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…

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 as…

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 Fr…

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 r…

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 ca…

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 …

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 PR…

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…

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 antib…

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 Remdesiv…

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 fo…

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 f…

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 preven…

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 pat…

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 de…

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 fibrillat…

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 Hospit…

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 withou…

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…

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…

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 Morta…

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 a…

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 P…

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 diff…

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 Snit…

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) RECOVER…

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 Hosp…

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…

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 Systol…

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…

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…

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 an…

Today we have special guest Dr. Valerie Vaughn to talk about her new paper in Open Forum Infectious Diseases about inappropriate treatment and testing for asymptomatic bacteriuria. Then we talk about the new ACTT-2 trial results of baricitinib plus remdesivir for COVID-19. We also review the BioNTech/Pfizer vaccine safety and efficacy results, a no…

Today we have special guests Dr. Claire Ciarkowski and Dr. Stacy Johnson to talk about two recent papers they published, as well as the new SOLIDARITY trial results. Are patient outcomes the same for resident, APC and solo hospitalist teams? How do you get doctors to switch to oral antibiotics faster when treating pneumonia? And with the new SOLIDA…

We're back with our second episode of the new season. Dr. Rupp is sporting a new mustache, and we discuss the mysterious monolith discovered in the Utah desert. If you want to skip the banter, go to 6:56. This week we try to figure out what that Danish Mask Study really showed. Is it safe to use rivaroxaban in patients with a bioprosthetic mitral v…

We're back after a prolonged hiatus, ready to break down the latest and greatest in the medical literature. Today's episode will get you caught up on the newest treatments for COVID-19. We promise to talk about something else next time :) If you want to skip all the banter about Baby Yoda and politics, go to 8:36. Remdesivir for COVID-19 Final Repo…

Today we are joined by a special guest, Dr. Lawanda Jim, chief of internal medicine at Northern Navajo Medical Center, to talk about what it's been like taking care of patients during the pandemic in Shiprock, NM. Check it out! Music from https://filmmusic.io "Sneaky Snitch" by Kevin MacLeod (https://incompetech.com) License: CC BY (http://creative…

Today we're back with a spirited discussion of a pre-print publication for the dexamethasone arm of the RECOVERY trial. Should hospitalized COVID19 patients receive dexamethasone? Take a listen and decide for yourself. Dexamethasone in Hospitalized Patients with COVID-19 Music from https://filmmusic.io "Sneaky Snitch" by Kevin MacLeod (https://inco…

We're back with another episode. We cover the latest highlights in COVID, including the exciting new results on remdesivir from the ACTT-1 trial. We also talk about whether you can use CRP to guide duration of antibiotic therapy in patients with gram negative bacteremia, and whether NT-pro-BNP can help you risk-stratify patients with syncope. Check…

We're back with some of the latest updates on COVID-19! Are hydroxychloroquine or azithromycin associated with increased risk of mortality or cardiac arrest? Does triple combination antiviral therapy shorten time to a negative viral swab? Does remdesivir shorten time to clinical improvement? Should we be giving patients convalescent plasma? If you …

It's been a while! We took a short hiatus while our lives were upended by the pandemic. But we couldn't stay away forever. Today we review some of the big trials published in the last month on Covid-19. We look at the large case series on New York patients published in JAMA, three hydroxychloroquine studies, the lopinavir-ritonavir study and the co…

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 w…

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 …

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 an…

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 …

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…

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…

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…

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 th…

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…