Last Week in Medicine
Wouldn't it be nice if someone reviewed all the latest internal medicine literature and distilled it into a brief podcast you could listen to on your way to work? Get updates from the New England Journal of Medicine, JAMA Network, Annals of Internal Medicine, Journal of Hospital Medicine, Journal of General Internal Medicine, Lancet and more.
Bleeding Risk with Apixaban vs Rivaroxaban for Acute VTE (COBRRA), Left Atrial Appendage Closure vs Medical Therapy for Atrial Fibrillation (CLOSURE-AF)
We are back with a landmark trial -- COBRRA was finally published! Apixaban wins again, but is rivaroxaban done for good??
Also, is left atrial appendage occlusion safer than oral anticoagulation in patients with a high risk of stroke and a high risk of bleeding? Check it out!
Apixaban vs Rivaroxaban for Acute VTE (COBRRA)
Left Atrial Appendage Closure vs Medical Management (CLOSURE-AF)
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2026 ACC/AHA Guidelines for Acute Pulmonary Embolism
The ACC/AHA published new guidelines for managing acute PE on February 19, 2026. Today I'm joined by Dr. Scott Woller, MD, MACP, FCCP, who was co-chair of the American College of Chest Physicians Clinical Practice Guideline for antithrombotic therapy for venous thromboembolism, last updated in 2021. He also served as co-chair for the peer review committee for these new guidelines, and has lots of great insights into how to use them in clinical practice and research.
2026 ACC/AHA Guidelines for Diagnosis and Managing Acute PE
Some highlights from the guidelines:
New categories of PE: A: asymptomaticB: sy...Hematopoietic Stem Cell Gene Therapy for Cystinosis
In this episode I'm joined by senior author Dr. Stephanie Cherqui to talk about her recent publication in the New England Journal of Medicine on gene therapy for cystinosis. This is a very personal episode for me, because two of my children have cystinosis. The article is linked below. Thanks for listening!
Hematopoietic Stem Cell Gene Therapy for Cystinosis
Donate to the Cystinosis Research Foundation
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Extended Apixaban for Provoked VTE (HI-PRO), Coffee and Atrial Fibrillation (DECAF), Age-Adjusted D-dimer for DVT, Beta Blockers after MI with Normal EF, Fish Oil for Dialysis (PISCES), Conservative Dialysis for AKI (LIBERATE-D)
In this episode, Dr. Austin Rupp and I try to answer the following questions:
Should patients with provoked VTE be offered long term anticoagulation if they have persistent risk factors, like obesity? Does coffee make atrial fibrillation worse (or better??)? Is age-adjusted d-dimer safe to use in DVT? Should we prescribe beta blockers after acute MI if the EF is normal?Does fish oil improve cardiovascular outcomes in patients on dialysis?What's the best approach for dialysis in patients with acute kidney injury?The articles:
Extended Apixaban for Provoked VTE (HI-PRO)
Coffee and Atr...
Semaglutide for CVD in Diabetes, PAD, and MASH, Semaglutide vs Tirzepatide, Normal Saline vs Lactated Ringer's, Oxygen Targets for Intubated Patients, Platelet Transfusion Guidelines, Apixaban vs Rivaroxaban
Today we do a round-up of some of the recent semaglutide trials. Does semaglutide ever miss? But what about tirzepatide, which causes even more weight loss?
We also review two new critical care trials, FLUID and the UK-ROX, new platelet transfusion guidelines, and a new retrospective study of apixaban vs rivaroxaban vs warfarin.
Oral Semaglutide for Diabetes with Cardiovascular Disease or CKD (SOUL)
Semaglutide for Peripheral Artery Disease (STRIDE)
Semaglutide for MASH (ESSENCE)
Semaglutide vs Tirzepatide for Obesity (SURMOUNT-5)
Normal Saline vs Lactated Ringers (FLUID)
C...
