Shows
2020-08-1311 min2020-04-2814 minHospital and Internal Medicine PodcastAcute Severe Hypertension - part 2Multiple treatment issues are discussed. This includes theoretical ideal blood pressure lowering rates, oral options (for hypertensive urgency and specific populations), intravenous options (for hypertensive emergency or NPO patients), specific issues with aortic dissection, coronary syndromes, acute pulmonary edema & heart failure, labetalol, esmolol, nitroglycerin, and nitroprusside.
2020-04-2816 minHospital and Internal Medicine PodcastAcute Severe Hypertension - part 3Did you know that intravenous labetalol and oral labetalol are not really similar? The great hydralazine debate. Things you must know about Clevidipine if you are going to use it.
2020-04-2714 minHospital and Internal Medicine PodcastAcute Severe Hypertension - part 4Did you know systolic and diastolic blood pressure are NOT measured by automated BP cuffs? PRES (Posterior Reversible Encephalopathy Syndrome), also known as RPLS (Reversible Posterior Leukoencephalopathy Syndrome), is something you should recognize when you see it. Brief mentions of esmolol, nitroprusside, and other topics are scattered somewhere in between musings.
2020-04-2517 min2020-04-2500 minHospital and Internal Medicine PodcastInteresting Studies, Facts, & Opinions - April 2020 editionIf you wonder why good food is more important than mortality and why ordering too many unnecessary consults worsens the food and doesn't impact mortality - this episode is for you. Tramadol is not well understood by many prescribers and there are some emerging facts we all need to know. A flashback to diuretic use in congestive heart failure with fluid overload and elevated creatinine is also discussed somewhere in the mix. Ohhh...and stop systematically prescribing nicotine replacement at high dosages for all hospitalized smokers.
Stevens JP, Hatfield LA, Nyweide DJ, Landon B. Association of Variation...
2020-04-2413 minHospital and Internal Medicine PodcastBalkan Reflections Forged By A Virus LockdownWorld War I was partly triggered by powerful allies of various nationalities being dragged into a Balkan conflict (nationalism, of course, was another major factor). The more recent Balkan conflict is even more preposterous - and here is my attempt to humorously explain the unexplainable.
2020-04-2310 minHospital and Internal Medicine PodcastRecent Interesting Internal Medicine Studies and Facts - December 2019Correcting Hypernatremia in adults (finally, a real study!). An option for that scary patient with hemoptysis. How many nephrons you have (and your patient has) - it matters.
2019-12-1018 minHospital and Internal Medicine PodcastAnemia of Inflammation - finally understand this common anemia that accomplished doctors often can't explainAnemia of Inflammation is also often referred to as Anemia of Chronic Disease. It is one of the most common anemias, yet often challenging to comprehend. This is an attempt is to try and simplify it.
2019-09-3009 minHospital and Internal Medicine PodcastAnemia of Inflammation - part 2If you know why red blood cells survive less (and are made less) during inflammatory conditions, and already know why ferritin increases in inflammation, and don't want to hear a lousy Iron Man plot idea - then you are good to go on skipping this episode.
2019-09-3007 min2019-09-3008 minHospital and Internal Medicine PodcastCreatine - part 1It occurs naturally in the body (because we synthesize it), it is in meat, and it is frequently used as a supplement. Since it is in you, why not understand what it is and what it does? Advice is provided on which supplement labels to particularly avoid. A brief reflection upon creatine within our brains (and the potential memory impact seen in one study) is utilized to make the point that when it comes to a performance enhancer, like creatine, it's not solely about the ramifications on muscle strength and endurance.
2019-08-2112 minHospital and Internal Medicine PodcastCreatine - part 2The replenishing of muscle ATP is one (of the several) mechanisms that creatine helps with when it comes to heavy anaerobic exercise. Other topics discussed are things to know about lab testing the kidneys while taking creatine. Thoughts on why some don't respond to creatine supplementation.
