The Curbsiders Internal Medicine Podcast

Dr. Denitza Blagev, a pulmonologist and medical director, shares her expertise on Chronic Obstructive Pulmonary Disease (COPD). She discusses the nuances of diagnosing COPD using pulmonary function tests and the importance of effective patient communication. The conversation dives into comprehensive management strategies including inhalers, medications, and non-invasive ventilation. They also touch on the emotional challenges healthcare providers face when discussing prognosis with patients, emphasizing the importance of empathy in medical practice.

Contraception simplified with clinical pearls from reproductive health and family planning experts, Dr Angeline Ti, and Dr Moira Rashid. We cover it all including: the menstrual cycle, mechanism of action for various methods of birth control, hormonal versus nonhormonal contraceptives (e.g. intrauterine devices, patches, pills, rings, implants), patient counseling, and lots of resources to make your job easier. Women’s health correspondent, Dr Molly Heublein returns as cohost. Take our self-assessment quiz! Written by: Molly Heublein, MD, Beth Garbitelli and Sarah Roberts, MPH. Edited by Matt Watto, MD Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Abolish anemia, and iron deficiency w/tips on IV iron therapy from real life iron man, Michael Auerbach, MD, FACP, Clinical Professor of Medicine Georgetown University School of Medicine. Topics include oral versus IV iron therapy, safety of IV iron, ferritin cutoffs, and how to diagnosis/ treat iron deficiency in patients with chronic inflammation, chronic kidney disease, pregnancy, heart failure, and more! Take our Self Assessment Test Here. Images by Beth Garbitelli; Written and produced by Justin Berk, MD and Matthew Watto, MD. Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

In this enlightening discussion, Dr. Eli Gelfand, a leading cardiology expert from Harvard, and GP Dr. Kate Grant dive deep into valvular heart disease. They unravel the complexities of TAVR vs. SAVR, share insights on anticoagulation strategies, and highlight the importance of echocardiograms. Their engaging anecdotes from unexpected medical situations add a light touch, while they emphasize guidelines for managing rheumatic heart disease and the significance of multidisciplinary care. A blend of humor and expert advice makes this conversation a must-listen!

In this insightful discussion, Dr. Eric Widera, a geriatrics expert, and Dr. Leah Witt, a Geriatrics Fellow, challenge common dementia treatment practices. They delve into the controversial use of cholinesterase inhibitors and antipsychotics, revealing risks and emphasizing patient-centered care. The duo advocates for the DICE approach to manage difficult behaviors and highlights the ethical implications of feeding decisions in advanced dementia. Their engaging dialogue underscores the importance of individualized care and effective communication with caregivers.

Mark W. Green, Director of Headache/Pain Medicine at the Icahn School of Medicine, explores the fascinating world of placebos and nocebos. He dives into how sugar pills can significantly impact treatment efficacy and discusses the ethical implications of their use in medicine. Listeners learn about the extraordinary power of patient perception and expectation in shaping treatment outcomes. The conversation also touches on open-label placebos and the complexities of the nocebo effect, making it clear that belief truly matters in healing.

Dr. John J. Ryan, a prominent cardiologist and director of the University of Utah Pulmonary Hypertension Center, dives into the complexities of pulmonary hypertension. He shares invaluable clinical pearls on diagnosing and managing this condition. The conversation highlights the fascinating reasons why cows don’t get ankle edema, along with key diagnostic tests and echocardiogram findings. Ryan explains how to best counsel patients and emphasizes the importance of understanding various risk factors and treatment options in pulmonary hypertension management.

Differentiate, diagnose, and treat the various forms of dermatitis and stop the ‘itch that rashes’ with this in-depth, myth-busting episode of “The Dermsiders” with Dr. Kalman Watsky Clinical Professor of Dermatology at Yale Medical School. Topics include: how to differentiate between and diagnosis various forms of dermatitis, topical therapies, common pitfalls, patch testing, and more! Special thanks to Bryan Brown and Beth Garbitelli who wrote and produced this episode and the show notes! Written by: Bryan Brown, MD and Beth Garbitelli Edited by: Matthew Watto, MD Infographics by: Bryan Brown, MD Cover image by: Beth Garbitelli Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