Hydrocortisone for Severe Pneumonia (REMAP-CAP), Intensive BP Control in Diabetes (BPROAD), Aldosterone Synthase Inhibitors for Hypertension (ADVANCE-HTN), Reduced-dose Apixaban for Cancer Associated Thrombosis (API-CAT)
What do you do when most trials suggest benefit for an intervention, but then a new trial suggests harm? We thought steroids in pneumonia was a settled question, but REMAP-CAP had other plans!
We also review a new RCT for BP targets in patients with hypertension and diabetes, a new aldosterone synthase inhibitor for hypertension, and reduced dose apixaban for cancer-associated thrombosis.
Hydrocortisone for Severe CAP (REMAP-CAP)
Predicting Benefit of Corticosteroids in Pneumonia
Intensive BP Control in Patients with Diabetes (BPROAD)
Lorundrostat for Uncontrolled Hypertension (ADVANCE-HTN)
Reduced D...
Half Dose DOAC for Long Term VTE Prevention, Biomarker Guided Antibiotics for Sepsis, GPT-4 Assistance for Physicians, Optimal Vasopressin Initiation for Shock, DOAC vs No AC for A fib After Intracerebral Hemorrhage, HFNC vs NIV for Respiratory Failure
For this episode we are joined by EBM guru, Dr. Brian Locke, who deftly breaks down all of our statistics questions.
Is half dose DOAC as good as full dose DOAC for preventing VTE, and does it reduce bleeding risk? Can procalcitonin reduce duration of antibiotics for infections without compromising mortality rates? Can LLMs like GPT-4 help physicians manage patients better? Can reinforcement learning models predict when to start vasopressin in patients with septic shock? What is the risk of resuming anticoagulation in patients with atrial fibrillation and prior intracerebral hemorrhage? Is high flow nasal cannula as g...
7 vs 14 Days of Antibiotics for Bacteremia, Factor XI Inhibition for Atrial Fibrillation, ACEi or ARB Before Elective Surgery, GLP-1 Agonist for HFpEF and Obesity
We're back, after a brief hiatus!
Today we talk about duration of therapy for bacteremia, Factor XI inhibition for atrial fibrillation, whether to stop ACEi or ARB before elective surgery, and whether GLP-1 agonists are beneficial in heart failure with preserved ejection fraction.
Go to minute 7:30 to skip the banter.
7 vs 14 Days of Antibiotics for Bacteremia (BALANCE)
Abelacimab vs Rivaroxaban for Atrial Fibrillation (AZALEA-TIMI-71)
Asenduxian vs Apixaban for Atrial Fibrillation (OCEANIC-AF)
ACEi or ARB Discontinuation Before Surgery (STOP or NOT)
Tirzepatide for HFpEF and Obesity (SUM...
Anticoagulation in AF with Cirrhosis, Trends in Anticoagulation for Acute PE, Beta Blockers for Acute MI with Normal EF, Finerenone for HFpEF, Continuous vs Intermittent Infusion for Antibiotics, Cefepime vs Piperacillin-Tazobactam for Sepsis
It's been a long time, but we are back!
Apologies on the audio quality from Dr. Jenkins. Apparently he was recording from inside a cardboard box.
Today we talk about important, practice changing studies in internal medicine from the last several months. What's the best anticoagulant in patients with cirrhosis and atrial fibrillation? Why do doctors use so much unfractionated heparin for acute PE? Should we still be using beta blockers in patients with acute MI? Does finerenone improve outcomes in HFpEF? Is continuous infusion of antibiotics better than intermittent? And will the cefepime vs...
Metformin and Long COVID, Central Lines and Thrombocytopenia, DOACs vs LMWH in Cancer Associated Thrombosis, Early vs Late Anticoagulation after Stroke with Atrial Fibrillation
Today we are joined by Dr. Brian Locke, recently graduated pulmonary-critical care fellow, who takes us on a journey of avoiding statistical fallacies. Does metformin reduce the likelihood of long COVID? Should we give platelet transfusions to thrombocytopenic patients before central line placement? Did the CANVAS trial change practice in cancer associated thrombosis? Should patients with a stroke due to atrial fibrillation start oral anticoagulation earlier or later? We discuss all these questions on more on today's episode. Check it out!
