Last Week in Medicine Stephen Jenkins, MD, Austin Rupp, MD

Today we are joined by Dr. Brian Locke, recently graduated pulmonary-critical care fellow, who takes us on a journey of avoiding statistical fallacies. Does metformin reduce the likelihood of long COVID? Should we give platelet transfusions to thrombocytopenic patients before central line placement? Did the CANVAS trial change practice in cancer associated thrombosis? Should patients with a stroke due to atrial fibrillation start oral anticoagulation earlier or later? We discuss all these questions on more on today's episode. Check it out!

Metformin for Long COVID
Definition of Post Acute Sequelae of Sars-CoV-2 Infection
Platelet Transfusion before CVC Placement in Thrombocytopenia
DOACs vs LMWH in Cancer Associated VTE
Early vs Late Anticoagulation for Stroke with AF







Music from Uppbeat (free for Creators!):
https://uppbeat.io/t/soundroll/dope
License code: NP8HLP5WKGKXFW2R

Today we have a special guest, Dr. Joel Topf, board-certified nephrologist and medical educator extraordinaire. Our listeners will likely recognize Dr. Topf from his prolific tweeting @Kidney_boy, as well as his numerous appearances on the Curbsiders podcast. He is a co-founder of the NephJC on Twitter, and host and founder of the NephJC podcast Freely Filtered. He is also host of the podcast Channel Your Enthusiasm, a deep dive monthly recap of the nephrology textbook Clinical Physiology of Acid Base and Electrolyte Disorders by Dr. Burton Rose (who, incidentally, is the creator of the original UpToDate). Dr. Topf wrote his own book on fluids, electrolytes and acid-base homeostasis.  He's the co-editor for the fourth edition of Nephrology Secrets and the first edition of The Handbook of Critical Care Nephrology.

Dr. Topf joined us to talk about a new paper he co-authored on osmotic demyelination syndrome and hyponatremia.

I'm also joined by Dr. Mita Hoppenfeld, hospitalist at the University of Utah, to talk about a new DOAC vs warfarin trial in On-X aortic valves, whether it's better to avoid hypertension or hypotension around time of surgery, and the diagnostic accuracy of CT abdomen scans without contrast. Check it out!

Osmotic Demyelination and Hyponatremia
Apixaban vs Warfarin for On-X Aortic Valve
Perioperative Blood Pressure Strategies
Diagnostic Accuracy of CT Abdomen Without Contrast







Music from Uppbeat (free for Creators!):
https://uppbeat.io/t/soundroll/dope
License code: NP8HLP5WKGKXFW2R

This week we have special guest, Dr. Adam Spivak, to talk about the new study on doxycycline post-exposure prophylaxis for STIs. Dr. Spivak is an infectious disease expert and works in both an HIV clinic and a free PrEP clinic.

I also review the latest COVID-19 anticoagulation trial and a paper looking at rates of fracture non-union in people who receive bisphosphonates. Check it out!


Doxycycline Post-exposure Prophylaxis for STIs
High dose prophylactic anticoagulation in COVID-19
Bisphosphonate and Rates of Fracture Non-unions





Music from Uppbeat (free for Creators!):
https://uppbeat.io/t/soundroll/dope
License code: NP8HLP5WKGKXFW2R

Today we have special guest, Dr. Sarah Gilligan, a nephrologist, to talk about the new study of thiazides for kidney stones. We all learn in medical school that thiazides reduce urinary excretion of calcium, but does that really translate to fewer kidney stones?

We also have Dr. Brian Locke on to talk about the CAPE COD trial, a big new critical care paper on using hydrocortisone in severe pneumonia, as well as the latest COPD guidelines and a retrospective study of oral antibiotics for infective endocarditis. Check it out!



Hydrochlorothiazide for Kidney Stones

Steroids for Pneumonia Meta-analysis

Hydrocortisone for Severe CAP (CAPE COD)

2023 GOLD COPD Guidelines

Real World Use of Oral Antibiotics for Endocarditis





Music from Uppbeat (free for Creators!):
https://uppbeat.io/t/soundroll/dope
License code: NP8HLP5WKGKXFW2R

Today we welcome special guest and fellow EBM lover Dr. Mita Hoppenfeld to talk about a new randomized controlled trial evaluating the best duration of antibiotics for febrile UTI in men. Is 7 days as good as 14 days? We also review the latest guidelines for lower GI bleeding and a new retrospective study on renal outcomes in patients with AKI who receive IV contrast.

7 vs 14 days of antibiotics for Febrile UTI in Men
Lower GI Bleeding Guidelines
IV Contrast in patients with AKI





Music from Uppbeat (free for Creators!):
https://uppbeat.io/t/soundroll/dope
License code: NP8HLP5WKGKXFW2R

We're back with Season 4! Sorry for the unplanned hiatus.

Today we talk about the CLOVERS trial, which tested the hypothesis that early vasopressors and restrictive fluid would be superior to liberal fluids plus rescue vasopressors. We also looked at the TRANSFORM-HF study, which compared torsemide and furosemide in congestive heart failure, the PREVENT CLOT study, which compared aspirin to enoxaparin for VTE prophylaxis after a traumatic fracture, and the AID-ICU study, which compared haloperidol to placebo in the treatment of ICU delirium.

CLOVERS trial
Torsemide vs Furosemide in CHF
Aspirin vs Enoxaparin for VTE ppx after Fracture
IV Haloperidol in ICU Delirium

We also quickly review some papers we missed in 2022:

Apixaban for VTE in ESRD
Acetazolamide for Congestive Heart Failure
Moderate or Aggressive IV Fluids for Pancreatitis
Perioperative Management of Anticoagulation
CRISTAL study (aspirin vs enoxaparin after TKA/THA)






Music from Uppbeat (free for Creators!):
https://uppbeat.io/t/soundroll/dope
License code: NP8HLP5WKGKXFW2R