It's a potpourri of Infectious Diseases with tips from expert, Dr Paul Sax, MD, Clinical Director of the Division of Infectious Diseases at Brigham and Women's Hospital, and Professor of Medicine at Harvard Medical School. We discuss the man flu, the flu vaccine, travel medicine, malaria, lyme disease, post lyme syndrome, chronic lyme, shingles, cellulitis, abscesses, antibiotics, c diff, antibiotic associated diarrhea, the dangers of fluoroquinolones, why doxycycline is awesome, and more! Told you it was a potpourri. Dr Shreya Trivedi joins Matt and Paul as guest host. Show Notes, MCQ by Shreya Trivedi, MD Edited by Matthew Watto, MD Infographics and cover image by Matthew Watto, MD Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Time Stamps: 00:00 Announcement 01:38 Intro 03:46 Picks of the Week 06:47 Guest bio 08:47 Getting to know our guest 15:40 Flu vaccination 19:54 Barriers to the flu vaccine 23:34 Can you give the flu vaccine to an ill patient 24:14 Man flu 26:27 Travel Medicine 30:35 Tick bites 33:49 Lyme serologies 35:38 Lyme prophylaxis 37:37 Chronic lyme disease and post lyme syndrome 38:55 Penicillin and antibiotic allergies 41:48 Fluoroquinolones and adverse reactions 45:24 Should antibiotics be given after an I&D of an abscess  49:34 Antibiotic associated diarrhea, C diff 52:10 Probiotics, stool transplantation, and C diff 54:50 Shingles, recurrent zoster, complications, and the new subunit vaccine 61:45 Using salad tongs at a buffet 63:04 Take home points 64:26 Outro Tags:  ID, infectious, diseases, disease, flu, influenza, lyme, doxycycline, cdiff, antibiotics, infection, cellulitis, abscess, vaccine, zoster, shingles, malaria, travel, assistant, care, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

Ease the tension around blood pressure goals in older adults and get inside the hypertension guidelines released by the ACP and ACC/AHA in 2017 with the sagacity of Dr. Mary Ann Forciea, MD, MACP, Professor of Medicine at University of Pennsylvania. We cover: how to properly measure blood pressure, how to diagnose hypertension, blood pressure targets, why BP goals differ by society, how to guidelines are written and how to interpret them with a critical eye, plus a hot take on the 2017 ACC/AHA guidelines. Dr. Shreya Trivedi joins as cohost. Special thanks to Hannah Abrams for her wonderful infographics and to Dr Trivedi for compiling our show notes. Time Stamps 00:00 The setup 02:15 Disclaimer 03:32 Picks of the Week 08:13 Getting to know Dr Forciea 13:35 Broad overview and a clinical case of geriatric hypertension 14:45 Brief history on BP targets 18:05 How do you measure a blood pressure? What type of monitors are available? 22:13 How to standardize BP in the office? 23:55  Ambulatory BP monitoring 24:55 Home blood pressure monitoring 26:11 Standing blood pressure readings and orthostatic hypotension 27:53 How guidelines are written 30:51 Evaluating evidence quality and strength of recommendation 32:35 Timeline and process for guideline generation 34:27 How to read guidelines with a “critical eye” 36:15 Return to our case of uncontrolled hypertension 38:25 Blood pressure targets from ACP guidelines and BP management in frail older adults 40:33 Counsel patients on BP targets    42:25 Low diastolic blood pressure 45:35 SPRINT and the ACP BP guidelines 48:58 Take home points from Dr Forciea 50:07 HTN targets and pay for performance in clinical practice 51:45 Curbsiders recap the ACP guidelines 53:45 Matt and Paul recap the AHA guidelines 54:47 AHA definitions of hypertension 56:15 Diagnosing hypertension and how to measure a blood pressure 60:35 Choosing a blood pressure monitor and HBPM 62:29 Blood pressure goals in ACC guidelines 66:08 Non-pharmacologic measures 69:15 Will we follow these new strict targets? 72:45 Outro Tags:hypertension, blood, pressure, monitor, cuff, heart, aha, acc, act, stroke, cardiac, cardiovascular, event, guidelines, assistant, care, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resid