Metformin for Long COVID
Definition of Post Acute Sequelae of Sars-CoV-2 Infection
Platelet Transfusion...
Osmotic Demyelination Syndrome and Hyponatremia with Dr. Joel Topf, Apixaban vs Warfarin for On-X Aortic Valve, Perioperative Blood Pressure Strategies, Diagnostic Accuracy of CT Abdomen Without Contrast
Today we have a special guest, Dr. Joel Topf, board-certified nephrologist and medical educator extraordinaire. Our listeners will likely recognize Dr. Topf from his prolific tweeting @Kidney_boy, as well as his numerous appearances on the Curbsiders podcast. He is a co-founder of the NephJC on Twitter, and host and founder of the NephJC podcast Freely Filtered. He is also host of the podcast Channel Your Enthusiasm, a deep dive monthly recap of the nephrology textbook Clinical Physiology of Acid Base and Electrolyte Disorders by Dr. Burton Rose (who, incidentally, is the creator of the original UpToDate). Dr. Topf...
Doxycycline Post-Exposure Prophylaxis for STIs (DoxyPEP), High Dose Prophylactic Anticoagulation for COVID-19 (ANTICOVID), Rates of Fracture Non-union and Bisphosphonates
This week we have special guest, Dr. Adam Spivak, to talk about the new study on doxycycline post-exposure prophylaxis for STIs. Dr. Spivak is an infectious disease expert and works in both an HIV clinic and a free PrEP clinic.
I also review the latest COVID-19 anticoagulation trial and a paper looking at rates of fracture non-union in people who receive bisphosphonates. Check it out!
Doxycycline Post-exposure Prophylaxis for STIs
High dose prophylactic anticoagulation in COVID-19
Bisphosphonate and Rates of Fracture Non-unions
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Thiazides for Kidney Stones, Hydrocortisone for Severe Pneumonia (CAPE COD), 2023 GOLD COPD Guidelines, Real World Use of Oral Antibiotics for Infective Endocarditis
Today we have special guest, Dr. Sarah Gilligan, a nephrologist, to talk about the new study of thiazides for kidney stones. We all learn in medical school that thiazides reduce urinary excretion of calcium, but does that really translate to fewer kidney stones?
We also have Dr. Brian Locke on to talk about the CAPE COD trial, a big new critical care paper on using hydrocortisone in severe pneumonia, as well as the latest COPD guidelines and a retrospective study of oral antibiotics for infective endocarditis. Check it out!
Hydrochlorothiazide for Kidney Stones<...
Antibiotic Duration for Febrile UTI in Males, Lower GI Bleeding Guidelines, Intravenous Contrast in Patients with Acute Kidney Injury
Today we welcome special guest and fellow EBM lover Dr. Mita Hoppenfeld to talk about a new randomized controlled trial evaluating the best duration of antibiotics for febrile UTI in men. Is 7 days as good as 14 days? We also review the latest guidelines for lower GI bleeding and a new retrospective study on renal outcomes in patients with AKI who receive IV contrast.
7 vs 14 days of antibiotics for Febrile UTI in Men
Lower GI Bleeding Guidelines
IV Contrast in patients with AKI
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Early Vasopressors and Restrictive Fluids in Septic Shock (CLOVERS), Furosemide vs Torsemide in Heart Failure (TRANSFORM-HF), Aspirin vs Enoxaparin after Extremity Fracture (PREVENT CLOT), Haloperidol for ICU Delirium (AID-ICU)
We're back with Season 4! Sorry for the unplanned hiatus.
Today we talk about the CLOVERS trial, which tested the hypothesis that early vasopressors and restrictive fluid would be superior to liberal fluids plus rescue vasopressors. We also looked at the TRANSFORM-HF study, which compared torsemide and furosemide in congestive heart failure, the PREVENT CLOT study, which compared aspirin to enoxaparin for VTE prophylaxis after a traumatic fracture, and the AID-ICU study, which compared haloperidol to placebo in the treatment of ICU delirium.
