The Curbsiders Internal Medicine Podcast

Join us for an extra-hot summer episode featuring our critical appraisal expert, Rahul Ganatra MD, MPH @rbganatra. Prepare to marvel as he breaks down his recent tweetorial on the RECOVERY trial of dexamethasone for COVID-19; to gasp as Paul Williams updates us on statins and ASCVD prevention and to be enthralled by the dulcet tones of Matt Watto explaining the latest research on DAPT vs. monotherapy with ticagrelor. Bonus: a new hotcakes rating scale has arrived! Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producer: Sarah Phoebe Roberts Show Notes by: Sarah Phoebe Roberts Writer: Rahul Ganatra MD, Sarah Phoebe Roberts, Matthew Watto MD, Paul Williams MD Cover Art: Matthew Watto MD Hosts: Rahul Ganatra MD, Matthew Watto MD, Paul Williams MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. Time Stamps 00:00 Intro 02:15 Picks of the Week 06:15 New Hotcakes rating scale 09:20 RECOVERY trial 17:30 Rapid home-testing for COVID 20:15 Statins and ASCVD prevention 32:30 Ticagrelor monotherapy after ACS 41:30 Outro Picks of the week Paul: U Talkin' Talking Heads 2 My Talking Head podcast Sarah: New hotcakes scale! Rahul: Chromeo’s new Quarantine Casanova album Watto: 30 Rock season 1, episode 3 “Blind Date”

Dr. Eve Bloomgarden, a board-certified endocrinologist from Northwestern University, shares her expertise on hyperthyroidism. She breaks down the nuances of interpreting thyroid function tests and conducting thorough examinations. The discussion includes insights on Graves' disease and its potential impact on eye health. Bloomgarden also covers treatment options like methimazole, radioactive iodine, and surgical interventions. Listeners will learn about the challenges of diagnosing thyroid disorders, especially with biotin supplements in play.

The American Academy of Pediatrics (AAP) recommends that schools strive to reopen in the Fall, but there is hesitation from families and teachers alike. We speak with Dr. Sharfstein, a public health expert and pediatrician, regarding the importance of reopening schools for children, what criteria need to be met prior to opening, and how to keep children and teachers safe. Tune in to learn transmission amongst children, how other countries have reopened, why to cohort children, and how the primary care pediatrician can assist in the coming school year! Credits Producers & Writers: Edward Corty, Nicholas Lee MD Infographic: Nicholas Lee MD Cover Art: Chris Chiu MD Hosts: Justin Berk MD, Chris Chiu MD, Edward Corty Editor:Justin Berk MD; Chris Chiu MD Guest(s): Joshua Sharfstein MD Sponsors: Pediatrics On Call Sponsor: VCU Health Continuing Education - to offer FREE continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org or cribsiders.vcuhealth.org Time Stamps Introduction 1:00 How to answer “What do you think about school openings?” 11:30 Risk Assessment of School Re-openings 14:40 Evidence of Transmission among Children 17:10 What Other Countries Have Done 19:40 Community Threshold for Re-Opening and Using Protocols 20:30 The Reasons to Cohort 22:45 How to Address Scenarios 24:20 Health Disparities and Return to School 27:00 Existing Inequities and Children’s Sacrifice of Education 29:00 “Opting Out” of School Return and Feeling Safe 31:30 How Can Governments Help Support the Return 35:50 Guidance to give as PCP 37:50 School Alternatives / Innovations to Going Back 40:10 The Difference Between Equity and Equality 42:50 Testing in Schools 43:45 Resources to Follow For More Information 46:00 Take-Away Points 47:10 Optimism 48:25 Picks of the Week 53:50

Swim through the sea of acronyms as Dr Scott Matherly (@liverprof) helps us become a little less baffled by the thought of NAFLD. We discuss the initial diagnosis of fatty liver disease, indications for additional evaluation with imaging and/or biopsy, and potential treatment options. With a quarter of the world affected, it’s crucial to understand the various forms of disease and how to counsel patients about this all-too-common condition! Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written and Produced by: Elena Gibson MD Infographic and Cover Art: Elena Gibson MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com Guest: Scott Matherly MD Sponsor: Pediatrics On Call Sponsor:  VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org and create your FREE account! Time Stamps 00:00 Intro 03:15 Guest one-liner; Picks of the Week*
: 08:15 Sponsor 08:50 Case from Kashlak part 1; What is hepatic steatosis? 11:43 NAFLD acronyms and definitions 18:20 Alcohol and Fatty Liver 23:15 Initial Evaluation of NAFLD 35:12 Dr Matherly’s piel to patients with fatty 41:11 NASH/Fibrosis Risk Assessment 48:54 Outcomes in NASH with Fibrosis 51:20 Statins are safe in liver disease 56:15 Treatment Options (surgery, Vitamin E, Pioglitazone, SLGT2 inhibitors and GLP1 agonists; Coffee?!) 71:42 Take home points and Outro

