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In community-acquired pneumonia, can steroids improve mortality? Past studies of steroids in CAP have been conflicting, with some showing a mortality benefit and others showing no difference. How does the CAPE COD trial change how we think about patients hospitalized with severe CAP? To find out, tune into the third episode of Beyond Journal Club, a new series brought to you by Core IM in collaboration with NEJM Group.Show Notes & Transcript01:50 Pathophysiology of Steroids and Infection03:50 Steroids in PNA Studies08:56 CAPE COD Trial14:13 Discussion of CAPE COD Trial18:36 Takeaways/DiscussionTags: IMCore, CoreIM, primary care, cardiology, nurse practitioner, pharmacist, physician assistantFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy
Syncope history, PPM/ICD prior to MRI or surgery, anticoagulation for pacemaker or ICD procedures and new cardiac devices and how they may look different on EKG or chest x-ray!Sponsor: Post Investment: Real Estate Syndications Show Notes & Transcript Timestamps:01:13 Pearl 1: Should we approach syncope history differently in our patients with pacemakers and ICDs?06:31 Pearl 2: Considerations for patients with implantable devices before surgery.12:26 Pearl 3: Considerations for patients with implantable devices before MRI.14:45 Pearl 4: Anticoagulation in patients undergoing pacemaker or ICD procedures. 18:17 Timestamp 5: Emerging cardiac device technology and how they might look different on EKG or chest x-rayTags: IM Core, CoreIM, cardiology, prodromal symptoms, CRT, biventricular pacingFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy
Is Cr or Cystatin C better to assess eGFR? What are pros & cons of each? Does eGFR tell the full picture of kidney function? What may cause false positive albuminuria?Sponsor: Panacea Financial Student Loan ConsultationCME : http://bit.ly/CIMCME || Show Notes & TranscriptTimestamp:00:13 Reviewing CKD Classification: G1-5 stage, A1-3 stage04:20" What's wrong with how we estimate GFR?06:50 Why is creatinine flawed as an estimator of GFR?10:52 Enter new contender...Cystatin C!16:16 Importance of the A Stage!20:21 Which patients should you measure proteinuria in?22:10 Treatments for albuminuria!24:27 Summary and ClosingTag: Creatinine, nephrology, renal, CoreIM, IMcore, internal medicine, primary care, nurse practitioner, physician assistantFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy
1Check out the original interview on Youtube:Essentials on Genetic Counselor | Lynch SyndromeWho should be referred for genetic counseling? How can we set our our patients and genetic counselors up for success? And let's do some genetics myth busting!Show Notes & TranscriptTimestamp03:13 Part 1: Who should be referred to genetic counseling?11:23 Part 2: How do we set up genetic counselors for success?22:38 Part 3: Genetic counseling myth busting!Tags: IMCore, CoreIM, primary care. oncology, surgonc, medonc, cancer, nurse practitioner, physician assistantFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy
What is the evidence behind K+ repletion? What is a framework to think through for hypokalemia? What are the different repletion formulations and what else can you do to mitigate hypokalemia? Stepping back, do we really need to get labs every single day?!Sponsor: Hellofresh (50% off + free shopping with code: 50COREIM)CME : http://bit.ly/CIMCME || Show Notes & TranscriptTimestamp01:45 Pearl 1: Evidence for potassium repletion 09:10 Pearl 2: Framework for hypokalemia17:09 Pearl 3: Repletion goals23:00 Pearl 4: Options for hypokalemia treatment29:13 Pearl 5: Frequency of lab checks and repletionTags: IMCore, CoreIM, nephrology, hospital medicine, potassium diet, interprofessional educationFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy
What is the difference between semaglutide (ozempic) and tirzepatide (mounjaro) in outcomes and mechanism? How did we find out diabetes medications can help with weight loss?Sponsors: Post Investment: Real Estate Syndications || Hellofresh Show Notes & Transcript02:08 Framework for thinking about obesity03:42 History of obesity treatment06:29 Gila monsters and GLP and GIP mechanisms08:29 Story of how medications for diabetes were found to have a weight loss benefit12:50 SURMOUNT-1 trialTags: IMCore, CoreIM, primary care, cardiology, nurse practitioner, pharmacist, physician assistantFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy
With progressing CKD & HFrEF, what GDMT medications can you start, continue or stop? What does the data on hydralazine/isosorbide tell us and what does it NOT tell us? What are the pros and cons of starting GDMT inpatient versus outpatient? Do you still keep patients on GDMT once their EF recovers? Sponsors: Hellofresh | Pranay's Effective Living Formula CoursePranay's Free Masterclass (Sept 20 and 27th at 5pm PST)CME : http://bit.ly/CIMCME || Show Notes & TranscriptTimestamps01:54 Pearl 1 – Recap of GDMT and CKD09:15 Pearl 2 – Hydralazine and Isosorbide Dinitrate 20:59 Pearl 3 – Ivabradine 25:47 Pearl 4 – Inpatient vs Outpatient Initiation of GDMT30:55 Pearl 5 – Ejection Fraction Recovery Tags: IMCore, CoreIM, hydralazine, heart failure reduced ejection fraction, HFmrEF, HFimpEF, chronic kidney disease, cardiologyFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy
