CEimpact Podcast

Routine pediatric vaccines are declining and 97% of pediatric influenza deaths are in unvaccinated children. Join host Geoff Wall, with guest Jake Galdo, as they discuss what the heck is happening with pediatric vaccines and how the healthcare community can step up. The GameChanger The Advisory Committee on Immunization Practices provides recommendations for routine vaccines for all persons. Pharm...

As preceptors, sometimes one of the hardest things we do is give feedback. What about when we receive it? Listen to learn how to engage students in ways that result in meaningful feedback you can use to improve your teaching. You're putting in the work. Why not make it as impactful as possible for your learners? This week I’m speaking with Nick Cox – a faculty member and preceptor in an ambul...

Patient use of any anticoagulation during an acute stroke is a contraindication for the use of thrombolytics or clot busters. Recent meta-analyses and animal studies raise the question of this contraindication. Join guest, Geoff Wall, as he examines the data on Direct Oral Anticoagulants (DOACs) and thrombolytics. The GameChanger DOACs have a significantly smaller intracranial hemorrhage (ICH) ris...

Osteoporosis may be a forgotten disease – common but rarely treated. The 2023 guidelines are not here. Join host, Geoff Wall, as he reviews the new treatment recommendations and how we can optimize pharmacotherapy for all persons with osteoporosis. The GameChanger Osteoporosis is common and routine screenings should be implemented. Bisphosphonates are still the drug of choice, but treatment for pe...

Hydrochlorothiazide is the go-to thiazide for hypertension control despite better data for chlorthalidone. Join host Geoff Wall as he evaluates the new randomized controlled study to determine what is the best thiazide. The GameChanger Several pharmacologic differences exist between hydrochlorothiazide and chlorthalidone. The new DCP Study did not find any differences in cardiovascular outcomes. S...

Results from early COVID-19 studies are still emerging. Some micronutrients, such as zinc, have been shown to decrease the severity of viral infections yet human data is sparse. Join host, Geoff Wall, as he evaluates a new study looking at the proposed benefit of zinc in COVID-19 infections. The GameChanger Zinc has several antiviral properties. A recent trial showed a decreased risk of ICU admiss...

Sometimes teaching isn't "telling" but "asking" - asking questions that encourage students and residents to problem-solve in a stepwise manner. Listen in as we discuss a teaching strategy that builds confidence and encourages curiosity in your learners. We’ve all heard students and residents complain about ‘pimping’ from preceptors during rotations or during their residenc...

Celiac disease is of the most common auto-immune diseases in the world. The only current treatment is maintaining a strict gluten-free diet. Join host, Geoff Wall, as he discusses the results of a phase 2 study investigating a novel pharmacologic treatment of Celiac disease. The GameChanger Celiac disease is common and has a myriad of symptoms. A new drug may offer a way for patients with Celiac d...

The American Diabetes Association Standards of Care in Diabetes are a “living” guideline – the recommendations are updated throughout the year and major revisions occur in January. In this episode, guest host, Jake Galdo, is joined by Susan Cornell as they evaluate new pharmacotherapy recommendations in the ADA Standards of Care. The GameChanger Treatment recommendations for diabetes are no longer...

Stimulant medications, like methylphenidate and amphetamines, have adverse cardiovascular effects, like elevated blood pressure, increasing the risk of cardiovascular events. Join host Geoff Wall as he reviews a new meta-analysis trying to quantify the risk of ADHD medications on cardiovascular outcomes. The GameChanger A large meta-analysis did not find an association between medications for ADHD...

COPD is a common and complex disease for both inpatient and outpatient providers. GOLD guidelines provide diagnosis and treatment recommendations for COPD and were recently updated. Join host Geoff Wall as he breaks down the salient recommendations in the 2023 GOLD guidelines. The GameChanger A new severity scoring system for COPD exists – category E. Additionally, inhaled corticosteroids may play...

We’ve heard a lot about microaggressions in the past couple of years. A microaggression can include verbal, behavioral, or environmental aggressions that negatively communicate about race, culture, or gender. They can be intentional or unintentional but can negatively impact healthcare interactions – whether those involve students, residents, patients, or all of the above. In this episode, speakin...