2019-08-0709 minHospital and Internal Medicine PodcastCreatine - part 3Is there a specific type of creatine to buy? What is creatine monohydrate? What is Creapure? What do some professional organizations have to say about the safety of creatine? The loading dose debate. Also dives into the several mechanisms of action for how creatine helps build muscle.
2019-08-0515 minHospital and Internal Medicine PodcastMedicare for All? (or maybe you call it Universal Healthcare or Single-Payer)Are you surprised that GoFundMe and crowdfunding are not the solution to a family healthcare crisis? How about Medicare for All? Hmmmm.....
2019-07-0247 minHospital and Internal Medicine PodcastPart 5 of Muscle and Strength Gaining Tips - The Emotional Connection and Overcoming Temporary Pain
2019-04-0820 minHospital and Internal Medicine PodcastClostridium Difficile - part 1A deceivingly difficult topic. Not so obvious points are made about asymptomatic carriers, transmission, and who to test.
2019-01-2513 minHospital and Internal Medicine PodcastClostridium Difficile - part 2Specific initial treatment regimens are discussed. Topics include fulminant disease, Vancomycin, Fidaxomicin, Metronidazole, and recurrence rates/regimens.
2019-01-2310 minHospital and Internal Medicine PodcastClostridium Difficile - part 3Many of the latest studies in the 2017-2018 timeframe are reviewed. The importance of looking at the eosinophil count on the CBC, probiotic future directions, microbiome transplant options, antibody treatment (bezlotoxumab), "penicillin allergic" patients, and a brief mention of available testing.
2019-01-2313 minHospital and Internal Medicine PodcastLive From My Basement BathroomExperiences that taught me some lessons.
2018-12-2416 minHospital and Internal Medicine PodcastType 2 Diabetes Treatment - Part 7 - GLP-1 Agonists and DPP-4 InhibitorsGlucagon-Like Peptide 1 (GLP-1) mimetics are also referred to as the GLP-1 receptor agonists. While this talk mostly focuses on GLP-1 mechanisms and actions, the hope is you will also better understand The Dipeptidyl Peptidase-4 (DPP-4) inhibitors
The current GLP-1 Agonists include Exenatide (Byetta), Liraglutide (Victoza), Dulaglutide (Trulicity), Abiglutide (Tanzeum), Lixisenatide (Adlyxin), Semaglutide (Ozempic).
The current DPP-4 Inhibitors include Alogliptin (Nesina), Linagliptin (Tradjenta), Saxagliptin (Onglyza), Sitagliptin (Januvia).
2018-12-1716 minHospital and Internal Medicine PodcastType 2 Diabetes Treatment - Part 6 - SGLT2 InhibitorsSodium-Glucose Transporter 2 Inhibitors decrease glucose re-absorbtion. The diuretic effect, weight loss, DKA, cardiac outcomes, blood pressure, genital infections and a whole bunch of other information is discussed.
SGLT2s include Canagliflozin (Invokana), Dapagliflozin (Farxiga), Empagliflozin (Jardiance), Ertagliflozin (Steglatro), with more to be released in the future.
2018-09-2620 minHospital and Internal Medicine PodcastType 2 Diabetes Treatment - Part 5 - HgA1CThere is a lot more to understanding HgA1C then most realize (particularly the quality industry and big corporations).
2018-08-2619 minHospital and Internal Medicine PodcastType 2 Diabetes Treatment - Part 4 - MetforminTackles - Vitamin B12, kidney disease, CHF, cancer, Impaired Glucose Tolerance (IGT), dosing, side-effects, lactic acidosis, cost, drinkers, hypoxic patients, glucose lowering, and a few other moments of erudation.
2018-05-2825 minHospital and Internal Medicine PodcastType 2 Diabetes Treatment - Part 3 GlucagonIf you want to understand drug classes like DPP-4 inhibitors, GLP-1 (GLUCAGON-like peptide) therapies, treating hypoglycemia, and an important player among the many etiologies of Type 2 diabetes - then you must understand the basics about glucoagon.
