The Curbsiders Internal Medicine Podcast

Dr. Erin Narewski, a pulmonologist specializing in interstitial lung disease, breaks down the classification, patient history, workup, and management of ILD in this engaging podcast. From favorite movies to book recommendations and career stories, the discussion covers the complexities of diagnosing ILD, treatment options like anti-fibrotics and palliative care, and real-life cases illustrating the challenges and nuances of managing ILD patients. Breathe easy with Dr. Narewski's expert insights!

We’re going upstream! Dr. Karen DeSalvo (@KBDeSalvo) talks social determinants of health, arming us with a framework to consider this very challenging aspect of patient care. As Society for General Internal Medicine President and Chief Health Officer at Google Health, she shares her clinical and public health experience, including weathering Katrina in New Orleans. While our clinical care largely focuses on the downstream medical consequences, we must recognize the upstream social context to address the barriers to health and wellbeing. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME! Credits Written and Produced by: Emi Okamoto MD Cover Art: Kate Grant MBChb, MRCGP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Emi Okamoto MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Karen DeSalvo MD, MPH, MSc Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org for and create your FREE account! Time Stamps Intro, disclaimer, guest bio 0:44 Dr Desalvo’s one-liner 3:34 Picks of the Week*- The Great Influenza book by John M Barry  5:01 Dr Desalvo’s advice and past experience 6:10 Case from Kashlak 10:30 What about the evidence for social determinants? 13:40 What to do about this in the clinic, and is it worth screening? 16:06 Approaching as a team and with the community 19:40 How do we affect the upstream, before the downstream consequences? 22:40 NAM recommendations and framework 26:00 The role of technology 30:00 What are Social Determinants of Health (SDOH), and who they affect 34:00 Start paying attention to SDOH 37:00 Outro 38:49

Answers to common questions in post-op care with our Kashlak Chief of Perioperative Medicine Dr. Avital O’Glasser. She provides updates in delirium prevention, perioperative medication management, pain control, and even clarifies a lesson from Meredith Grey about causes of post-op fever. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME! Credits Written: Hannah Abrams MD, Avital O’Glasser MD Produced by, Infographic and Cover Art by: Hannah Abrams MD Hosts: Hannah Abrams MD; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Avital O’Glasser MD (written materials); Clair Morgan of nodderly.com Guest: Avital O’Glasser MD Sponsor: ACP - acponline.org/member Sponsor: VCU Health CE -Check out curbsiders.vcuhealth.org and create your FREE account! Time Stamps 00:00 Intro 02:53 Guest one-liner, Picks of the Week*: 12 Angry Men 1957 Movie; Hedwig and the Angry Inch Cast Recording; PCSSNow Buprenorphine Waiver Training for Medical Students 09:28 Sponsor 10:17 Kashlak case; How to collaborate with our surgical colleagues 13:45 Questions to ask at the time of transfer 23:00 Routine Post-Op Care: Bowel regimen, pain control, delirium prevention, glucose, antihypertensives, and nausea 44:25 Co-managing Complications and Fever/Tachycardia; Brief discussion of VTE prophylaxis 57:55 Outro

Join us as we delve into the paradigm-shifting ethos of trauma-informed care with renowned expert Dr. Megan Gerber, Associate Professor of Medicine at Boston University School of Medicine, Medical Director of Women’s Health for VA Boston where she directs the Women’s Health Fellowship, editor of “Trauma-informed Health Care Approaches: A Guide for Primary Care.”  We discuss the framework for trauma-informed universal precautions, as well as basics about the prevalence of trauma, strategies for integrating a trauma-sensitive approach into primary care, practical changes for the office environment,  modifications for physical exam methods, and more. We recognize this topic may be triggering. If you are struggling with thoughts of harming yourself, the national suicide prevention lifeline number is 1-800-273-8255. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producer/Writer/Graphics: Beth Garbitelli Co-Producer: Paul Williams MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Beth Garbitelli Editor: Molly Heublein MD (written materials); Clair Morgan of nodderly.com Guest: Megan Gerber MD, MPH, FACP Sponsor: ACP - Visit acponline.org/member Sponsor: VCU Health CE - Check out curbsiders.vcuhealth.org and create your FREE account! Time Stamps Intro, disclaimer, guest bio (0:00 - 3:15) Guest one-liner (3:30) Kashlak Cases (13:45) Epidemiology of trauma (15:18) Trauma and #MeToo (18:10) Defining Trauma-Informed Care (TIC) (19:00) Integrating TIC into primary care (22:48) Screening in TIC (25:00) Containment and retraumatization (29:00) Inquiring about trauma (30:45) Recap and Office Visit Mechanics (35:30) Building the Relationship (38:00) Common Inquiry Mishaps (38:52) TIC Physical Exam (40:20) Resources for Patients (44:30) Office Environment (48:00) Provider Burnout (50:00) TIC in Covid-19 (52:30) Take-home Points (56:20)