Get a grip on acute kidney injury (AKI) with Dr. Joel Topf (AKA @kidney_boy), Kashlak’s Chief of Nephrology! We’ve put together an AKI highlight reel - focusing on practical tips and tricks to help you identify, diagnose and manage AKI, plus how to recognize AIN and random myths and musings on vancomycin, NSAIDS, contrast nephropathy, and the risk of NSF from gadolinium.  Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written (including CME questions) and Produced by: Cyrus Askin, MD Infographic by: Cyrus Askin, MD Cover Art: Kate Grant MBChb, MRCGP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com Guest: Joel Topf, MD Sponsor: Pediatrics On Call  Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account! Time Stamps 00:00 Intro 03:00 Guest one-liner, Picks of the Week*: Zoe Keating albums (Cellist); Mrs. America (TV series) on FX; The Last of Us (Videogame); 08:45 Sponsor 09:15 Definition of acute kidney injury (AKI) and fundamentals 11:00 Cardiorenal syndrome 12:24 Schema for AKI 17:30 Establish an etiology, determine urine output and address electrolyte abnormalities 21:22 AKI in the otherwise-healthy patient; 32:20 Rhabdomyolysis
38:21 Vancomycin 41:43 Acute interstitial nephritis (AIN) 44:52 Contrast induced nephropathy (CIN) 50:37 Gadolinium in AKI and/or CKD 52:53 Timing of dialysis 56:37 AKI in the out-patient setting and how to handle home meds e.g. TMP-SMX, RAAS inhibitors; 62:01 Is Ultrasound necessary in AKI 64:58 Dr. Topf’s take home points and Plug for Seminars in Nephrology

Listen as our expert guests, Kelly Graham, MD, MPH (@KellyGrahamMD) and Lekshmi Santhosh, MD MAEd (@LekshmiMD), detail the professional and personal challenges faced by women in medicine during the COVID-19 pandemic. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!   Credits Produced by: Leah Witt MD & Shreya Trivedi MD  Written by: Molly Heublein MD, Isabel Valdez PA-C, Leah Witt MD & Shreya Trivedi MD Infographic & Cover Art: Edison Jyang Hosts: Leah Witt MD & Shreya Trivedi MD, Justin Berk MD, MPH, MBA Editor: Molly Heublein MD and Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guests: Kelly Graham, MD, MPH; Lekshmi Santhosh, MD MAEd    Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account!   Episode Breakdown Intro, disclaimer Introduction and bio for Kelly Graham, MD, MPH Introduction and bio for Lekshmi Santhosh, MD MAEd One-liner for Kelly Graham, MD, MPH One-liner for Lekshmi Santhosh, MD MAEd Gender Awakening Moments Picks of the Week* Case from Kashlak Difficulty with lack of childcare while working Hippocratic Oath paradox Dr. Santhosh’s 3 Ps Motherhood penalty-fatherhood bonus Two Pandemics, One Response Breadwinner-homemaker bias Female physician burnout Minority Tax Silver Linings Take home points and Outro

Jump into an episode dedicated to hospital based addiction medicine, as we cover common scenarios hospitalists encounter.  In this episode we talk to addiction medicine expert, Dr. Melissa Weimer @DrMelissaWeimer (Yale) about inpatient management of patients with substance use disorders. Topics include: the management of polysubstance withdrawal,  approaching acute pain management for a person with opioid use disorder, and inpatient harm reduction strategies. After this episode listeners will gain new tools to help them best care for hospitalized patients with substance use disorders. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME! Credits Writers and Producers: Carolyn Chan MD, Deb Gorth, and Nora Taranto MD Cover Art and Infographics by: Carolyn Chan, MD Hosts: Stuart Brigham MD; Paul Williams MD, FACP; Carolyn Chan MD Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com Guest: Dr. Melissa Weimer Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account! Time Stamps Intro, disclaimer, guest bio : 00:00 Guest one-liner:    03:00 Picks of the Week*:   08:20 Case from Kashlak:  10:30 Urine Toxicology Screens 11:30 Discussing Urine Toxicology Screens with Patients  13:20 Management of Polysubstance Withdrawal 16:16 Tapering Benzodiazepines   19:56 Acute Pain Management and Opioid Use Disorder 30:35 Active Drug Use in the Hospital 38:52 Harm Reduction 40:00 Discharges - Planned 43:43 Perioperative Buprenorphine and Methadone: 46:50 QT Prolongation and Methadone - 52:53 Outro 56:21