2018-05-1608 minHospital and Internal Medicine PodcastType 2 Diabetes Treatment - Part 2 - Reversing The Disease With Lifestyle Changes
2018-05-0113 min2018-05-0108 minHospital and Internal Medicine PodcastInternal Medicine Pearls #5Diuretic therapy for congestive heart failure treatment, antibiotics for diabetic osteomyelitis after foot surgery, and practical tips with new-onset seizures - is among the knowledge dropped (because, after all, school can't teach us everything).
2018-04-0333 minHospital and Internal Medicine PodcastSome Recent Studies Worth Knowing About - February 2018Some new stuff about Vitamin D & Calcium supplementation, another about the timing of hip fracture surgery, etc
2018-02-0111 min2017-12-2234 minHospital and Internal Medicine PodcastInternal Medicine Pearls #4Checking glucose levels in Type 2 Diabetes, ACE Inhibitors for women, and using Azithromycin in Asthma.
2017-11-1414 min2017-10-0415 minHospital and Internal Medicine PodcastPatent Foramen Ovale Evaluation and Closure After a Stroke - part 2
2017-09-2615 minHospital and Internal Medicine PodcastPatent Foramen Ovale Evaluation and Closure After a Stroke - part 1
2017-09-2211 minHospital and Internal Medicine PodcastThe Overhead Airplane Request for Medical Assistance - A No Win Situation
2017-09-2005 min2017-08-3117 min2017-08-3120 min2017-08-1010 min2017-07-3112 min2017-07-1509 minHospital and Internal Medicine PodcastUrine Drug Testing - Misinterpretation is Very CommonYou know all those people on social media wanting mandatory drug testing for welfare recipients? Perhaps, reasonable in theory, if the test wasn't frequently producing false-positives and false-negatives. Making accurate clinical decisions is always challenging, but particularly with urine drug testing. The consequences of misinterpretation can be awful.
2017-05-2821 min2017-05-2220 minHospital and Internal Medicine PodcastInternal Medicine Pearls #3A look at some new data: COPD and Oxygen use - low serum creatinine levels - BMI considerations - the RDW - the age of blood.
2017-05-1120 minHospital and Internal Medicine PodcastLet's do this! Simple changes to healthcare that nearly everyone can agree on.
2017-04-3019 min2017-04-0516 minHospital and Internal Medicine PodcastI'm a nerd looking at the world and shamelessly speaking my mind
2017-03-0721 minHospital and Internal Medicine PodcastRenal and Ureteral Stones (Nephrolithiasis - Kidney Stones) - part 4Oxalate intake reduction, thiazide diuretics, and tamsulosin are some of the therapies discussed in this lecture.
2017-02-2213 minHospital and Internal Medicine PodcastRenal and Ureteral Stones (Nephrolithiasis - Kidney Stones) - part 3Stone analysis, labs, calcium & fluid intake, sodium in the diet, and beverage choices.
2017-02-1513 minHospital and Internal Medicine PodcastRenal and Ureteral Stones (Nephrolithiasis - Kidney Stones) - part 2A few words about the proximal ureter, I.V. Fluids, colic, and hematuria.
2017-02-1310 minHospital and Internal Medicine PodcastRenal and Ureteral Stones (Nephrolithiasis - Kidney Stones) - part 1This episode discusses symptoms, the importance of size, and a few other pearls.
2017-02-0107 minHospital and Internal Medicine PodcastWhat is Taurine?You see it in energy drinks. It is in our food, supplements, it naturally occurs in multiple organs, and most people don't know anything about it.
2017-01-2518 minHospital and Internal Medicine PodcastPart 4 of Muscle and Strength Gaining Tips for Men, Women, Bodybuilders, and BeginnersLifestyle, carbohydrates, protein, and eccentric weight training are part of the focus of this sermon.