CLOVERS trial
Torsemide vs Furosemide in CHF
Aspirin vs Enoxaparin for...
SGLT2 Inhibitors for Acute Heart Failure, SGLT2 Inhibitors vs Metformin, High Dose Dexamethasone for COVID-19 in ICU, Isolated Distal DVT, Monkeypox, Blood Donor Sex and Mortality, Outcomes in Surgeons Who Operate the Night Before
Today we have a couple special guests under the age of 2. Birdie and Gus!
Do SGLT2 inhibitors improve diuresis in acute heart failure? Are they better than metformin for reducing cardiovascular mortality? Is high dose dexamethasone better than standard dose in ICU patients with COVID?
We also talk about outcomes in patients with isolated distal DVT compared to proximal DVT, a large case series of patients with monkeypox infection, blood donor outcomes and the outcomes for surgeons who operated the night before. Check it out!
SGLT2-Inhibitors for Acute Heart Failure
...
Restrictive Fluids in Septic Shock, Short vs Standard Antibiotics in Neutropenic Fever, IV Vitamin C for Septic Shock, Hospitalist Workload and Patient LOS, Fluid Bolus for Intubation, General Internist Practice Choices
Today we are joined by Dr. Brian Locke to talk about multiple new critical care trials, including the CLASSIC trial of a restrictive vs standard fluid strategy, the LOVIT trial of vitamin C in septic shock, and the PREPARE-II trial of fluid bolus at the time of intubation to prevent cardiovascular collapse. We also look at whether 72 hours of antibiotics are safe in patients with neutropenic fever, whether hospitalist workload affects patient length of stay, and what kind of careers general internists are pursuing over the last decade.
Restrictive Fluids for Septic Shock
Short vs Standard...
Inpatient Management of Opioid Use Disorder, Hep C Treatment in IVDU, Final SOLIDARITY Results for Remdesivir, TAVI for Moderate Risk Severe AS, Mediterranean Diet vs Low Fat Diet, Steroids for IgA Nephropathy, GLP-1s and Gallbladder Disease
Today we had Dr. Patricia Liu to talk about a new study from Journal of Hospital Medicine on the management of opioid use disorder in the hospital. And then we got a little carried away covering way too many articles!
Inpatient Management of Opioid Use Disorder
Hepatitis C Care for People Who Inject Drugs
Final SOLIDARITY trial results for Remdesivir
TAVI for Moderate Risk Severe Aortic Stenosis
Mediterranean Diet vs Low Fat Diet for Secondary Prevention of CVD
Steroids for IgA Nephropathy
GLP-1 Agonists and Gallbladder Disease
Pig to Human K...
2022 AHA/ACC/HFSA Heart Failure Guidelines with Dr. James Fang, Guideline Committee Member
Today, Dr. James Fang, Chief of Cardiovascular Medicine at the University of Utah, and AHA/ACC/HFSA Heart Failure Guideline Committee Member, joins us to talk about the new heart failure guidelines, published in April 2022. We talk about the new classifications, including HF with improved EF and HF with mildly reduced EF, and new recommendations for medical therapy for all the heart failure types. How do you start someone on GDMT? Who should get SGLT-2 inhibitors? How can we get more people on ARNIs? Dr. Fang provides lots of clinical pearls and practical wisdom for applying these new recommendations. C...
Oral Carbapenem for Complicated UTIs, Awake Proning for COVID-19, 1-2 Months DAPT vs 12 Months DAPT, Low Sodium Diet for Heart Failure, Excess Mortality From COVID-19, IV Iron and Anaphylaxis, Pickle Juice for Cramps in Cirrhosis
Dr. Brian Locke is back to talk about that "nonrandomized" proning trial. We also talk about the new oral carbapenem for UTI trial, whether 1-2 months of DAPT is non-inferior to 12 months of DAPT, whether less than 1500 mg of sodium reduces heart failure hospitalizations, the risk of anaphylaxis from IV iron, and whether pickle juice is effective for treating cramps in cirrhosis. Check it out!
