Annals On Call Podcast

Dr. Centor discusses why guidelines recommending that clinicians advise patients on lifestyle changes may be a questionable approach to improving public health with Dr. Minna Johansson.

Mark Sarnak, Chief of Nephrology at Tufts School of Medicine, dives deep into the role of renin-angiotensin system blockade in advanced chronic kidney disease. He discusses the complexities and risks associated with using ACE inhibitors and ARBs, particularly hyperkalemia and acute kidney injury. Highlighting meta-analyses, he reveals significant reductions in kidney failure events with these treatments. The conversation also covers new insights into potassium management and the promising role of SGLT2 inhibitors, capturing the optimism in nephrology communities.

Eileen Barrett, an expert in internal medicine and former chair of the American College of Physicians Board of Regents, joins Amanda Collar, an internal medicine intern and kratom researcher. They unpack the recreational uses of kratom, noting its methods of consumption and its potential for pain relief. The discussion dives into the regulatory challenges and health risks associated with kratom, as well as its complex role as a possible gateway substance. Emphasis is placed on improving physician-patient communication and the urgent need for further research on kratom's safety.

Dr. Centor discusses the importance of physician humility with Dr. Caroline Matchett.

Dr. Barbara Jones, an associate professor at the University of Utah specializing in pulmonary and critical care, dives into the intricate world of diagnosing community-acquired pneumonia. She highlights the clinical challenges that arise from overlapping symptoms, especially in older patients. The conversation reveals how misdiagnoses can occur in emergency settings and introduces innovative tools like natural language processing to enhance diagnostic accuracy. The importance of communication and patient involvement in navigating diagnostic uncertainty is emphasized throughout.

Dr. Centor discusses the diagnosis of giant cell arteritis with Dr. Sebastian Sattui.

Nadia Daneshvar, an expert in the responsible use of AI in healthcare, joins Deepti Pandita, a medical professional, to discuss critical topics surrounding AI integration in medicine. They highlight the ethical and legal frameworks necessary for effective AI application. The conversation emphasizes the need for human oversight in clinical decision-making and the importance of personalized healthcare. They also explore the transition to value-based care and the challenges posed by opaque AI processes, advocating for improved education and the crucial role of physicians.

Dr. Michael Klompas, a leading expert in sepsis, joins to unpack the complexities surrounding this often-misunderstood condition. They discuss the varying presentations of sepsis and the critical risks of misdiagnosis in atypical cases. A retrospective analysis reveals how infection sites and organ dysfunction impact patient outcomes. Klompas emphasizes the importance of precise classifications and the necessity for clinical judgment over rigid prediction models. The conversation sheds light on treating sepsis as a spectrum, calling for tailored management strategies.

Dr. Centor discusses time-restricted eating as a weight loss strategy with Dr. Nisa Maruthur.

Dr. Centor discusses the pharmacologic treatment of type 2 diabetes in light of newer drugs with Dr. Carolyn Crandall.