2016-12-2918 minHospital and Internal Medicine PodcastPart 3 of Muscle and Strength Gaining Tips for Men, Women, Bodybuilders, and BeginnersThis episode is part philosophy, part motivation, and a discussion of some traps men and women get caught in.
2016-12-2413 minHospital and Internal Medicine PodcastPart 2 of Muscle and Strength Gaining Tips for Men, Women, Bodybuilders, and Beginners
2016-10-2615 minHospital and Internal Medicine PodcastMuscle and Strength Gaining Tips for Men, Women, Bodybuilders, and Beginners - part 1
2016-10-2114 minHospital and Internal Medicine PodcastPulmonary Embolism - Part 4The use of Inferior Vena Cava (IVC) filters and the length of anticoagulation in unprovoked DVT/PE are considered. A rant about hyper-coagulable panels in provoked DVT/PE is opined.
2016-10-1023 minHospital and Internal Medicine PodcastPulmonary Embolism - part 3 - Massive PEUnderstanding what causes hypotension in PE is essential to understanding the severity of the situation. The relevance of the stressed right ventricle is emphasized. Thrombolytic therapy for hypotension and other clinical scenarios resulting from pulmonary embolism are contemplated.
2016-08-2917 minHospital and Internal Medicine PodcastPulmonary Embolism - part 2The treatment challenges of subsegmental pulmonary embolism, with emphasis on the 2016 guidelines are reviewed. Ventilation/perfusion (V/Q) scan interpretations in those unable to get a CT scan are considered.
2016-07-2415 minHospital and Internal Medicine PodcastPulmonary Embolism - part 1The topics covered are D-Dimer testing, false positive over-diagnosis of PE on CT scanning, the ADJUST-PE study, and clinical signs and symptoms of a pulmonary embolism.
2016-06-0417 min2016-05-2618 minHospital and Internal Medicine PodcastIron Deficiency Anemia - part 3Various topics regarding intravenous iron are pondered, especially some of the new data available that has not yet seemed to obtain the influence that the information deserves.
2016-05-1623 minHospital and Internal Medicine PodcastIron Deficiency Anemia - part 2This episode mostly centers around oral iron replacement.
2016-04-2816 min2016-03-0316 minHospital and Internal Medicine PodcastNatriuretic Peptides in Congestive Heart FailureBNP use as a lab and therapeutic are discussed. The episode also explores the PARADIGM-HF trial and Neprilysin inhibition. The novel combination medication sacubitril/valsartan (Entresto) for systolic CHF is evaluated in depth. Clinical tips for avoiding angioedema and other clinical pearls are provided.
2016-01-1419 minHospital and Internal Medicine PodcastHealthcare Mergers and AcquisitionsIf you think the seismic shift in U.S. healthcare is all a result of the Affordable Care Act, you may not be seeing a large part of the picture. This has become an era of "BIG MEDICINE" and that phenomenon is increasing through mergers and acquisitions. Some of these mergers are strategic, while others are defensive. Practical advice on how doctors and companies can improve their chances of merging successfully is provided. The lecture concludes with potential implications of the insurance-industry merger wave on patients and those working in the healthcare industry.
2015-12-0811 minHospital and Internal Medicine PodcastAcute Pancreatitis (part 3) - Pseudocysts, Pain Control, and a few other pearlsThis episode offers some advice in thinking about the very difficult topic of pancreatic pseudocysts. Some philosophical waxing about pain control and some items not addressed in the previous episodes are also discussed.
2015-10-0200 minHospital and Internal Medicine PodcastAcute Pancreatitis (part 2) - Severe Pancreatitis, Pancreatic Necrosis, Antibiotic & Surgical ConsiderationsImaging, fluid resuscitation, fine needle aspiration, determining sterile vs infected necrosis, and suggestions from the guidelines are discussed.
