A real pain in the neck (Get it?! We have fun.)
Protect your neck! Learn how to evaluate a patient with neck pain, and differentiate between mechanical neck pain, radiculopathy, and myelopathy. You’ll learn who should be reassured, who should see a surgeon, and what nonoperative options are available. We’re joined by Dr. Anthony Mikula @anthony_mikula from Mayo Clinic.
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Show Segments
00:00 Introduction
06:14 Anatomy and Pain Generators
09:58 Approach to Neck Pain
22:57 Differentiating Radiculopathy from Non-Specific Neck Pain
24:05 Management of Mechanical Neck Pain
27:36 Indications for Imaging
29:21 Terminology and Explanation of Spondylosis, Spondylolisthesis, and Spondylolysis
30:48 Diffuse Idiopathic Skeletal Hyperostosis (DISH)
32:23 Imaging Terminology and Plain Films
36:19 Pathophysiology of Cervical Radiculopathy
38:34 Physical Examination for Cervical Radiculopathy
44:54 Diagnostic Work-up for Radiculopathy
51:53 Interventions for Cervical Radiculopathy
53:53 Considerations for Surgery
57:49 Recognizing Cervical Myelopathy
01:00:17 Natural History of Myelopathy
01:02:25 Referral and Treatment for Myelopathy
01:09:28 Summary and Takeaways
Credits
Written and Produced by: Paul Williams, MD, FACP
Show Notes: Paul Williams, MD, FACP
Infographic and Cover Art: Paul Williams, MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Leah Witt, MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Anthony Mikula, MD
Sponsor: Freed
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Apr 15
1 hr 14 min
It’s NOT Always a UTI!
Sounds like another UTI but it could be more than that! Time to explore the entire pelvic floor and see what more you can treat. School’s in session with the Bladder Teacher, Kellen Choi, DO from the University of Louisville @KellenChoi
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Show Segments
Intro
Rapid fire questions/Picks of the Week
Case #1 and Definitions
Bowel habits
Water intake
Case #2
Vaginal Estrogen
Non-antibiotic prophylaxis
Antibiotic in prophylaxis
Pelvic Floor Physical Therapy
Take-home points
Outro
Credits
Producer, Writer & Show Notes: Isabel Valdez, PA
Infographic & Covert Art: Edison Jyang
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Fatima Syed, MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Kellen Choi DO, FAOCS
Sponsor: Freed
You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.
Sponsor: Locumstory
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Apr 8
1 hr 2 min
Step up your diabetes game! Learn the ins and outs of continuous glucose monitors (CGM) including key features, what and how to order, interpreting CGM data (time in range, time above range, etc.), and how to make adjustments to a patient’s insulin regimen, aka “insulin pattern matching”. We discuss common scenarios including overnight hypoglycemia, exercise-induced hypoglycemia, post-prandial hyperglycemia, what to do when the patient runs high all the time, and how to incorporate GLP1 agonists and SGLT2 inhibitors into a patient's regimen. Returning guest and Paul’s favorite frenemy, Dr. Jeff Colburn (VCU Health) returns!
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Show Segments
00:00 Introduction and Diabetes Puns
01:00 Introduction of Guest and Topic
09:12 Qualifications and Eligibility for CGMs
11:32 Types of CGMs and Sensor Placement
24:47 Interpreting CGM Data and Alarms
34:30 Troubleshooting Patterns and Adjustments
35:23 Understanding Hypoglycemia and Counter Regulatory Hormone Responses
36:15 The Rule of 15 and Addressing Hypoglycemia
37:10 Reducing Basal Insulin to Address Nocturnal Hypoglycemia
38:29 Addressing Postprandial Highs with GLP-1, SGLT-2 Inhibitors, or Prandial Insulin
39:51 Managing Exercise-Induced Hypoglycemia
41:43 Preventing Exercise-Induced Hypoglycemia with Snacks
43:42 Managing Nocturnal Hypoglycemia with Sulfonylureas
45:31 Addressing Postprandial Hyperglycemia with GLP-1, SGLT-2 Inhibitors, or Prandial Insulin
46:54 Adjusting Basal Insulin to Address Morning Hyperglycemia
51:18 Troubleshooting High Blood Sugars with Basal Insulin and Mealtime Insulin
56:49 Managing High Blood Sugars with Basal Insulin and Mealtime Insulin
57:44 Addressing Adherence and Medication Barriers
59:39 Using Continuous Glucose Monitors (CGMs) for Diabetes Management
01:02:30 Using Sulfonylureas and Basal Insulin Combination as a Stopgap
01:05:49 Considering Patient Adherence and Barriers to Treatment
Credits
Writer and Producer: Matthew Watto MD, FACP
Show Notes: Matthew Watto MD, FACP
Cover Art and Infographic: Matthew Watto MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Jeff Colburn MD
Sponsor: Freed
You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.
Sponsor: Panacea Financial
Download the 2024 Residents & Fellows Survey Report for free at panaceafinancial.com/report.
