The Curbsiders Internal Medicine Podcast

Dr. Laurence Sperling, a leading preventive cardiologist and former director at Emory's Heart Disease Prevention Center, dives into cutting-edge advancements in ASCVD risk assessment. He introduces the innovative PREVENT risk calculator and discusses its significance in modern lipid management. The conversation highlights the importance of interpreting ApoB and Lp(a), the role of lifestyle changes, and how next-gen therapies could revolutionize treatment. Sperling also covers familial hypercholesterolemia and the strategic use of statins to enhance patient outcomes.

Dr. Rachel S. Rubin, a board-certified urologist and sexual medicine expert, transforms menopause care with her innovative insights. She discusses the evolution of guidelines post-WHI, addressing misconceptions surrounding hormone therapy. Rachel emphasizes the importance of individualized treatment options and the need to balance clinician fears with patient education. She also explores practical applications for vaginal and systemic therapies, including testosterone use in women, and shares a stepwise approach for managing menopause symptoms effectively.

Dr. Adam Cifu, a professor of medicine and general internist, joins the hosts to tackle a stack of intriguing topics. They dissect recent findings on PSA screening, revealing a strong push for shared decision-making rather than changing current practices. The discussion shifts to a systematic review suggesting a potential link between prenatal acetaminophen and neurodevelopmental disorders; the panel advises caution in interpreting these findings. Finally, they examine the AQUATIC trial, advocating against combining aspirin with anticoagulants in chronic coronary syndrome due to increased risks.

Scott Matherly, an associate professor of Hepatology and the transplant hepatology program director at Virginia Commonwealth University, shares his insights on cirrhosis management. He discusses the intricacies of diagnosing cirrhosis and highlights the significance of elastography and MR elastography. Matherly emphasizes the importance of physical exam clues and patient education, while detailing the risks associated with cirrhosis, including liver failure and hepatocellular carcinoma. He also dives into treatment strategies for decompensation and when to refer patients for transplant evaluation.

Join Dr. David Hale, a neurologist and expert in vestibular disorders from Johns Hopkins, as he unpacks the complexities of dizziness. He clarifies the differences between dizziness and vertigo, emphasizing the importance of timing and triggers. Learn how to effectively perform diagnostic maneuvers like Dix-Hallpike and the HINTS-Plus exam for accurate assessments. Dr. Hale also covers chronic dizziness approaches and treatment strategies for conditions like PPPD, offering practical insights to navigate this often bewildering symptom.

Dr. Laura M. Bridge, an internal medicine physician specializing in eating disorders, delves into the complexities of GLP-1 medications. She explores how these drugs can both aid and harm individuals with eating disorders, emphasizing risks like inappropriate use. Key topics include recognizing red flags in primary care, the importance of sensitive conversations, and the nuanced relationship between weight loss and health. Dr. Bridge advocates for a multidisciplinary treatment approach while warning against transitioning to restrictive eating behaviors.

Join geriatrician Alyson Michener and physical therapist Suzanne Zukoski as they dive into the critical topic of falls in older adults. They discuss the Age-Friendly 5Ms Framework for multifactorial risk assessment and fall prevention strategies. Hear about the importance of medication review, mobility assessments, and targeted home modifications. They explore how chronic conditions and mental health impact fall risk, alongside evidence-based exercise programs like Tai Chi that enhance strength and balance. Practical tips for safer home environments are also shared!

In this discussion, Dr. Tom DeLoughery, a seasoned hematologist at Oregon Health & Science University, dives into the intricacies of iron deficiency anemia. He highlights the importance of ferritin as the primary iron test and shares insights on dietary influences on iron absorption. Tom differentiates between iron deficiency and thalassemia using clever CBC metrics. He also discusses management strategies, including oral versus IV iron, and when to refer patients to a specialist. Throughout, he emphasizes the impact of menstrual history on diagnosis and treatment.

Dr. Aline Charabaty, a leading gastroenterologist and clinical director at the IBD Center at Johns Hopkins, shares her expertise on inflammatory bowel disease (IBD). She discusses the importance of early diagnosis, differentiating IBD from other GI symptoms, and the latest imaging modalities. Treatment options range from anti-TNFs to dietary strategies for better management. Dr. Charabaty emphasizes preventive health, including vaccinations and screening for nutrient deficiencies, while noting the rising incidence of IBD and the need for a multidisciplinary approach.

Dr. James Callaway, an associate professor and expert gastroenterologist, shares invaluable insights on gastroesophageal reflux disease (GERD) and non-erosive reflux disease (NERD). He discusses when to initiate ambulatory reflux monitoring and the circumstances that warrant long-term PPI therapy. Listeners will learn about the mechanisms behind reflux, the importance of differentiating between erosive and non-erosive conditions, as well as strategies to manage and taper off PPIs effectively. Callaway also highlights the significance of patient-centric care in treatment.