Oral Tebipenem vs IV Ertapenem for Complicated UTI
Awake Proning for Hospitalized COVID-19 Patients
1-2 Months of DAPT vs 12 months of DAPT vs ACS
Low Sodium Diet for Heart F...
Reliever-Triggered ICS Therapy for Asthma, Methenamine for UTI Prevention, CT vs Invasive Coronary Angiography, Melatonin for Delirium Prevention, Interpretation of Home COVID Tests, Characteristics of Type 2 MI
Today we have Dr. Brian Locke back on to talk about asthma management and a new trial of reliever-triggered inhaled glucocorticoids for Black and Latinx patients with asthma. Other questions we try to answer: Does methenamine prevent recurrent UTIs in women? Should CT coronary scan be done before invasive coronary angiography? Does melatonin prevent delirium in ICU patients? How good are patients at interpreting home COVID tests? What is the most common cause of type 2 NSTEMI? Give it a listen and find out!
Reliever Triggered Inhaled Glucocorticoid Therapy in Black and Latinx Asthma Patients
Methenamine vs A...
Paxlovid for COVID-19, Ivermectin Ineffective for COVID-19, One Year Outcomes for ICU COVID-19 Patients, Diagnostic Strategies for Ruling Out PE, Thiamine for Alcohol Use Disorder, Skin Color and Pulse Oximetry
We finally have the published trial results for Paxlovid! We also look at the latest trial showing the ivermectin is ineffective in treating COVID-19 and one year outcomes in ICU COVID-19 patients. We also look at a meta-analysis of trials looking at different diagnostic strategies for ruling out PE, a retrospective study of thiamine use in ICU patients with alcohol use disorder, and a new study on pulse oximetry in people with different skin color. Check it out!
Paxlovid for High Risk, Nonhospitalized Patients with COVID-19
Ivermectin for Mild to Moderate COVID-19
County-Level P...
Balanced Crystalloid vs Normal Saline (PLUS trial), Midline vs PICC, LOLA for Hepatic Encephalopathy, Eat-Walk-Engage Program for Older Inpatients, Post-Discharge Thromboprophylaxis for COVID-19, Mindfulness Training and Burnout
Today we are joined by Dr. Brian Locke to talk about the newest big trial on IV fluids in critically ill patients and a meta-analysis that looks at all the similar trials. Is this question finally settled?
We also look at PICC lines vs midlines, IV L-ornithine L-aspartate in acute treatment of hepatic encephalopathy, a new ward-based program for delirium prevention in older inpatients, post-discharge thromboprophylaxis for high risk COVID patients, and whether mindfulness training can help burnout in residents.
Balanced Multielectrolyte Solution vs Normal Saline in Critically Ill Patients (PLUS)
Balanced Crystalloid vs...
Ultrasound JVP to Estimate CVP, IV Metoprolol vs Diltiazem for Atrial Fibrillation with RVR, Ischemic Stroke and Bleeding Risk with Apixaban vs Rivaroxaban, Reducing Sleep Interruptions in Hospital, Outpatient Remdesivir, Molnupiravir for COVID-19
It's our last episode in 2021! This episode we have Dr. Libo Wang and Dr. Jon Harrison on to talk about their new paper in the Annals of Internal Medicine about ultrasound JVP for estimating CVP, validated with right heart catheterization. We also ask them their thoughts on a new meta-analysis looking at metoprolol vs diltiazem for atrial fibrillation with RVR.
We also look at a new large retrospective study of apixaban vs rivaroxaban for stroke prevention, a study looking at reducing sleep interruptions in the hospital, and two new outpatient therapies for COVID-19 infection.
Happy...
