2, 2020.
LIVE! from Mayo Clinic, a practical approach to lymphadenopathy with Carrie Thompson MD @cathompsonmd (Hematology Oncology, Mayo Clinic). Dr. Thompson provides her simplified approach to the history, differential diagnosis, high yield lab testing, imaging, how to counsel patients with adenopathy and tips on when, where and how to biopsy!   Special Thanks! The Curbsiders are insanely grateful to the Mayo Clinic  Internal Medicine Residency Chief Residents @mayomn_imres (@JasonEckmannMD @SamiRyanMD @BHuffmanMD @CourtHarrisMD) and their amazing program director @AmyOxentenkoMD for an amazing trip to Rochester!    Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com     Credits Written and Produced by: Carrie Thompson MD and Matthew Watto MD, FACP Infographic: Matthew Watto MD, FACP Cover Art: Kate Grant MBChB DipGUMed Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Carrie Thompson MD   Join The Curbsiders!  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 Announcement: We’re looking for Medical Student members. Send applications to thecurbsiders@gmail.com by April 10, 2020. 01:20 Intro, guest bio, one-liner, career advice; Pick of the week*: In Shock by Rana Awdish
 07: 00 Lymphatic system 
09:19 Differential diagnosis for lymphadenopathy
 11:38 Taking a history (ALL AGES mnemonic), Red Flags
 19:15 Physical exam for lymphadenopathy 
22:30 Which labs to order; Flow cytometry 
26:05 Imaging 
28:30 Counseling patients with LAD
 31:10 Biopsy: How to choose type and location
 37:35 Take Home Points 
39:00 Audience Questions
 42:25 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 and systematic approach to evaluating the patient with lymphadenopathy.    Learning objectives After listening to this episode listeners will... Describe differential diagnosis of enlarged lymph nodes. Summarize the evaluation of lymphadenopathy. Identify the most appropriate type and timing of lymph node biopsy.   Disclosures Dr Thompson reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.    Citation Thompson C, Williams PN, Brigham SK, Watto MF. “#202 LIVE! Lymphadenopathy: Taking Your Lumps”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. March 30, 2020.
Listen as the pioneers of the COVID pandemic share their experiences taking care of some of the first COVID patients in the US. Our guests have a broad range of expertise and experiences. This episode features hospitalist Dr. Francisco Alvarez (University of California at San Francisco, @fnalvarez), Infectious Disease fellow Dr. Karolina Maciag (University of Washington, @KMaciag), Critical Care and Pulmonology Fellow Dr. David Furfaro (Columbia University, @david_furfaro) and intensivist and founder of onepagericu.com, Dr. Nick Mark (Seattle, WA).   Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com    Credits Written and Produced: Justin Berk MD MPH MBA Cover Art: Kate Grant MBChB DipGUMed Hosts: Justin Berk MD MPH MBA; Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Dr. Francisco Alvarez, Dr. Karolina Maciag, Dr. Dave Furfaro, Dr. Nick Mark   Sponsor Primary Care Internal Medicine of Ithaca Join a well established practice in beautiful upstate New York near the finger lakes and wine country! You'll have flexible hours and the ability to take the time you need with patients! Contact Dr. Ann Costello arcostello@gmail.com to find out more about this incredible opportunity to join the team at Primary Care Internal Medicine of Ithaca https://www.primarycareinternalmedicineofithaca.com/.   Time Stamps 00:00 Sponsor - https://www.primarycareinternalmedicineofithaca.com/. 00:20 Intro, disclaimer, guest bios and a bad pun 04:28 Francisco: Process leading up to first case 07:42 Karolina: The perspective of the consultant- calm in the storm 11:40 (Karolina) Seattle Flu Study as early warning 16:00 Dave: ICU patients 20:30 Nick: making decisions with a moving target     25:05 Sponsor - https://www.primarycareinternalmedicineofithaca.com/. 25:53 Francisco: data available on Twitter 28:00 Francisco: the role of generalist during the COVID pandemic 31:15 Karolina: on vulnerable populations during pandemic 38:26 Dave/Nick: how generalists should be preparing themselves 45:16 Avoiding aerosolized procedures / nebulizers 47:46 What was the big surprises 54:20 How do you address the anxiety 60:12 Plugs64:20 Outro   Links* The Seattle Flu Study research team helped identify first patterns of COVID in the US A New York Times article highlighted the story of the Seattle Flu Study  was one of the first  A published case series of the first 12 US COVID patients (Dr. Alvarez is a co-author) The CDC offers a very comprehensive video for donning and doffing A previous “Things We Do For No ReasonTM” article suggests MDIs are non-inferior to nebulizer treatments COVID Communications Guide CardioNerds: Episode #20: COVID-19 in the ICU UW COVID Resource Site OnePagerICU.com   Goal Listeners will recall the perspectives of the first providers taking care of COVID patients and will be able to apply some of their insights to when the epidemic hits their region.   Learning objectives After listening to this episode listeners will…   Be familiar with the ICU and hospitalist challenges in taking care of COVID patients. Describe how to learn new information and connect with others in the COVID community. Recognize the social challenges associated with the epidemic for patients and providers.   Disclosures Drs. Maciag, Mark, Alvarez, and Furfaro report no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.    Citation Alvarez, F, Maciag K, Furfaro D, Mark N, Berk, JB, Williams PN, Watto MF. “#201: COVID Narratives: Stories from Physicians at the Front Lines”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. March 26, 2020.