Apr 1
1 hr 13 min
Join us as we review recent practice-changing articles on E-cigarettes for smoking cessation, Gabapentin and COPD exacerbations, lidocaine patches for mechanical neck pain, Cdiff risk by antibiotic type, and “dosing by clicks” for GLP1 agonists. Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto).
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Credits
Written and Hosted by: Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP
Cover Art: Matthew Watto MD, FACP
Reviewer: Rahul Ganatra MD, MPH
Technical Production: Pod Paste
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Show Segments
Introduction and disclaimer
E-cigarettes for smoking cessation
Gabapentinoids and COPD exacerbations
Topical lidocaine for neck pain
Association between specific antibiotics and C. diff infection
Shortage of GLP-1 agonists and “dosing by clicks”
Sponsor: Locumstory
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Sponsor: Freed
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Mar 25
56 min
Show description:
Join us as we review the diagnosis and treatment of pericarditis, myocarditis, peri-myocarditis, myo-pericarditis…and everything in between! We are joined by our esteemed guest, Dr. Vivek Kulkarni (@VivekKulkarniMD), a clinical cardiologist and assistant program director for the Cardiovascular Disease Fellowship at Cooper University Health Care, who helps us get to the heart of the matter!
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Show Segments
Intro, disclaimer
A case of pericarditis
Diagnosing pericarditis
The difference between pericarditis, myocarditis, myopericarditis, and perimyocarditis
Etiologies of pericarditis and initial testing recommendations
Treatment of acute uncomplicated pericarditis
Using colchicine to prevent recurrent pericarditis
Patient counseling after diagnosing pericarditis
A case of myocarditis
Interpreting elevated troponin levels
Distinguishing between myocardial infarction and myocardial injury
Diagnostic testing for suspected myocarditis
When to pursue cardiac MRI and endomyocardial biopsy
The spectrum of myocarditis presentations
Fulminant myocarditis
Common etiologies of myocarditis
Immune checkpoint inhibitor myocarditis
Myocarditis from mRNA vaccines and from SARS-CoV-2 infection
Management of patients with myocarditis
Activity restrictions for patients with myocarditis
Outro
Credits
Hosts: Paul Williams, MD, FACP, Matthew Watto MD, FACP
Guest: Vivek Kulkarni, MD, FACC
Producer, Script, and Show Notes: Adam Barelski, MD
Infographics and Cover Art: Edison Jyang
Reviewer: Leah Witt, MD
Technical Production: Pod Paste
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Sponsor: Freed
You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.
Sponsor: Panacea Financial
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Sponsor: Factor
Head to factormeals.com/curb50 and use code curb50 to get 50% off.
Mar 18
54 min
This episode has been Unlocked from patreon.com/curbsiders!
Hone your obesity medicine skills in primary care! We discuss overcoming barriers, patient counseling, obesity pathophysiology, motivational interviewing, tools and tips from a weight loss program, and how to discuss medications for weight loss including phentermine/topiramate, bupropion/naltrexone, orlistat, oral superabsorbent hydrogel, and GLP1 agonists. We’re joined by obesity medicine expert, Dr. Kimberly Anne Gudzune of @HopkinsMedicine, recorded @SocietyGIM#SGIM23 in Denver, Colorado This audio episode is only available on Patreon!
Below are links to the original interview & show notes.
#405 Obesity Medicine, GLP1 agonists, Weight Loss Management Tools and Tips
Picks of the week:
Paul recommends: Blue Eye Samurai (Netflix)
Matt recommends: Live, Die, Repeat aka Edge of Tomorrow (film)
Show Segments
00:00 Introduction and Happy New Year
02:22 Overview of Obesity Medicine
04:13 Challenges in Weight Maintenance
06:07 Prevention of Obesity
08:04 Barriers to Obesity Care
09:29 Setting Realistic Weight Loss Goals
10:24 Counseling Patients on Weight Loss
11:45 Measuring Waist Circumference
12:44 Telemedicine and Tracking Apps
13:41 Psychological Considerations in Obesity Medicine
15:05 Low-Carb Diets
21:04 Managing Side Effects of GLP-1 Agonists
23:54 New Medication for Obesity
24:52 Prolia and Forteo for Osteoporosis
26:18 Statins and Lab Testing
29:30 Annual Labs and Urine Testing
32:37 Picks of the Week
35:02 Outro
Join our Patreon today and save 16% on an annual membership at patreon.com/curbsiders. Kashlak Admitting Privileges comes with ad-free episodes, access to the Kashlak Vault, which contains PDF files and graphics from over 400 Curbsiders shows, access to our private Discord group, plus twice monthly bonus episodes like this one!
Mar 13
37 min
Is bicarbonate supplementation for metabolic acidosis in chronic kidney disease (CKD) a thing we do for no reason? We cover the pathophysiology and long-term consequences of metabolic acidosis, the history of bicarbonate use, alternative options for bicarbonate repletion including baking soda, lemon juice, fruits and veggies, whether the renal diet works, counseling patients with CKD, and common mistakes and pitfalls in managing metabolic acidosis in CKD. Our guest is Dr. Timothy Yau (@Maximal_Change, @WUNephrology, @AJKDOnline). It’s NephMadness 2024! Fill out your bracket today and check out the other podcasts participating in the NephMadness pod crawl!