2015-08-2415 minHospital and Internal Medicine PodcastAcute Pancreatitis - part 1This episode addresses some of the debates regarding nutrition timing in acute pancreatitis. Methods such as nasogastric, nasojejunal, and oral feeding are compared.
2015-07-2911 minHospital and Internal Medicine PodcastHypercalcemia TreatmentTreatments that include hydration, cinacalcet, calcitonin, bisphosphonate, denosumab, and other options are reviewed.
2015-06-0813 minHospital and Internal Medicine PodcastHyperparathyroidism - Hypercalcemia part 3Indications for parathyroidectomy, pre-operative localization issues, diagnosing hyperparathyroidism, and a brief summary of the guidelines are among the topics addressed in this episode.
2015-06-0619 minHospital and Internal Medicine PodcastHypercalcemia - Clinical Symptoms and Diagnostic TestingSpecial attention is paid to gastrointestinal, bone, and cardiovascular disease as a result of hypercalcemia. Laboratory interpretation of calcium and phosphorus levels is also discussed.
2015-03-3114 minHospital and Internal Medicine PodcastHypercalcemia etiology - Vitamin D, Calcium Supplements, Diuretics, Malignancy, Sarcoidosis, and other causes
2015-03-1016 min2014-12-2923 min2014-12-2117 min2014-10-3112 min2014-10-3011 min2014-10-2917 min2014-10-0516 minHospital and Internal Medicine PodcastPneumonia part 5- Treatment of Healthcare Associated Pneumonia
2014-08-1418 min
2014-08-0316 minHospital and Internal Medicine PodcastPneumonia- part 3- Legionella & PseudomonasPseudomonas aeruginosa and Legionella pneumophila bacterial lower respiratory tract disease are explored in depth.
2014-06-1821 minHospital and Internal Medicine PodcastPneumonia - Part 2 - Pneumococcal PneumoniaStreptococcus pneumoniae is a frequent cause of pneumonia. What makes this organism unique? Listen and find out.
2014-05-0413 minHospital and Internal Medicine PodcastPneumonia - Part 1Does the patient really have pneumonia? Differential diagnosis and mimics are considered in this common clinical problem. Dive deeper into how microbes and the immune system interact in lower respiratory infections.
2014-04-2607 minHospital and Internal Medicine PodcastAcute Liver Injury From Drugs (other than acetaminophen)Hepatotoxicity from antibiotics, NSAIDs, dietary supplements and other sources are explored. Idiosyncratic drug induced immune related and non-immune related injuries are differentiated, which can change treatment.
2014-04-0615 min2014-01-0212 min2014-01-0112 minHospital and Internal Medicine PodcastInfluenza - part 2 - Lessons From H1N1 PandemicsWas H1N1 accidentally released from a laboratory? Is it really a "swine flu"or is it a misnomer?What is this H3N2 swine flu we periodically hear about in the media?What makes a pandemic?Find these answers and more in this episode.
2013-12-3012 minHospital and Internal Medicine PodcastInfluenza - The Flu - part 1Some years the vaccine is better than others - but there is still good reason to get it. Let's discuss those reasons.How is flu transmitted?How do weather patterns influence the spread of influenza?Get these answers and more in this episode.
2013-12-2916 min
2013-10-1326 min2013-08-1200 min2013-08-1020 minHospital and Internal Medicine PodcastMRSA - The basics about Methicillin Resistant Staphylococcal AureusResistance and virulence mechanisms are discussed. Clinical presentations as well as the difference between colonization and infection are considered.Screening, prevention, and understanding Community Acquired MRSA vs Healthcare Acquired MRSA strains can be challenging, so practical information is presented for the common questions patients, families, and health care workers will often have.
2013-05-1211 min2013-01-1410 min2013-01-0113 min2012-12-0317 min2012-10-2316 min2012-09-2510 min2012-08-3011 min2012-08-2318 min