Run the List

Brooke Matson, an endocrinologist specializing in obesity management, shares her insights on treating obesity as a chronic disease. She emphasizes a patient-centered approach that focuses on modest weight loss to prevent complications. Brooke discusses the importance of lifestyle changes, the role of medications like GLP-1 receptor agonists, and when to consider bariatric surgery. The conversation highlights the need for support teams and community programs, along with addressing mental health in obesity management. A practical, compassionate view on navigating obesity is the key takeaway.

Dr. Navin Kumar, a gastroenterologist from Brigham and Women's Hospital and co-founder of the podcast, joins Ally Scheve to discuss effective treatment strategies for Small Intestinal Bacterial Overgrowth (SIBO). They delve into the significance of SIBO subtypes—hydrogen vs. methane—and their impact on treatment choices. Navin shares insights on using rifaximin and the complexities of managing methane-predominant cases with dual therapy. He also highlights non-antibiotic solutions like the low FODMAP diet and specific supplements for symptom relief.

Dr. Navin Kumar, a gastroenterologist and co-founder of a clinical education platform, teams up with guest-host Ally Scheve to unravel the complexities of diagnosing Small Intestinal Bacterial Overgrowth (SIBO). They dive into diagnostic tools, particularly focusing on the lactulose breath test and its procedure. Key insights include how to prepare for an accurate test, the significance of monitoring hydrogen and methane levels, and the impact of rapid transit on results. This conversation is packed with essential knowledge for those navigating digestive health.

In this discussion, Ally Scheve, a third-year medical student, teams up with Dr. Navin Kumar, a gastroenterologist, to unravel the complexities of Small Intestinal Bacterial Overgrowth (SIBO). They delve into the pathophysiology behind SIBO and how bacterial growth triggers uncomfortable GI symptoms like gas and bloating. Dr. Kumar highlights how nutritional deficiencies, particularly B12, arise from bacterial interference and identifies key risk factors, including altered GI motility and the impact of proton pump inhibitors on SIBO development.

Dr. Mitchell Charap, a seasoned internal medicine clinician and former residency program director at NYU Langone, delves into a perplexing clinical case. He highlights the pitfalls of relying solely on illness scripts for diagnosis, especially when symptoms can be misleading. The discussion includes a patient experiencing unusual chest and shoulder pain, leading to the surprising discovery of pulmonary emboli through meticulous diagnostics. Charap emphasizes the importance of physical exams and adapting clinical reasoning, especially in younger patients.

Dr. Maria Sunseri, a critical care attending and clinical assistant professor, and Dr. Brynna Crovetto, a critical care pharmacist focused on optimizing medication in the ICU, share their expertise on sedation and analgesia. They discuss assessing agitation in patients and using the Richmond Agitation and Sedation Scale for tailored sedation levels. The duo compares various sedative agents like fentanyl and dexmedetomidine, emphasizing individualized protocols. They also offer insights on safely weaning sedation and the importance of interdisciplinary collaboration during extubation.

Dr. Matthew Pullen, an infectious disease physician at the University of Minnesota, sheds light on blastomycosis, a rare fungal infection. He discusses an intriguing case of a patient with unusual symptoms that complicate diagnosis. The conversation highlights the challenges in identifying the disease across various clinical manifestations, including pulmonary and cutaneous forms. Dr. Pullen also emphasizes the importance of diagnostic tests, such as tissue biopsy and antigen testing, along with treatment strategies based on disease severity.

Dr. Vikramjit Mukherjee, a critical care physician specializing in septic shock management, joins Dr. Emily Gutowski for an eye-opening discussion. They break down the differences between SIRS, sepsis, and septic shock, highlighting essential identification techniques. The conversation also dives into recognizing infection sources and red flags, along with the importance of timely fluid resuscitation for vulnerable patients. Lastly, they detail the critical use of vasopressors, emphasizing the need for swift action in improving patient survival.

Dr. Brooke Matson, an endocrinologist at UNC Chapel Hill, dives into the world of osteoporosis. She explains the diagnosis process, including the use of the FRAX calculator for assessing fracture risk. Brooke discusses the differences between antiresorptive and anabolic therapies, emphasizing patient-centric treatment. Practical lifestyle changes for fracture prevention, such as dietary tips and exercise strategies, are also highlighted. This engaging discussion is a must-listen for anyone interested in bone health!

Dr. Michael Janjigian, an associate professor at NYU and expert in perioperative medicine, joins Dr. Emily Gutowski to delve into preoperative assessments. They discuss recent updates to management guidelines and the use of cardiac risk scores, such as RCRI and Gupta. Insights are shared on the importance of evaluating comorbidities and readiness for surgery, including the role of BNP levels. The conversation emphasizes a multidisciplinary approach and the necessity of teamwork in optimizing surgical outcomes, making complex topics accessible for all.