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Show Segments
Time stamps refer to the ad-free version
00:00 Introduction and Guest Bio
07:46 Case Presentation
08:42 Initial Approach to CKD Management
09:10 Metabolic Acidosis in CKD
13:30 Consequences of Metabolic Acidosis
22:28 Administration of Bicarbonate
23:54 Alternative Options for Bicarbonate Repletion
24:47 Citrate and Bicarbonate
26:02 Sodium Bicarbonate for CKD
30:19 Dietary Modifications
33:35 Renal Diet
38:20 Counseling CKD Patients
41:39 Veverimer and Other Treatments
44:36 Mistakes and Pitfalls
46:55 Conclusion
Credits
Writer and Producer: Matthew Watto MD, FACP
Show Notes: Matthew Watto MD, FACP
Cover Art and Infographic: Matthew Watto MD, FACP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Timothy Yau MD
Sponsor: Rocket Money
Cancel your unwanted subscriptions by going to RocketMoney.com/CURB
Sponsor: Freed
You can try Freed for free right now by going to freed.ai And listeners of Curbsiders can use code CURB 50 for $50 off their first month.
Mar 11
53 min
Elevate your primary care management of anxiety. Become confident in counseling patients about a new anxiety diagnosis, 2nd and 3rd line medications, augmentation for anxiety treatment, and options for non-pharmacological anxiety treatment. We are joined by psychiatrist and mental health expert Dr. Jessi Gold, @drjessigold (University of Tennessee System; drjessigold.com).
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Show Segments
Intro
Case from Kashlak
Diagnosing anxiety
Explaining anxiety to patients
Non-pharmacological management of anxiety
Pharmacological management of anxiety
2nd and 3rd line treatments
Cannabis and anxiety
Outro
Credits
Writer, Producer, Show Notes, Infographic, Cover Art: Edison Jyang
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Sai Achi MD, MBA
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Jessi Gold MD
Sponsor: Locumstory
Tune in to The Locumstory Podcast on Spotify, Apple, or Google podcasts.
Sponsor: Freed
You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.
Sponsor: Allbirds
Visit Allbirds.com and use code CURB for a free pair of socks with a purchase of $48 or more.
Mar 4
1 hr 32 min
Join us as we review recent articles and news featured in The DIGEST #48, #49, and #50 including thromboprophylaxis for patients receiving chemotherapy, eosinophil count to guide steroids in COPD exacerbations, anticoagulation in subclinical atrial fibrillation, the new genetic testing recommendations for patients with breast cancer, and at-home STI testing–not to mention trial names galore. Fill your brain hole with a fully digestible meal! Featuring Paul Williams (@PaulNWilliamz), Nora Taranto (@norataranto) and Matt Watto (@doctorwatto).
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Credits
Written and Hosted by: Nora Taranto MD; Paul Williams, MD, FACP, Matthew Watto MD, FACP
Cover Art: Nora Taranto MD
Reviewer: Emi Okamoto MD
Technical Production: Pod Paste
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Show Segments
00:00 Introduction + Pun
06:06 Target TP Trial: Thromboprophylaxis in Cancer Patients
13:07 Steroids for COPD Exacerbations
25:25 Anticoagulation in Subclinical Atrial Fibrillation
34:01 Genetic Testing in Breast Cancer
43:38 Home STI Testing
Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.
Sponsor: Factor
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Sponsor: NetSuite
Download NetSuite’s popular KPI Checklist, designed to give you
consistently excellent performance - absolutely free, at NetSuite.com/CURBSIDERS.
Sponsor: Freed
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Feb 26
55 min
The clinical picture of an underrecognized disease
Amyloidosis demystified. Learn the clinical clues that suggest possible amyloidosis and how to order the correct tests to diagnose this disease. We are joined by Dr. Michelle Kittleson who shows us the ropes of treating fibril accumulation, @MKittlesonMD (Cedars Sinai).
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Show Segments
Introduction
Case Presentation: Mr. Smith
Differential Diagnosis of Heart Failure with Preserved Ejection Fraction
Understanding Amyloidosis
Clinical Clues and Red Flags for Amyloidosis
Physical Examination Findings
Workup for Amyloidosis
Treatment Options
AL Amyloidosis and Hematologist's Role
ATTR Amyloidosis and Cardiologist's Role
Other Therapies for TTR Amyloidosis
Therapy on the Horizon
Cost and Access to Tafamidis
Alternative Therapies and Supplements
Monitoring and Side Effects of Tafamidis
Symptomatic Management and Anticoagulation
Take Home Points
Credits
Written and Produced by; Deborah Gorth, MD, PhD
Infographic and Cover Art: Meryl Gorth, RD, MPH and Deborah Gorth, MD, PhD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Sai S. Achi MD MBA
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Michelle Kittleson, MD, PhD
Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.
Sponsor: Panacea
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Feb 19
1 hr 8 min
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