Chlorthalidone in CKD, Factor XI Inhibition for VTE Prevention, Untreated Subsegmental PE and Risk of Recurrent VTE, Rivaroxaban and GI Bleeding, Mental Stress Induced Ischemia, Depression and Residency, Patient Outcomes for Part Time Hospitalists
Somehow we got through 7 articles today, and none of them are about COVID-19!
Happy Thanksgiving!
Chlorthalidone in CKD
Milvexian for VTE Prevention
Risk of Recurrent VTE in Subsegmental PE
Rivaroxaban associated with higher rates of GI bleeding
Depression and Residency
Mental-Stress Induced Myocardial Ischemia
Patient Outcomes for Part Time Hospitalists
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Race and Estimated GFR, Bleeding Risk in Oral Anticoagulation after First VTE, HEP-COVID trial, High Dose Dexamethasone for COVID-19
Today we talk about the effect of eliminating the race coefficient from the estimated GFR calculators, the risk of bleeding from anticoagulation after first unprovoked VTE, another trial looking at therapeutic anticoagulation in COVID-19, and whether 12 mg of dexamethasone is better than 6 mg for severe COVID-19 infections.
New GFR Equations without Race
Race, Genetic Ancestry and Estimating Kidney Function
Long Term Bleeding Risk from Oral AC after First Unprovoked VTE
Therapeutic Heparin for COVID-19 (HEP-COVID)
High Dose Dexamethasone for Severe COVID-19
Music from...
Empagliflozin for HFpEF, Antibiotic Duration for UTIs in Men, Targeted Temperature after Cardiac Arrest, Normal Saline vs Balanced Solution in ICU Patients, Baricitinib and Therapeutic Anticoagulation for Hospitalized COVID-19 Patients
We're back after a nice relaxing summer taking care of a surge of COVID-19 patients. To start off season 3 we decided to do a rapid review of some of the best articles over the last three months. Dr. Brian Locke returns to help us break down some critical care papers, we talk about the miracle of SGLT-2 inhibitors, the treatment of UTIs in men, and the latest in COVID-19 literature.
Hypothermia vs Normothermia after Cardiac Arrest
Empagliflozin for Heart Failure with Preserved EF
Antibiotic Duration for Afebrile UTIs in Men
Normal Sal...
Antibiotic Duration for Prosthetic Joint Infections, Colorectal Cancer Screening Guidelines, Hospital Observation after ACS Ruled Out in ED, Morning Discharges, Personalized Steroid Regimen for COPD Exacerbation
Today is our season 2 finale, and we have a master class on prosthetic joint infections from Dr. Laura Certain. Is 6 weeks as good as 12 weeks for prevent recurrent infections? How does the surgeon decide what kind of surgery to do? Should we use oral or IV antibiotics? When should you use rifampin?? Dr. Certain answers all these questions and more.
We also talk about the new colon cancer screening guidelines from USPSTF, hospital admission for chest pain after ACS ruled out in the ED, whether morning discharges improve patient throughput, and a study looking at personalized steroid dose...
Antibiotic Delay Intervals and Hospital Mortality for Patients with Suspected Sepsis, Guidelines for High Flow Nasal Oxygen and Point of Care Ultrasound for Acute Dyspnea, Screening for Atrial Fibrillation in Older Patients
How long can you delay antibiotics in patients with suspected sepsis before the risk of hospital mortality increases? What proportion of patients with suspected sepsis end up having actual sepsis? Dr. Devin Horton joins us to review a paper in Critical Care Medicine that tries to answer these questions.
Antibiotic Delay Intervals and Hospital Mortality for Patients with Suspected Sepsis
High Flow Nasal Oxygen
POCUS for Acute Dyspnea
Screening of Atrial Fibrillation in Older Patients
Music from https://filmmusic.io
"Sneaky Snitch" by Kevin Mac...
Hospital at Home for Geriatric Patients, RAAS Inhibition and Pulmonary Hypertension, Vaccine Induced Immune Thrombotic Thrombocytopenia (VITT)
Today we have special guest Dr. Natalie Como to talk about Hospital at Home and what it's like to practice hospital medicine at a rural critical access hospital. We also look at a retrospective paper on ACE/ARBs in veterans with pulmonary hypertension and talk about vaccine-induced immune thrombotic thrombocytopenia (VITT). Check it out!