Practical tips and discussion of what we do and don’t know about COVID-19 transmission, testing, NSAIDs, ACE inhibitors, quarantine, treatment, personal protective equipment (PPE) and more with Paul Sax MD, @paulsaxMD (Brigham and Women’s Hospital/Harvard Medical School). This episode is sure to go viral! Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com    Credits Written and Produced by: Sarah Phoebe Roberts MPH; Chris Chiu MD; Beth Garbitelli; Hannah Abrams; Rahul Ganatra MD, MPH; Matthew Watto MD, FACP Cover Art and Infographic by: Beth Garbitelli Hosts: Rahul Ganatra MD, MPH; Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Paul Sax MD   Sponsor Primary Care Internal Medicine of Ithaca Join a well established practice in beautiful upstate New York near the finger lakes and wine country! You'll have flexible hours and the ability to take the time you need with patients! Contact Dr. Ann Costello arcostello@gmail.com to find out more about this incredible opportunity to join the team at Primary Care Internal Medicine of Ithaca https://www.primarycareinternalmedicineofithaca.com/.   Time Stamps   00:00 Sponsor- Primary Care Internal Medicine of Ithaca https://www.primarycareinternalmedicineofithaca.com/ 00:20 Intro, guest bio, guest one-liner 04:12 SARS-CoV-2/COVID-19 vs. SARS, MERS, and influenza  07:00 Rahul highlights areas of caution interpreting COVID cases studies  12:35 Sponsor- Primary Care Internal Medicine of Ithaca https://www.primarycareinternalmedicineofithaca.com/ 13:20 Case of cold symptoms; Wearing masks in public; Advice on self quarantine with mild symptoms 18:05 Patient with mild symptoms and COVID exposure; Duration of quarantine and PCR positivity 21:15 Who merits testing for COVID-19 23:19 Case of confirmed COVID with mild symptoms; Instructions to patient and family about quarantine 25:50 COVID-19 testing characteristics (sensitivity, false negatives); Does co-infection occur?; Advice on when to send patient to a hospital  30:10 ACEIs, ARBs, NSAIDS; Is reinfection possible? 32:20 Pharmacotherapy: Hydroxychloroquine, Remdesivir, Tocilizumab; Definition of the “high risk” patient; COVID-19 vaccine 36:50 Case of healthcare worker (HCW) with COVID exposure; How long can COVID live on surfaces?  40:20 Do exposed HCWs without symptoms require quarantine? 41:30 Personal Protective equipment (PPE) 45:00 COVID-19 in pregnancy 47:30 COVID-19 and vulnerable patient populations (patients who are immigrants, homeless, incarcerated, etc.)  50:45 Where should you get your COVID-19 information? 52:30 Closing remarks and outro   Goals Listeners will review the current research on COVID-19 including transmission, protection strategies, testing, symptoms, and basics of management.   Learning objectives After listening to this episode listeners will know… The basics of COVID-19 including epidemiology, prevention, transmission, and treatment Where to find reliable data sources and how to interpret new studies with caution  The importance of PPE and limiting disease exposure  What drug regimens are recommended and what experimental treatments are available The role of virtual visits, telemedicine and other non-traditional methods to reduce patient contact Impact of COVID-19 on at-risk populations    Disclosures Paul E. Sax, MD, has disclosed the following relevant financial relationships:  Served as a director, officer, partner, employee, advisor, consultant, or trustee for: Bristol-Myers Squibb Company; Gilead Sciences, Inc.; GlaxoSmithKline; Janssen; Merck. Received research grant from: Bristol-Myers Squibb Company; Gilead Sciences, Inc.; GlaxoSmithKline; Merck. The Curbsiders report no relevant financial disclosures.    Citation Sax P, Roberts SP, Chiu CJ, Garbitelli B, Abrams H, Williams PN, Watto MF. “#200 COVID-19 with Paul Sax MD”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. March 22, 2020.
