The Curbsiders Internal Medicine Podcast

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.

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.