Core IM | Internal Medicine Podcast

The discussion delves into the evolution of HIV prevention strategies, comparing oral PrEP options like Truvada to innovative long-acting injectables. The groundbreaking PURPOSE trials showcase lenacapavir's impressive efficacy, particularly in diverse populations, revealing zero infections among treated cisgender women. Barriers to access and adherence are critically examined, emphasizing the need for equitable solutions. With promising results on the horizon, the future of HIV prevention looks brighter, potentially revolutionizing care for those at risk.

Dr. Steve Nissen from Cleveland Clinic, a leading figure in lipoprotein(a) research, joins Dr. Greg Katz from NYU to delve into crucial insights about this underappreciated lipid layer. They discuss why Lp(a) is essential for evaluating cardiovascular risk and who should be tested. Listeners will learn about interpreting results, managing elevated levels, and the potential roles of aspirin and PCSK9 inhibitors. The episode highlights the evolving strategies in understanding and treating Lp(a), offering a fresh perspective on patient care.

Dr. Rebecca Carpley, a hematologist at Massachusetts General Hospital, dives into the complexities of hypercoagulability and the nuances of clot management. She discusses reframing clots by reversibility, shedding light on how Virchow's triad categorizes clot etiology. Dr. Carpley addresses inherited protein deficiencies, emphasizing factors influencing testing. The conversation also examines the reliability of genetic tests like Factor V Leiden, considering the critical role of family history in assessing thrombosis risks. Insights into individualized care for women of childbearing age add depth to this engaging discussion.

Dive into the untapped world of microplastics and their alarming connection to cardiovascular health. Discover how microplastics infiltrate our bodies and their potential role in heart disease, as highlighted by the APAChE study. The discussion navigates the challenges of educating families about plastic exposure, especially for children, and emphasizes the urgent need for further research. With a focus on informed decision-making, the podcast sheds light on a pressing environmental health issue that affects us all.

Discover the emotional impact of music therapy in hospice care. Learn how music can create connections and ease anxiety for patients in their final moments. Hear moving stories illustrating the profound effects of music on grief and healing. Explore the challenges faced by music therapists and their essential role in enhancing the quality of life during end-of-life care. This discussion underscores the importance of integrating music therapy into healthcare for emotional and cognitive well-being.

Rob Palowell, a pulmonologist from Massachusetts General Hospital, and Kelly Graham, a primary care physician at Beth Israel Deaconess Medical Center, delve deep into interstitial lung disease (ILD). They discuss the challenges of diagnosing incidental lung findings and the nuances between antifibrotics and immunosuppression. The conversation also highlights the complexities of patient care, especially when social barriers hinder treatment. Both emphasize a holistic approach, addressing patients' basic needs alongside their medical conditions for better care outcomes.

Join Dr. Aaron Goodman, a hematology oncologist from UC San Diego, and Dr. Vincent Rajkumar, an expert in multiple myeloma, as they delve into the complexities of monoclonal gammopathies. They clarify the roles of SPEP and immunofixation in diagnosis. Listeners will learn about the continuum from MGUS to multiple myeloma and the importance of urine testing. The discussion also tackles the clinical significance of symptoms in renal, neurologic, and dermatologic contexts. Key insights into patient counseling round out this informative conversation!

Explore the world of immune checkpoint inhibitors and their unusual, yet challenging, adverse events. Learn how to distinguish these reactions from infections, delving into issues like pneumonitis, colitis, and dermatitis. Discover the importance of early identification and the role of imaging techniques in diagnosing respiratory symptoms. Understand the long-term management of endocrinopathies, including hormone replacement strategies. Each case study reveals the complexities of treatment and the essential need for teamwork in patient care.

Dr. Allie Sheridan, an expert in inhaler delivery systems and patient counseling for respiratory issues, dives into the importance of proper inhaler techniques for asthma and COPD management. The conversation also highlights crucial insights on iron deficiency in pregnancy, stressing the need for routine screening to protect maternal and fetal health. Listeners gain valuable knowledge on the differences between oral and IV iron treatments, emphasizing the best practices for supporting pregnant women and addressing broader health impacts.

Discover the latest research on stress ulcer prophylaxis in ICU patients, focusing on proton pump inhibitors (PPIs) and their potential risks like aspiration pneumonia. Dive into the REVISE trial findings and understand the complexities surrounding the use of PPIs in critically ill patients. The discussion also tackles the evolution of treatments, addressing the need for high-quality evidence to guide practices while highlighting the importance of patient-centered outcomes. Plus, enjoy some engaging banter to lighten the mood!