Hospital at Home with Comprehensive Geriatric Assessment
RAAS Inhibition and Pulmonary Hypertension
Vaccine-Induced Immune Thrombotic Thrombocytopenia
Music from https://filmmusic.io
"Sneaky Snitch" by Kevin MacLeod (https://incompetech.com)
Three Days of Antibiotics for Pneumonia, IV Contrast and Kidney Function, DOACs for Valvular Atrial Fibrillation
Today we are joined by heavy hitter Dr. Brian Locke to talk about the new paper on 3 vs 8 days of antibiotics for pneumonia, a clever new paper looking at whether there is any association between IV contrast and kidney function, and a new retrospective study on DOAC use for valvular atrial fibrillation. Check it out!
Three Days of Antibiotics for Pneumonia
IV Contrast and Kidney Function
DOACs for Valvular Atrial Fibrillation
Music from https://filmmusic.io
"Sneaky Snitch" by Kevin MacLeod (https://incompetech.com)
License: CC B...
Weekly Semaglutide for Weight Loss (STEP 1, 2 and 3 Trials), 4PEPS Rule for Pulmonary Embolism, Nafcillin vs Cefazolin for Epidural Abscess, Ferritin/Procalcitonin Ratio for COVID19, Intermediate Thromboprophylaxis for COVID19
Today we are doing double duty: podcasting and parenting. Fortunately our babies were well-behaved. We talk about three trials for semaglutide and weight loss and a new 4 level pre-test probability rule for diagnosing PE. We also talk about a retrospective study of cefazolin vs nafcillin for epidural abscess, a ferritin/procalcitonin ratio for differentiating bacterial from COVID pneumonia, and a new randomized controlled trial of intermediate thromboprophylaxis for ICU patients with COVID19. Check it out!
Semaglutide for Weight Loss (STEP 1)
Semaglutide for Weight Loss in Diabetics (STEP 2)
Semaglutide + Intensive Calorie Restriction for Weight Loss (STEP...
Albumin Infusion for Decompensated Cirrhosis (ATTIRE trial), Terlipressin for Type 1 Hepatorenal Syndrome (CONFIRM trial)
Today has a nice liver disease theme. Does targeting a serum albumin above 3 g/dL reduce death, infections and kidney failure in patients with decompensated cirrhosis? Does terlipressin work in hepatorenal syndrome?
Albumin Infusion for Decompensated Cirrhosis
Terlipressin for Type 1 Hepatorenal Syndrome
Music from https://filmmusic.io
"Sneaky Snitch" by Kevin MacLeod (https://incompetech.com)
License: CC BY (http://creativecommons.org/licenses/by/4.0/)
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IL-6 Receptor Antagonists Reduce Mortality in Critically Ill COVID-19 Patients (REMAP-CAP, RECOVERY), Convalescent Plasma Fails to Improve Mortality
Today I am joined by Infectious Disease expert Dr. Emily Spivak to talk about the latest batch of tocilizumab trials for COVID-19 and a meta-analysis of all the convalescent plasma trials. Check it out!
Tocilizumab in Hospitalized Patients with COVID-19 (COVACTA)
IL-6 Receptor Antagonists in Critically Ill Patients with COVID-19 (REMAP-CAP)
RECOVERY Tocilizumab pre-print
Meta-analysis of Convalescent Plasma for COVID-19
Music from https://filmmusic.io
"Sneaky Snitch" by Kevin MacLeod (https://incompetech.com)
License: CC BY (http://creativecommons.org/licenses/b...
Gender-Based Discrimination and Harassment Among Hospitalists, Educational Resource Utilization in Internal Medicine Residents, Transfusion Thresholds for ACS, DOACs for VTE prevention in CKD
Today we have special guests Dr. Emily Signor and Dr. Amanda Breviu, two hospitalists, to talk about a survey published in JHM on gender-based discrimination among hospitalists. We also discuss a survey published in JGIM on educational resources used by internal medicine residents. Check it out!