Our very first Cribsiders/Curbsiders crossover episode! Learn about cystic fibrosis care across the lifespan. We dive into the diagnosis of CF (don’t lick your patients!), management of pulmonary and extrapulmonary complications, and the future of CF. You’ll also get tips on CF in adolescents and young adults, as well as recognizing undiagnosed CF in older patients. Our guest, Dr. Whittney Warren, is a pulmonary critical care doctor and the medical director of the Adult Cystic Fibrosis clinic in an academic hospital in Texas. Show notes: https:/www.thecribsiders.com/.   Credits Writer, Producer, Infographic, CME Questions: Clara Mao  Cover Art: Christopher Chiu MD Hosts: Justin Berk MD, Christopher Chiu MD, and Matthew Watto MD Editor: Justin Berk MD; Clair Morgan of nodderly.com Guest: Whittney Warren DO    Time Stamps Intro / Disclaimer 0:00 Guest bio 2:25 Guest one-liner, picks of the week 3:15 Explaining CF to patients, life expectancy  7:00 Types of CF mutations and phenotypes 11:50 Presentation of CF in older patients 15:20 Screening and diagnosis 16:40 PFTs and airway clearance 25:20 Nutrition and the “CF diet” 29:10 CF exacerbations and antibiotic selection 32:25 Extrapulmonary manifestations 39:35 Transition of care for CF adolescents (alcohol, exercise, sex) 43:50 CFTR modulator therapy 51:35 Lung transplantation 54:45   Goal Listeners will develop a systematic approach towards long-term management and acute exacerbations of cystic fibrosis.   Learning objectives After listening to this episode listeners will…   Explain the pathophysiology underlying cystic fibrosis. Identify maintenance therapies that optimize pulmonary function and nutritional status in patients with cystic fibrosis. Choose evidence-based practices in the management of cystic fibrosis-associated pulmonary exacerbations.

This episode is Half COVID Cakes, Half Hotcakes, and entirely enlightening.  Our guest Dr. Utibe Essien MD, MPH @UREssien and Curbsider/epidemiologist, Dr. Rahul Ganatra MD, MPH @rbganatra discuss some Hot COVID Cakes including: racial differences in COVID-19 outcomes, why dogs and dexamethasone may hold the key to defeating COVID-19, how hormonal adjunctive therapies might be key for depression, and when to poo-poo probiotics versus when a side of Lactobacillus may be beneficial. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME! Credits Written and Produced by: Rahul Ganatra MD, MPHl Emi Okamoto MD; Sarah P. Roberts MPH; and Matthew Watto MD Show Notes and CME questions by: Deborah J. Gorth ScM Cover Art: Deborah J. Gorth ScM Hosts: Matthew Watto MD; Rahul Ganatra MD, MPH, Emi Okamoto MD, and Sarah P. Roberts MPH Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Utibe Essien MD, MPH Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account! Time Stamps 00:00 Intro, disclaimer, guest bio 02:20 Silver Linings / Picks of the Week: Chicken Run (2000) and Chicken Run 2 on Netflix; Philly Inquirer story on COVID sniffing dogs; Buy some peaches! And check out their Wikipedia page! 07:33 Hospitalizations and Mortality Among Black and White patients with COVID-19 26:10 Dexamethasone for COVID-19 28:55 Hormonal therapy for depression 38:16 Probiotics 45:00 Outro

Listen as our esteemed guest Dr. Utibe Essien @UREssien walks us through key terminology and evidence necessary to understand anti-Black racism in medicine. Dr. Essien provides insights into ways that racism impacts our work in the clinical and academic settings and offers approaches for addressing anti-Black racism in these settings. Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME! Credits Producer and Writer: Joniqua Ceasar MD, Hannah Abrams MD Cover Art: Hannah Abrams MD Infographic: Beth Garbitelli Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Joniqua Ceasar MD Editor: Paul Williams MD, Chris Chiu MD (written materials); Clair Morgan of nodderly.com Guest: Utibe Essien MD Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account! Time Stamps 00:00 Intro, disclaimer, guest bio 02:40 Guest one-liner, Picks of the Week*: Just Mercy 09:20 Statement from the show; Importance of discussing racism in medicine 14:11 Definitions 18:06 Identifying how racism manifests in the clinical setting 37:46 Ideas for advocacy 49:50 Take points and Outro