Introducing our friends, The Curious Clinicians: Why do human bodies work how they do? Why do medications work, or not work? Do you miss digging into the “why” behind what we do every day? Join Hannah Abrams (@hannarabrams), Tony (@tony_breu), and Avi (@AvrahamCooperMD) in the Curious Clinicians podcast as they delve into these questions & more, starting with episode 1: Why does fingernail clubbing happen in so many different diseases? https://curiousclinicians.com/ Check out their website and subscribe on your favorite podcast player.

Stay current with the emerging COVID-19 research including: ACTT-1 (remdesivir), triple therapy with interferon, and conundrums  about SARS-CoV-2 PCR and serologic testing. We’re led by the one and only Curbsider/internist/epidemiologist, Rahul Ganatra MD MPH (@rbganatr). And...just in case you live outside of the habitat for murder hornets and your anxiety about the pandemic had begun to abate, we touch on the CDCs guidance to beware of hungry aggressive rats. Gross!   Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME!     Credits Written and Produced by: Rahul Ganatra MD, MPH, Deborah J. Gorth ScM, Emi Okamoto MD, Sarah P. Roberts MPH, and Matthew Watto MD 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   Sponsors: ACP and VCU Health CE   Time Stamps 00:00 Sponsors 00:30 Intro, disclaimer 02:40 Fomites, groceries and killer rats 08:22 Sponsor 09:22 ACTT-1 trial of remdesivir 18:22 Triple therapy with lopinavir/ritonavir, ribavarin and interferon 33:10 Background on PCR testing for SARS-CoV-2; How common are false negative PCR tests? 44:25 Serologic testing for SARS-CoV-2; Utility of antibody testing; Test characteristics 50:30 Outro

Learn the nuances of caring for and building relationships with patients experiencing homelessness from expert internal medicine and addiction physician Stefan Kertesz, return guest from Episode 74 on Opioids and Health Policy (highly recommend a re-listen, y’all!).  Topics: the challenge of creating a welcoming and useful space for individuals experiencing homelessness, how to meet patients where they’re at--both physically and mentally--the challenge of managing diuretics for those without stable access to a bathroom (avoid, if possible), and how absolutely essential the foot exam is. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written and Produced by Nora Taranto MD Infographics by Nora Taranto MD Cover Art by Kate Grant MBChB, MRCGP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Nora Taranto MD Editor: Carolyn Chan (written materials); Clair Morgan of nodderly.com Guest: Stefan Kertesz MD Sponsor: VCU Health CE Time Stamps 00:00 Intro, disclaimer, guest bio 3:17 Guest one-liner 8:55 Picks of the Week*: Dr. Kertesz’s Book Recommendation: Saul Weiner’s On Becoming A Healer; Nora’s Pick of the week: BackStory (especially their episode on dynamite!) https://www.backstoryradio.org/ 10:07 Case from Kashlak 10:56 Language: How to ask where a patient lives? 13:25 Terminology: Persons Experiencing Homelessness: 14:35 The stats on prevalence of health and illness in the homeless population, and the importance of both medical and environmental factors 20:44 How to start the visit, and how to establish trust early on? 27:40 Why is the mortality rate higher? 35:15 Special conditions and Medication Considerations: Hypertension, Diuretics, Insulin and Food Insecurity, Substance Use Disorders, Feet, and Hepatitis C 54:15 COVID and homeless healthcare 57:00 Care Models 62:30 Take Home Points and Outro