NephMadness 2020 is here! Listen as Dr. Ryann Sohaney (@ryannsohaney), Dr. Deborah Clegg and Dr. Joel Topf (@kidney_boy) discuss this year’s first Nephmadness topic, Hyperkalemia in CKD. They will (1) review the use of potassium binders for management of hyperkalemia in CKD (2) identify the potential health benefits of dietary potassium and challenge the use of low-potassium diets in CKD, and (3) describe how exercise influences serum potassium and consider exercise recommendations in CKD. Check out the regions and fill out your brackets for NephMadness 2020 here! Sign-up as a part of The Curbsiders team! Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits Written and Produced by: Elena Gibson MD  Infographic: Caitlyn Vlasschaert MD  Cover Art: Elena Gibson MD Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Matthew Watto MD, FACP (written materials); Clair Morgan Nodderly.com (audio) Guest: Ryann Sohaney, MD; Deborah Clegg, PhD; 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. Time Stamps 00:00 Sponsor - AccessMedicine.com (McGraw-Hill) http://bit.ly/MHCurbsiders 00:20 Intro, disclaimer, guest bio 02:55 Guest one-liners; Intro to NephMadness 2020 07:28 Sponsor - AccessMedicine.com (McGraw-Hill) http://bit.ly/MHCurbsiders 08:15 Hyperkalemia in CKD; Case of hyperkalemia; Meds, supplements and a bit on diet 17:07 Patiromer, Sodium zirconium, SPS 31:08 Diet and potassium 46:00 Exercise and hyperkalemia. Is it safe in CKD? 51:51 Take home points and Outro Learning objectives After listening to this episode listeners will…   Recognize when and how to manage hyperkalemia in CKD  Identify when to use potassium binders in CKD  Define the pharmacology, adverse effects and evidence behind different potassium binders  Develop an approach to using renin-angiotensin-aldosterone system inhibitor (RAASi) medications in patients with hyperkalemia Define the potential benefits of high-potassium diets and the potential harms of low-potassium diets  Recognize how exercise influences potassium Disclosures The Curbsiders 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 Sohaney R, Gibson E, Clegg D, Topf J, Williams PW, Brigham SK, Watto MF. “#199 NephMadness: Hyperkalemia, Diet, Potassium Binders, Exercise”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. March 16, 2020.
Polycystic ovary syndrome (PCOS) is more common than we think!  Listen as our esteemed guest Dr Katherine Sherif (@katherinesherif) reviews common patient complaints that should trigger PCOS in the differential, its pathophysiology, key physical exam findings, an algorithm for lab evaluation for PCOS diagnosis, and common treatments (OCPs, metformin, spironolactone and more!). Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits Written and Produced by: Molly Heublein, MD Cover Art and Infographic: Kate Grant MBChB DipGUMed  Hosts: Matthew Watto MD, FACP; Molly Heublein, MD Editor: Emi Okamoto MD (written materials); Clair Morgan of Nodderly.com (audio) Guest: Katherine Sherif, 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.   Primary Care Physician Opportunity in beautiful Ithaca, NY! Join a well established practice in beautiful upstate New York near the finger lakes and wine country! You'll have flexible hours and the ability to take the time you need with patients! Contact Dr. Ann Costello arcostello@gmail.com to find out more about this incredible opportunity to join the team at Primary Care Internal Medicine of Ithaca https://www.primarycareinternalmedicineofithaca.com/.  Time Stamps 00:00 Sponsors - AccessMedicine.com (McGraw-Hill) http://bit.ly/MHCurbsiders; Primary Care Internal Medicine of Ithaca https://www.primarycareinternalmedicineofithaca.com/ 00:35 Intro, disclaimer, guest bio 03:00 Guest one-liner, book recommendation; Picks of the Week*: The Beginner’s Guide to the End: Practical Advice for Living Life and Facing Death, by Dr BJ Miller and Shoshana Berger; Overdrive App to download audio books and other media from libraries 07:58 AccessMedicine.com (McGraw-Hill) http://bit.ly/MHCurbsiders; Primary Care Internal Medicine of Ithaca https://www.primarycareinternalmedicineofithaca.com/ 09:30 Case of PCOS; Definition; Common presenting complaints 14:40 Hirsutism and terminal hair growth 17:05 Alopecia 20:25 Acne; Hidradenitis suppurativa 23:05 Irregular menses; Lab workup; Non-classic congenital adrenal hyperplasia 28:38 Hyperandrogenism lab workup (Testosterone, DHEA-S, Anti-Mullerian Hormone, utility of LH and FSH); Quick word on US 37:15 Recap of how to diagnose PCOS 38:15 Insulin resistance, body habitus in PCOS 40:04 Pathophysiology in PCOS (two schools of thought: Hypothalamus vs Insulin) 43:27 Dr. Sherif’s spiel to patients newly diagnosed with PCOS 46:40 Long term risks in PCOS 50:35 Approach to treatment of PCOS (OCPs, metformin, spironolactone, hair removal) 60:35 Treatment of alopecia; Lifestyle factors 63:55 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 explain the basic pathophysiology, diagnosis, and management of PCOS. Learning objectives After listening to this episode listeners will…   List the criteria for diagnosis of PCOS. Explain the relationship between PCOS and metabolic risks. Determine first line treatments for PCOS symptoms including oligomenorrhea, hirsutism, acne and alopecia.  Counsel patients on long term risks associated with PCOS and how to mitigate these. Disclosures Dr Sherif reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.  Citation Sherif K, Heublein M, Grant K, Okamoto E, Watto MF.  “#198 PCOS: Polycystic Ovary Syndrome with Katherine Sherif MD”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. March 9, 2020.
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Comments (3)

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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