Gender Based Discrimination and Harassment Among Hospitalists
Educational Resource Utilization Among Internal Medicine Residents
Liberal vs Restrictive Transfusion Threshold for Patients with ACS and Anemia
DOACs for VTE prevention in CKD
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Early Ablation vs Medications for Atrial Fibrillation (STOP-AF First, EARLY-AF), ACEi and ARBs in COVID-19, IV vs Oral Antibiotics for Appendicitis, Rifaximin after TIPS, Low vs High Oxygen Targets
Today we have a special guest, Dr. Jared Bunch, an international expert in atrial fibrillation and ablation, to talk about the state of atrial fibrillation and which patients benefit from early catheter ablation based on two new trials published last week in the NEJM. We also talk about whether you should stop ACEi or ARBs in patients admitted with COVID-19, whether oral antibiotics are adequate for uncomplicated appendicitis, and whether you should target a high (90 mmHg) or low (60 mmHg) paO2 in patients with respiratory failure.
STOP-AF First trial
EARLY-AF trial
ACEi and ARBs in COVID-19
Inhaled Treprostinil for Pulmonary Hypertension due to Interstitial Lung Disease, Omecamtiv Mecarbil for Systolic Heart Failure (HFrEF)
Today I am joined by pulmonary hypertension and heart failure expert, Dr. John Ryan, to talk about inhaled treprostinil for pulmonary hypertension due to ILD, and a new cardiac myosin activator, omecamtiv mecarbil, for treatment of systolic heart failure. Check it out!
Treprostinil for Pulmonary Hypertension due to ILD
Omecamtiv Mecarbil for Systolic Heart Failure
Music from https://filmmusic.io
"Sneaky Snitch" by Kevin MacLeod (https://incompetech.com)
License: CC BY (http://creativecommons.org/licenses/by/4.0/)
Music from U...
Prevalence of Pulmonary Embolism in Acute COPD Exacerbation, Tocilizumab for COVID-19 Round 3
WARNING: This episode is long on banter. If you would like to skip the intro conversation and get right to the articles, skip ahead to 12:13.
Today we are joined by Dr. Jason Carr, pulmonary-critical care all-star, to talk about how often PE is present in patients with acute COPD exacerbations. We also review more tocilizumab RCTs because they just keep coming.
Prevalence of Pulmonary Embolism in Acute COPD Exacerbation
STOP-IT COVID trial
RCT-TCZ-COVID-19 trial
CORIMUNO-TOCI-1 trial
REMAP-CAP trial pre-print
Music from htt...
Treatment of Inpatient Hypertension, Testing and Treatment of Primary Aldosteronism in Patients with Resistant Hypertension, Tocilizumab for COVID-19 Round 2
The president's supporters may have stormed the capitol and attempted a coup today, but the show must go on. Today I'm joined by Dr. Dani Babbel to talk about treatment of hypertension in the hospital, as well as testing for primary aldosteronism in patients with resistant hypertension. Check it out!
Treatment and Outcomes in Inpatient Hypertension
Testing for Primary Aldosteronism and MRA Use Among US Veterans
Tocilizumab in Hospitalized Patients with COVID-19
Music from https://filmmusic.io
"Sneaky Sni...
Thrombosis and COVID-19
Today I do a quick review of the COVID-19 thrombosis literature from the last year to try to answer some of the following questions: Why does COVID-19 cause thrombosis? How many patients with COVID-19 develop thrombotic complications? Why do patients with COVID-19 on VTE prophylaxis still develop blood clots? Should we use intermediate dosing of anticoagulation for prophylaxis? What about full dose therapeutic anticoagulation (no!) What do the guidelines say?
Lots of papers:
JAMA IM Review
Autopsy Findings and VTE in Patients with COVID-19
Klok et al
Helms et al
Shah et al