Gabapentin is often used in a multi-model pain management strategy in both peri- and post-operative setting. Little data exists looking at the adverse effects of this practice. Join host Geoff Wall, as he reviews data from a new study looking at this question. The GameChanger Gabapentin’s data is sparse for use in postoperative pain; however, new data suggest use after orthopedic surgery is associ...

The standard of care for pancreatitis has been aggressive (liters) of intravenous fluids. New data suggests that this level of fluid resuscitation may not be needed – and possibly harmful. Join host Geoff Wall as he evaluates the role of fluids in pancreatitis treatment. The GameChanger In patients with mild disease, moderate fluid resuscitation is safer than aggressive fluid use. Show Segments 00...

A recent study showed that ethanol abuse is a leading cause of death in young adults in the US and that rates of alcoholism have increased. Join host Geoff Wall as he reviews the treatment of ethanol withdrawal. The GameChanger Ethanol abuse is a leading cause of death in young adults. Fortunately, multiple therapies exist to treat hospitalized patients with acute ethanol withdrawal.  Show Segment...

Obesity is still at epidemic levels in the United States. More and more medications are coming to market to help with weight loss. The American Gastroenterological Association (AGA) just released guidelines for evidence-based care for persons with obesity. The GameChanger Guidelines are now available for the treatment of obesity. The evidence-based recommendations will help providers determine app...

Health Equity is achieved when every person has the opportunity to attain their full health potential and no one is disadvantaged. Oftentimes, this is evaluated and addressed through resolving social determinants of health. A recent study evaluated the impact of food insecurity on cardiovascular outcomes. Join host, Geoff Wall, as he discusses how healthcare teams can address food insecurity with...

Whose job is it to teach risk management principles to pharmacy learners? Sure – they have to take a law course as part of their curricular requirements, but how much does that mean to them until they are in real life situations as part of their IPPEs, APPEs, or residency? As preceptors, it’s important that we not only recognize and manage the legal risks of welcoming pharmacy learners within our...

Various SGLT-2s have been shown to improve cardiovascular outcomes in the presence and absence of diabetes. A recent study evaluated the effect of dapagliflozin in mildly reduced or preserved ejection fraction. Join host, Geoff Wall, as he discusses how SGLT-2s may be a real GameChanger in heart failure with expert, Troy Lynn Lewis. The GameChanger The data showcasing the benefits of SGLT-2s in pa...

Less than ten percent of people filled a glucagon prescription after a hospitalization due to hypoglycemia. In the past few years, a slew of new glucagon products have come to market. Join host, Geoff Wall, as he discusses how to optimize glucagon therapy with diabetes expert, Jamie Pitlick. The GameChanger Despite glucagon products being proven safe and effective, they are severely under-prescrib...

The GRADE studies evaluated the pharmacotherapy of diabetes after initiation of metformin – for both micro- and macrovascular outcomes. Join host, Geoff Wall, and guest Jake Galdo as they examine these studies to determine if they are GameChangers in diabetes management. The GameChanger Insulin glargine and liraglutide had the biggest decrease in A1c; however, many patients still did not reach goa...

The role of anticoagulant therapy (warfarin) with antiplatelet therapy (aspirin) is a balance of risk versus benefit. However, reducing risk by de-prescribing is often avoided due to hypothetical efficacy reduction. Join host, Geoff Wall, as he evaluates de-prescribing aspirin in patients taking anticoagulants. The GameChanger Anticoagulant therapy provides as good or better protection against vas...

So often, we can fall into the trap of viewing our time with experiential learners as a burden – something that takes time and energy that we feel we don’t have in a busy practice. How can you operationalize and optimize student contribution on-site, build trust among all parties, and overcome challenges and barriers that come along with experiential learning? Tune in to find out how one busy comm...

Studies suggest that patients admitted to the hospital with heart failure are inadequately diuresed before discharge. Join host, Geoff Wall, as he reviews the data on acetazolamide for diuresis in heart failure. The GameChanger Augmentation of loop diuretics with acetazolamide significantly increases diuresis in persons with heart failure. Geoff produces music under the name, Prophets of Jupiter....

The current standard of care is to provide a bolus of 30 mL per kg of isotonic fluid for patients with septic shock. Recent retrospective studies question this practice. Join host, Geoff Wall, as he reviewed a NEJM article on the role of fluids in septic shock. The GameChanger Large boluses of fluid during septic shock may have unintended adverse events. Some data show that an approach with restri...