Last Week in Medicine

Seems like a lot has happened in just one week!  The whole world is different. Today we talk about some of the most recent articles published about the ongoing COVID-19 pandemic.  We also discuss whether gabapentin can be used to treat people with alcohol use disorder, and whether apixaban is better than rivaroxaban for preventing strokes in people with atrial fibrillation. Incubation Period for C...

Austin finally returns to the podcast with harrowing tales of almost being eaten by a wolf.  Today we discuss a new NEJM paper about long acting injectable therapy for HIV and a new JAMA paper about pregnenolone, a neurosteroid that may help treat the scourge of primary care: chronic low back pain. Long Acting Cabotegravir and Rilpivirine for HIV-1 Pregnenolone vs Placebo for Chronic Low Back Pain...

Today we had Dr. Dani Babbel back on the show to talk about the latest COVID-19 updates, whether gastric acid suppression increases your risk of MDRO colonization, and how to improve care to patients boarding in the emergency department.  Check it out! Characteristics of Covid-19 in China Covid-19 Report from CDC of China Gastric Acid Suppression and MDRO Colonization Hospitalist Care of ED Boarde...

Today we had the pleasure of talking to Dr. Barbara Jones, first author on a new paper in JAMA IM about the outcomes in veterans treated with empirical anti-MRSA therapy vs standard therapy.  She gives us a master class in propensity weighted analysis and instrumental variable analysis.  We also look at whether outcomes are different in patients who are cared for by hospitalists who call more cons...

Today we have the venerable EBM guru Dr. Brian Locke on the show to talk PLEX and DEX.  Does plasma exchange for ANCA-vasculitis really work?  Do steroids make any difference in patients with ARDS?  Also, have you ever wondered which Hogwarts house your medical specialty belongs to? Plasma Exchange and Glucocorticoids for ANCA-Vasculitis Dexamethasone for Acute Respiratory Distress Syndrome The So...

Today we are joined by the man, the myth, and the legend, Dr. Stacy Johnson, to talk about a new meta-analysis of using aspirin for DVT prophylaxis after a total hip or knee replacement.  We also review a new retrospective cohort study from Cleveland Clinic on whether it's safe to give the recommended 30 ml/kg fluid bolus to patients with sepsis who also have CHF, cirrhosis or ESRD.  Check it...

Today we are joined by the very smart Dr. Jason Carr, a pulmonary/critical care fellow, to talk about two big papers from the wonderful world of lungs.  Does CT screening for lung cancer save lives?  Do you have to put a chest tube in every patient with a spontaneous pneumothorax?  Check it out! CT Screening for Lung Cancer, AKA NELSON Conservative vs Interventional Treatment for Spontaneous Pneum...

It's our tenth episode!  Thanks for getting us this far.  Today we discuss the new coronavirus outbreak, what to do with high sensitivity troponins, whether hydroxyethyl starch should be used in abdominal surgery (spoiler alert: it shouldn't) and the appropriate use of testosterone therapy. Novel Coronavirus in China High Sensitivity Troponins and the Fourth Universal Definition of MI Hy...

Today we are joined by the wonderful Dr. Emily Signor to talk about new therapeutic approaches to DVT prophylaxis, how much time physicians spend using the EHR in clinic, and whether that Vitamin C cocktail works for septic shock.  Check it out! Effect of Osocimab in Preventing VTE in Patients Undergoing TKA   Physician Time Spent Using the EHR During Outpatient Encounters Vitamin C, Thiamine and...

Today we try something a little different -- three co-hosts!  Dr. Dani Babbel joins Jenkins and Rupp for some lively discussion about hotspotting, very severe aortic stenosis and whether adherence improves when medications are free.  Check it out! Health Care Hotspotting Early Surgery for Asymptomatic Aortic Stenosis Effect on Treatment Adherence of Distributing Essential Medicines at No Charge Mu...

Happy New Year and welcome to the first episode of 2020!  We've got some great articles to review today.  Can we save money by taking care of some acutely ill patients in their own homes?  Are patients admitted for "social" reasons at the same risk for adverse events as acutely ill patients?  Can NT-ProBNP level predict cardiovascular death and myocardial injury after non-cardiac su...

Dr. Rupp is back! Today we talk about whether it's safe to give group 2 gadolinium based contrast agents to patients with CKD stage 4 and 5 and whether metoprolol can be used to prevent COPD exacerbations.  We also shine some more sunlight on the sunshine vitamin's inability to change any meaningful outcomes, and discuss some interesting data from the Intern Health Study. Risk of Nephrog...

This week we have a special guest host, Dr. Dani Babbel.  We talk about the new guidelines on upper GI bleeding, a new study on E-VALI, and the possible association of beta blockers with heart failure hospitalizations in heart failure with EF > 50%. Management of Upper GI Bleeding Guidelines Clinical presentation, treatment and short term outcomes of E-VALI Association of Beta-Blocker Use with...

Can you get away with a higher d-dimer value in patients with a low pre-test probability for PE?  Does working more days in a row improve patient outcomes?  How often are people inappropriately prescribing fluoroquinolones?  How often are people using systemic lytics vs catheter directed lytics in acute PE, and what are the outcomes? Music from https://filmmusic.io "Sneaky Snitch" by Kev...

Today we talk about the effects of vitamin D in progression of CKD in people with diabetes, and whether SGLT-2 inhibitors like dapagliflozin can be used to treat heart failure with reduced ejection fraction in people without diabetes.  We also talk about ticagrelor monotherapy after three months of DAPT, rivaroxaban for the treatment of APS (don't do it!) and LDL targets for stroke prevention...

Lots of cardiology to discuss this week with the Apple Heart and COLCOT studies, both published in the New England Journal of Medicine.  We also talk about the 3 Wishes Project, the net clinical benefit of oral anticoagulation with aging over 75, the benefits of non-pharmaceutical treatment of agitation, and getting blood cultures before you give antibiotics.  Music from https://filmmusic.io &quot...

Should we add blood pressure medications or increase the dose while patients are in the hospital?  What are the risk factors and outcomes for people who receive antibiotics for asymptomatic bacteriuria?  And how does the DRIP score stack up against previous tools for identifying patients at high risk for drug resistant pneumonia?  Music from https://filmmusic.io "Sneaky Snitch" by Kevin...