The Curbsiders Internal Medicine Podcast

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.

Dr. Amber Bird, an academic general internist at Penn, engages in a thorough discussion about upper respiratory infections. She shares insights on diagnosing and treating common colds while emphasizing when to prescribe antibiotics judiciously. The conversation also navigates the overlap between COVID-19 and colds, as well as various effective home remedies. Dr. Bird highlights patient communication and education about vaccinations, offering strategies to manage infections in both children and adults. Her practical tips will enhance confidence in clinical practice.

Dive into the fascinating world of CBD and its potential liver risks. Discover the latest on IV iron treatments for heart failure and the timing of blood pressure medications. Learn about the surprising links between carpal tunnel syndrome and rheumatoid arthritis. Plus, catch the buzz on the FDA's approval of finerenone for heart failure, marking a significant step in management. This engaging discussion is packed with insights that can truly inform clinical practice!

Dr. Andrej Spec, an infectious disease expert and co-director of the Invasive Mycoses Clinic at Washington University, dives into the intricacies of fungal infections. He discusses how mislabeling mycoses can lead to diagnostic confusion and the impact of climate change on fungal disease spread. Through real-life cases, he highlights the importance of patient history in diagnosis and urges clinicians to proactively test for conditions like histoplasmosis and blastomycosis. Listeners will also learn about updated treatment approaches that can make all the difference.

In this lively discussion, Dr. Cynthia Sears, a professor at Johns Hopkins, unpacks the complexities of Clostridioides difficile (C. diff) infections and their impact on gut health. She breaks down the difference between C. diff colonization and infection, discusses treatment strategies, and highlights microbiome recovery tactics. The conversation also dives into the challenges of recurrent infections, the role of probiotics, and the potential of new therapies, including monoclonal antibodies and microbiota replacement. A must-listen for anyone interested in gut health!

Dr. Linda Blustein, a physician specializing in hypermobility disorders and Ehlers-Danlos syndrome, dives into listener questions surrounding these complex conditions. She discusses the limitations of the Beighton Score and introduces a new five-point assessment tool. The importance of finding knowledgeable healthcare providers is emphasized, along with the relationship between EDS and conditions like dysautonomia and celiac disease. Additionally, practical strategies for managing related concerns, such as lipedema and medication sensitivities, are explored.

Dr. Elliot Tapper, Chief of Hepatology at the University of Michigan, brings his expertise in liver disease to the table. He discusses the importance of understanding Non-Alcoholic Fatty Liver Disease (NAFLD) and introduces effective treatment strategies that include lifestyle changes and medications. The conversation highlights the significance of clear communication with patients about liver health and the complexities of diagnostic approaches. Dr. Tapper also shares innovative tools like AI medical scribes to enhance patient care.

Dr. Una Makris, a Professor of Medicine at UT Southwestern, discusses effective strategies for managing joint pain in older adults. She emphasizes an age-friendly approach, focusing on diagnosing and treating osteoarthritis and rheumatoid arthritis. The conversation includes insights into non-pharmacological interventions and the importance of lifestyle changes. Dr. Makris highlights the need for comprehensive assessments to combat ageism and improve treatment outcomes, advocating for personalized care and timely referrals for joint replacements.

Dr. Joel Topf, a passionate nephrologist and clinical assistant professor, shares his expertise on managing diabetes and hypertension in chronic kidney disease. He emphasizes the interplay between these conditions and kidney health, providing invaluable insights into blood pressure control and the importance of effective communication in patient care. The discussion also highlights the significance of cystatin C over creatinine as a marker for kidney health and advises on personalized treatment strategies to improve patient outcomes. Prepare to laugh while learning!