Chase that metronidazole with a beer! Pop some 30 year old pills! Retrain your brain as our esteemed guest Dr. Douglas Paauw goes over his popular annual ACP presentation on Medical Myths. Learn about how some common medical myths originate and continue in our practice. We discuss why it’s okay to drink on metronidazole, take expired medications, inject epinephrine into extremities and why recurrent sinusitis may not really exist. Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME! Credits Written and Produced by: Justin Berk, MD MPH MBA Infographic and Cover Art: Beth Garbitelli Hosts: Justin Berk, MD, MPH, MBA; Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com Guest: Douglas Paauw, MD Sponsor: VCU Health CE Time Stamps 00:00 Intro, disclaimer, guest bio 02:22 Guest one-liner; Career Advice, Picks of the Week*: Being Mortal, book by Atul Gawande; The Band Played On, book by Randy Shilts; Lagunitas Hoppy Refresher: zero alcohol, zero calories! 06:15 Medical Myth Definitions 10:20 Dogma: Metronidazole and Alcohol; Healthy RCT Metronidazole and Alcohol 19:09 Expired Medications; Military Stockpiling Study 24:22 Aspirin and Nitroglycerin; Unopened eye drops; Epi-Pens; Expired Med Recap 31:13 Sinus Headaches; Trigeminal Nerve; Pearl: Recurrent headaches; Study showing Effectiveness of treatment (92%) 41:07 Epinephrine in extremity; RCT of Epi in Extremities Study showing Experts use it; Podiatry journal 48:39 Take home points and Outro

Elevate your critical appraisal skills as we review the first RCT of remdesivir and share the latest and greatest COVID-19 stories including: Llama antibodies, Stroke statistics, Future Waves, Exit Strategies and Awake Proning. We’re joined by everyone’s favorite Curbsider/internist/epidemiologist, Rahul Ganatra MD MPH (@rbganatra). Rahul provides critical appraisal of the newest randomized control trial (RCT) on remdesivir from the Lancet, and gives us a lesson on why statistical power is so important to consider. We also share updates on strokes, awake proning, pandemic predictions, and we reveal another reason to love llamas (besides those luscious lashes). Llama mia, here we go again! Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | CME! Credits Written and Produced by: Sarah P. Roberts MPH, Rahul Ganatra MD, MPH, Emi Okamoto MD, Paul Williams MD and Matthew Watto MD Cover Art: Beth Garbitelli Hosts: Matthew Watto MD, Paul Williams MD, Rahul Ganatra MD MPH, Emi Okamoto MD , Sarah P. Roberts MPH, Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Sponsor: VCU Health CE Time Stamps 00:00 Intro 02:10 Fun animal facts: Llama antibodies 09:10 Remdesivir RCT by Wang et al 12:40 Power and Sample Size 16:32 Baseline Characteristics, Results and Author’s conclusions 19:15 Rahul’s conclusions: How chance and bias affected the results 24:00 Right censoring; Viral load and timing of antivirals 30:30 Final thoughts on Remdesivir RCT by Wang et al; Looking ahead to the NIAID (ACTT) trial 33:53 Are patients really having fewer strokes and heart attacks? 38:20 Awake proning 43:30 Paul teaches us not to use the term “happy hypoxemic” 45:00 CIDRAP viewpoint on future waves and exit strategies 50:22 Outro

Listen as our esteemed guest Dr. Nina Mingioni (Jefferson) walks us through her approach to fatigue, from differential diagnosis, to the evidence behind physical exam, laboratory workup, and beyond! Show Notes | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Writer, Producer, Infographic, and Cover Art: Hannah R. Abrams Hosts: Hannah R Abrams, Matthew Watto MD, FACP; Paul Williams MD, FACP Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com Guest: Nina Mingioni MD, FACP Sponsor: VCU Health CE Time Stamps 00:00 Intro, disclaimer, guest bio and a bad pun 03:00 Guest one-liner 07:10 Case from Kashlak, Defining fatigue; Taking a general history 11:36 Most common causes of fatigue and how to elicit them from the history 20:39 Physical exam for fatigue; Medications that cause fatigue; 25:25 Exam findings and LRs for anemia; Sleep apnea 30:55 Lab workup for fatigue; Expanded testing: Ferritin, Vitamins, EBV, Rheumatologic diseases, Celiac disease, Lyme 47:55 Spiel to the patient when no answer is found 51:14 Other diagnoses to consider: Fibromyalgia, Myalgic Encephalomyelitis 55:09 Take home points and Outro