Anticoagulation with the DOACsFrom October 2018, My Pancreas is Necrosing!
It’s time for Hematology Rounds with Dr. Tom DeLoughery! In this segment, he and our own Matt DeClerck review the indications for and potential benefits and pitfalls of the direct oral anticoagulants (DOACs).31min 9Tom Deloughery, MD and Matthieu DeClerck, MD
Fluoroquinolones: Risks to Patients and ProvidersFrom October 2018, My Pancreas is Necrosing!
While widely prescribed, fluoroquinolones have been associated with a large number of adverse events and are the focus of multiple lawsuits against providers. • Currently there are FDA warnings regarding quinolone use and the risk of tendinitis, tendon rupture and peripheral neuropathy. More …11min 30Matthew DeLaney, MD, FACEP, FAAEM
New C Diff Infection GuidelinesFrom September 2018, Retrieve Those Filters
The new IDSA/SHEA practice guidelines on Clostridium difficile infection have a few changes from what we’re used to, mostly about the diagnostic algorithm and first-line treatment options. In this segment, Drs. Devang Patel and Neda Frayha review the new guidelines and how they impact our clinical …20minDevang Patel, MD and Neda Frayha, MD
Hyperemesis GravidarumFrom September 2018, Retrieve Those Filters
Miz and Jenny discuss diagnosis and management of hyperemesis gravidarum. Given recent concerns raised about the safety profile for Ondansetron • in both maternal and fetal health, Miz and Jenny review the most recent ACOG guidelines for treatment regimens as well as referral indications.20min 26Jenny Beck-Esmay, MD and Mizuho Morrison, DO
Is Aspirin Dead in A-Fib?From July 2018, All Risk, No Reward
In this PC RAP family reunion, Rob Orman and Neda Frayha discuss the latest evidence on the use of aspirin in low-risk a-fib (CHA2DS2-VASc score of 0 or 1).12min 14Neda Frayha, MD and Rob Orman, MD
Paper Chase #4 | Opioid vs Non Opioid Analgesia for Acute Extremity PainFrom May 2018, The Buzz That Won't Quit
For patients with acute extremity pain in the ED, there were no differences in pain reduction at 2 hours among single-dose treatment with ibuprofen and acetaminophen or with 3 different opioid and acetaminophen combination.4min 16Andrew Buelt, DO and Joe Weatherly, DO
SuboxoneFrom April 2018, Will You Be My Facebook Friend?
Adrien and Eric discuss the potential role of naloxone/buprenorphine (Suboxone) in helping patients manage opioid dependence. They review its pharmacology, indications, contraindications, administrations and potential pitfalls.20min 22Adrien Selim, MD and Eric Contant, MD
Lifestyle and Diabetes - Part 2From April 2018, Will You Be My Facebook Friend?
In part 2 of this segment on lifestyle and diabetes,Neil and Heidi review yet more evidence pointing toward the effectiveness of weight management and exercise in preventing and managing DM2. As a bonus, Neil concludes his story of how exercise has changed his life and health.17min 43Heidi James, MD and Neil Skolnik, MD
Vitamin D - An Update!From April 2018, Will You Be My Facebook Friend?
Love it or hate it, vitamin D has been quite the fad of 21st century medicine. Just when we think we have a handle on the most recent literature, a few more studies come out to throw us off our game. In this segment, Brandon Grove shares his reading of the vitamin D tea leaves based on the latest …15min 44Brandon Grove, MD
Paper Chase #3 - ACE Inhibitors and Statins in Adolescents with Type 1 DiabetesFrom March 2018, What’s Your (Code) Status?
ACE inhibitors and statins did not change the albumin to creatinine ratio over time in this study population.2min 54Andrew Buelt, DO and Joe Weatherly, DO
Erectile Dysfunction (ED) - Part 1From March 2018, What’s Your (Code) Status?
Erectile dysfunction is common,so it behooves primary care providers to be comfortable engaging our patients in conversation about the condition. Many factors can cause erectile dysfunction, including medications, DM, and OSA. It’s important to remember that if blood flow to the penis is …10min 4Vanessa Cardy, MD and Andrew Buelt, DO
Paper Chase #1 - Hormonal Contraception & Breast CancerFrom March 2018, What’s Your (Code) Status?
The risk of breast cancer was higher in women who were currently or had recently used contemporary hormonal contraceptives when compared to women that never utilized hormonal contraception.4min 42Andrew Buelt, DO and Joe Weatherly, DO
LithiumFrom March 2018, What’s Your (Code) Status?
Lithium is often used to treat bipolar disorder. Dosing begins at 300 mg od and can range up to 1800 daily. Adverse effects are most likely to affect GI, renal, cardiac, neurologic systems as well as the thyroid and parathyroid glands. Toxicity can be either acute or chronic. Regular monitoring …15min 55Adrien Selim, MD
Erectile Dysfunction (ED) - Part 2From March 2018, What’s Your (Code) Status?
Erectile dysfunction is common,so it behooves primary care providers to be comfortable engaging our patients in conversation about the condition. Many factors can cause erectile dysfunction, including medications, DM, and OSA. It’s important to remember that if blood flow to the penis is …12min 50Vanessa Cardy, MD
Things I Do But Should I - GoutFrom March 2018, What’s Your (Code) Status?
Adrien and Vanessa cover the vexing topic of Gout Prophylaxis in the context of uric acid lowering therapy options. They discuss the pros and cons of using different medications to help prevent a gout flare when starting allopurinol. And because they are badass rebels, they also review NOT using …11min 18Vanessa Cardy, MD and Adrien Selim, MD
Things I Do But Should I - Vitamin D Levels and Frequency of DosingFrom February 2018, The Tragically Sore Hip
Vitamin D is a vitamin in flux, at least with regards to how much we should be recommending our patients take and the frequency with which they should take it. Vaness and Adrien sift through the evidence and conclude that weekly or monthly dose is adequate for most patients. They also remind us …8min 33Adrien Selim, MD and Vanessa Cardy, MD
Paper Chase #3 | AC Use and Risk of Ischemic Stroke and BleedingFrom February 2018, The Tragically Sore Hip
in patients who develop afib secondary to another medical condition like COPD or ACS, this study demonstrates that the benefit of anticoagulation in not strong and can be associated with a higher risk of bleeding.5min 19Andrew Buelt, DO and Joe Weatherly, DO
Knee Osteoarthritis (OA)From February 2018, The Tragically Sore Hip
Jake and Andrew break down the data for us on knee OA treatments. Lo and behold, there is not a lot of evidence!18min 54Andrew Buelt, DO and Jake Anderson, MD
Antidepressants Low DownFrom February 2018, The Tragically Sore Hip
With a solid knowledge of SSRIs, SNRIs, and bupropion, Dr. Hersevoort believes that primary care providers can manage 95% patients who have depression. Referral to psychiatry is recommended if you are consider augmenting therapy with anti-psychotics.10min 17Shawn Hersevoort, MD, MPH and Rob Orman, MD
The COMPASS TrialFrom February 2018, The Tragically Sore Hip
This branch of the COMPASS trial examined 3 anticoagulation strategies in patients with “stable atherosclerotic disease”: rivaroxaban 5mg BID, ASA 100mg od + placebo BID, ASA 100 BID + rivaroxaban 2.5 mg BID. Casey’s analysis focused on the ASA groups, not the NOAC alone group. He concludes that …13min 36Casey Parker, MD