What does medical education research say about improving diagnostic errors? What habits help in getting to diagnostic excellence?Timestamps01:00 System 1 vs. System 207:46 Cognitive Biases13:46 Case for Knowledge18:29 Other Practices to Decrease Error28:26 Conclusion CME: http://bit.ly/CIMCME || Show Notes & TranscriptThis episode is made in part of ACP’s Diagnostic Excellence curriculumTags: IMCore, CoreIM, clinical reasoning, system 1 vs. system 2, cognitive bias, feedback and reflectionFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy
What are side effects of tacrolimus and mycophenolate? And what are common medication interactions? What causes of acute kidney injury are unique to renal transplant recipients When a patient has a fever, what are the viral syndromes we should work up? What are signs and symptoms of rejection? Timestamps02:41 Types of Immunosuppression14:31 Medication Reconciliation22:36 AKI in the Transplant Patient31:53 Infections in the Transplant Patient40:00 Transplant rejection, cancer after transplantCME: http://bit.ly/CIMCME || Show Notes & TranscriptTags: IMCore, CoreIM, renal, internal medicine podcast, hospitalist, nephrology, immunosuppressiveFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy
In patients with heart failure with low ejection fraction and chronic coronary disease without unstable symptoms, does stenting open blocked coronary arteries extend life or reduce hospitalizations? There is some literature to suggest those with low EF may benefit from revascularization with surgery.How does the REVIVED trial change how we think about these patients? Tune in to the first episode in this new series brought to you by Core IM in collaboration with NEJM Group.Show notes & TranscriptAccess to Rotation Prep Cardiology guide on NEJM Resident 360 is free for August 2023. View the relevant sections on ACS and CHF.Timestamps00:50 Question REVIVED addressed01:44 Revascularication in HFrEF06:32 Revascularization in stable CAD10:02 REVIVED trial12:20 Summary and takeawaysTags: IMCore, CoreIM, cardiology, internal medicine podcast, hospitalist, stent, CABG, evidence-based medicineFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy
Laugh and be humbled along some of Dr. Maria Rosasco's most memorable July stories !Listen to the original July Stories: https://bit.ly/3Y4n8jGSubscribe to our new Youtube Channel !Tags: medical humanities, internal medicine, residency, medical school, interprofessional education, rotation, imposter syndrome, feedbackFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy
BONUS on Cosyntropin stimulation tests! What exactly is it? How do you interpret them? What is the difference between adrenal insufficiency and steroid withdrawal syndrome?Use promo code COREIM for 1 month of free access to Glass Pro at https://glass.health/coreim Show notes & TranscriptSubscribe to our new Youtube Channel !Tags: IMCore, CoreIM, endocrine, internal medicine podcast, hospitalist, glucocorticoid withdrawal, fatigueFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy
How do you choose between the different steroids? At what dose and duration do you get concerned about worrisome complications? What types of prophylaxis should be started in patients on steroids and when?In which patients should we wean steroids vs. stop abruptly, and how should we do so? What factors limit steroid weaning?Use promo code COREIM for 1 month of free access to Glass Pro at https://glass.health/coreim Subscribe to our new Youtube Channel !Use this link for CME-MOC credit with ACPShow notes & TranscriptTime Stamps02:59 Types of Corticosteroids14:31 Side Effects of Steroids21:15: Prophylaxis 27:32 Steroid Weaning 33:38 Steroid Weaning Limitations Tags: IMCore, CoreIM, endocrine, adrenal insufficiency, internal medicine podcast, hospitalist, hydrocortisone, fludrocortisone, methylprednisolone, prednisone, dexamethasone, steroid withdrawal syndromeFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy
In cirrhosis, what actually contributes to the bleeding vs. clotting risk? Does the INR capture it? What is in FFP? Do you have to give FFP prior to a paracentesis and a thoracentesis? How much of FFP stays in the intravascular space? Does indwelling pleural catheters increase risk of malnutrition or infection?Show notes & TranscriptTime Stamps02:36 Deep Dive 1: Bleeding risk of paracentesis and thoracocentesis05:35 Deep Dive 2: FFP effect on bleeding risk15:43 Deep Dive 3: Risks of FFP19:45 Deep Dive 4: Indwelling pleural catheters30:31 RecapTags: IMCore, CoreIM, hepatology, internal medicine podcast, hospitalist, heme/onc, pulmonaryFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy
How long can fatigue last for after radiation? Are all patient post radiation immunocompromised? What are the potential acute and long-term side effects after lung, breast, prostate and brain radiation?Use promo code COREIM for 1 month of free access to Glass Pro at https://glass.health/coreim Use this link for CME-MOC credit with ACPShow notes & TranscriptWhiteboard Animation Video of Radiation PhysiologyTime Stamps02:37 Systemic Radiation Side Effects14:29 Lung Radiation Side Effects18:22 Breast Radiation Side Effects21:45 Prostate Radiation Side Effects24:54 Brain Radiation Side EffectsTags: IMCore, CoreIM, cancer, tumor, internal medicine podcast, hospitalist, heme/onc, rad onc, EBRT, brachytherapyFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy
What are the different types of radiation? What should we and shouldn’t we put in our one-liners? What makes palliative radiation different from curative radiation? And when to refer to for palliative radiation?Show notes & TranscriptWhiteboard Animation Video of Radiation PhysiologyTime Stamps02:04 What is radiation?03:17 How does radiation therapy work?04:50 How is today’s radiation different from the past?05:40 What role does radiation play in cancer treatment?07:48 What are the different types of radiation?15:34 How do you write a rad onc one-liner as an internist?19:59 What is palliative radiation and how/when should we use it?Tags: IMCore, CoreIM, cancer, tumor, internal medicine podcast, hospitalist, heme/onc, EBRT, brachytherapy Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy
What did you have to "unlearn" in your learning journey? How do you organize your time? Organize how you keep up with medical evidence? What is your calendar management system? How can you use your leadership skills to improve the well-being of your team members?Show notes & TranscriptTime Stamps01:12 Learning Journey05:58 Lifelong Learning11:14 Time Management16:38 Role Modeling19:59 Re-Calibrating FailureTags: IMCore, CoreIM, failure, fixed mindset, growth mindset, imposter syndrome, leadership, learning styles, role modeling, success, time managementFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy
What does the HbA1c really measure? What are its limitations? How does fructosamine and glycated albumin work? What will falsely elevate or decrease it? What are the benefits of continuous glucose monitoring? What are the limitations of a glucose-centric view and should we be more insulinocentric? Show notes, Transcript and ReferencesTime stamps00:35 Random Glucose, Fasting Glucose, Glucose Tolerance Test03:03 Hemoglobin A1c08:26 Fructosamine and Glycated Albumin10:50 Continuous Glucose Monitoring15:44 The Overlooked Issue of Insulin Resistance19:11 SummaryTags: IM Core, CoreIM, insulin resistance, diabetes, microvascular and macrovascular complicationFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy
When do you have a device interrogated? Do you know what kind of device your patient has? Do you know how to manage patients with a device who develop bacteremia? How do you discuss end of life care in patients with devices such as a pacemaker or ICD?Visit www.medmastery.com/coreim for 15% off Medmastery Pro subscription. Discount code: “COREIM15”Use this link for CME-MOC credit with ACPShow notes, Transcript and ReferencesTime stamps02:51 What are the different types of pacemakers and defibrillators? Who is it indicated for? How can where the leads clue you what the implantable device may do?21:28 How to determine which type of device your patient has?25:10 What can a device interrogation tell you and doesn't tell you?32:13 Do all patients with bacteremia need their implantable cardiac devices taken out? 38:44 End-of-life considerations with pacemakers vs. ICDs Tags: IM Core, CoreIM, sinus node dysfunction, AV dissociation, palliative care, CRT, biventricular pacingFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy
How does transplant compare to dialysis? Who is a good candidate for a kidney transplant? How long do patients have to wait for a deceased donor kidney transplant? What can increase or decrease the waiting time for your patient? Who is a good living donor candidate? What are the risks of living donors?Use promo code COREIM for 1 month of free access to Glass Pro at https://glass.health/coreim Use this link for CME-MOC credit with ACPShow notes, Transcript and ReferencesTime stamps03:49 Episode start07:13 Dialysis vs. kidney transplant morbidity and mortality11:44 Eligibility for kidney transplant and when to refer21:34 Pre-transplant evaluation process25:38 How long are wait times on the transplant list?36:21 What benefits of living donation? What are risks to the kidney donor?Tags: IM Core, CoreIM, renal, dialysis, nephrology, nephrologist, renal, CKD, chronic kidney disease, living donor kidneyFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy
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great ep
Thank you for once again awesome ep
Super helpful. Thank you very much for your hardwork
That was really interesting case!
All the laughing and jokes distracts from the podcast info.