The Curbsiders Internal Medicine Podcast

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.

In this special session, the hosts dive into stimulating topics like the promising role of AI in healthcare and the surprising links between antibiotic use and colorectal cancer risk. They also tackle insomnia treatments, discussing effective options beyond traditional medications. Thyroid health takes center stage with insights on the impact of selenium on antibodies. Personal reflections on career burnout and memorable failures round out the conversation, highlighting the importance of resilience and continual learning in medicine.

Dr. Cyrus Askin, a pulmonologist and critical care physician, shares insights on managing COPD. He discusses the latest GOLD updates and emphasizes the importance of spirometry in diagnosing airflow obstruction. Nonpharmacologic strategies, like smoking cessation and pulmonary rehab, are highlighted for improving patient outcomes. Askin also explains the complexities of treatment options, including inhaled corticosteroids guided by eosinophil levels, and introduces new therapies like ensifentrine. His real-world pearls make COPD management practical and effective.

In this insightful discussion, Dr. Michelle Kittleson, a leading expert in heart failure at Cedars-Sinai, unpacks the complexities of heart failure with preserved ejection fraction (HFpEF). She explores key diagnostic strategies like the H2F-PEF score and the challenges of interpreting BNP levels in obese patients. The conversation also highlights the benefits of weight loss and supervised exercise, the role of SGLT2 inhibitors, and nuances in managing comorbidities. Dr. Kittleson provides practical tips for identifying when to refer patients, making this a must-listen for healthcare professionals.

Dr. Jori May, an expert in thrombosis and coagulation at the University of Alabama-Birmingham, dives into the complexities of DOAC treatment in hospitalized patients. He discusses what constitutes anticoagulation failure and the key factors to consider, such as missed doses and patient adherence. Insights on when to switch to warfarin, the implications of D-dimer levels, and the evaluation of anatomical causes of thrombosis are highlighted. Dr. May emphasizes the importance of thorough assessment before changing anticoagulation therapies, ensuring effective patient care.

Join Dr. Ashish Thakrar, an internist and addiction medicine specialist from the University of Pennsylvania, as he provides invaluable insights on managing opioid withdrawal amid the fentanyl crisis. Discover the intricacies of choosing between methadone and buprenorphine, and learn about the importance of personalized treatment approaches. The conversation dives into the challenges posed by adulterants in the drug supply and emphasizes the critical role of empathetic care in breaking the cycle of addiction. Don’t miss these essential strategies for effective management!

Dr. Phillip Coffin, Director of the Center on Substance Use and Health, discusses the evolving landscape of treating methamphetamine use disorder. He highlights a patient-centered four-step management approach, innovative medications, and the crucial role of harm reduction strategies. The conversation intertwines personal anecdotes with insights into assessing patient exposure and the importance of customized treatment plans. Listeners gain practical knowledge on integrating psychosocial therapies and the latest advancements in addiction medicine.