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June 30, 2020
Did you know systolic and diastolic blood pressure are NOT measured by automated BP cuffs? PRES (Posterior Reversible Encephalopathy Syndrome), also known as RPLS (Reversible Posterior Leukoencephalopathy Syndrome), is something you should recognize when you see it. Brief mentions of esmolol, nitroprusside, and other topics are scattered somewhere in between musings.
April 29, 2020
Did you know that intravenous labetalol and oral labetalol are not really similar? The great hydralazine debate. Things you must know about Clevidipine if you are going to use it.
April 28, 2020
Multiple treatment issues are discussed. This includes theoretical ideal blood pressure lowering rates, oral options (for hypertensive urgency and specific populations), intravenous options (for hypertensive emergency or NPO patients), specific issues with aortic dissection, coronary syndromes, acute pulmonary edema & heart failure, labetalol, esmolol, nitroglycerin, and nitroprusside.
April 27, 2020
Did you know that intravenous labetalol and oral labetalol are not really similar? The great hydralazine debate. Things you must know about Clevidipine if you are going to use it.
April 26, 2020
Multiple treatment issues are discussed. This includes theoretical ideal blood pressure lowering rates, oral options (for hypertensive urgency and specific populations), intravenous options (for hypertensive emergency or NPO patients), specific issues with aortic dissection, coronary syndromes, acute pulmonary edema & heart failure, labetalol, esmolol, nitroglycerin, and nitroprusside.
April 25, 2020
Did you know systolic and diastolic blood pressure are NOT measured by automated BP cuffs? PRES (Posterior Reversible Encephalopathy Syndrome), also known as RPLS (Reversible Posterior Leukoencephalopathy Syndrome), is something you should recognize when you see it. Brief mentions of esmolol, nitroprusside, and other topics are scattered somewhere in between musings.
April 23, 2020
If you wonder why good food is more important than mortality and why ordering too many unnecessary consults worsens the food and doesn't impact mortality - this episode is for you. Tramadol is not well understood by many prescribers and there are some emerging facts we all need to know. A flashback to diuretic use in congestive heart failure with fluid overload and elevated creatinine is also discussed somewhere in the mix. Ohhh...and stop systematically prescribing nicotine replacement at high dosages for all hospitalized smokers. Stevens JP, Hatfield LA, Nyweide DJ, Landon B. Association of Variation in Consultant Use Among Hospitalist Physicians With Outcomes Among Medicare Beneficiaries. JAMA February 21, 2020 “Twenty Common Mistakes Made in Daily Clinical Practice” American Journal of Medicine 2020:133(01):1-3 Cristobal Young, Xinxiang Chen, Patients as Consumers in the Market for Medicine: The Halo Effect of Hospitality, Social Forces Tramadol is an odd, unpredictable opioid, scientists say - By The Associated Press - December 13, 2019
December 10, 2019
Correcting Hypernatremia in adults (finally, a real study!). An option for that scary patient with hemoptysis. How many nephrons you have (and your patient has) - and why that really matters.
September 30, 2019
Anemia of Inflammation is also often referred to as Anemia of Chronic Disease. It is one of the most common anemias, yet often challenging to comprehend. This is an attempt is to try and simplify it.
September 30, 2019
If you know why red blood cells survive less (and are made less) during inflammatory conditions, and already know why ferritin increases in inflammation, and don't want to hear a lousy Iron Man plot idea - then you are good to go on skipping this episode.
August 26, 2019
Is there a specific type of creatine to buy? What is creatine monohydrate? What is Creapure? What do some professional organizations have to say about the safety of creatine? The loading dose debate. Also dives into the several mechanisms of action for how creatine helps build muscle.
August 21, 2019
The replenishing of muscle ATP is one (of the several) mechanisms that creatine helps with when it comes to heavy anaerobic exercise. Other topics discussed are things to know about lab testing the kidneys while taking creatine. Thoughts on why some don't respond to creatine supplementation.
August 20, 2019
It occurs naturally in the body (because we synthesize it), it is in meat, and it is frequently used as a supplement. Since it is in you, why not understand what is and what it does? Advice is provided on which supplement labels to particularly avoid. A brief reflection upon creatine within our brains (and the potential memory impact seen in one study) is utilized to make the point that when it comes to a performance enhancer, like creatine, it's not solely about the ramifications on muscle strength and endurance.
August 6, 2019
The replenishing of muscle ATP is one (of the several) mechanisms that creatine helps with when it comes to heavy anaerobic exercise. Other topics discussed are things to know about lab testing the kidneys while taking creatine. Thoughts on why some don't respond to creatine supplementation.
August 5, 2019
Is there a specific type of creatine to buy? What is creatine monohydrate? What is Creapure? What do some professional organizations have to say about the safety of creatine? The loading dose debate. Also dives into the several mechanisms of action for how creatine helps build muscle.
July 1, 2019
Are you surprised that GoFundMe and crowdfunding are not the solution to a family healthcare crisis? How about Medicare for All? Hmmmm.....
February 11, 2019
Many of the latest studies in the 2017-2018 timeframe are reviewed. The importance of looking at the eosinophil count on the CBC, probiotic future directions, microbiome transplant options, antibody treatment (bezlotoxumab), "penicillin allergic" patients, and a brief mention of available testing.
January 29, 2019
Specific initial treatment regimens are discussed. Topics include fulminant disease, Vancomycin, Fidaxomicin, Metronidazole, and recurrence rates/regimens.
January 25, 2019
A deceivingly difficult topic. Not so obvious points are made about asymptomatic carriers, transmission, and who to test.
January 24, 2019
Many of the latest studies in the 2017-2018 timeframe are reviewed. The importance of looking at the eosinophil count on the CBC, probiotic future directions, microbiome transplant options, antibody treatment (bezlotoxumab), "penicillin allergic" patients, and a brief mention of available testing.
January 23, 2019
Specific initial treatment regimens are discussed. Topics include fulminant disease, Vancomycin, Fidaxomicin, Metronidazole, and recurrence rates/regimens.
January 23, 2019
Many of the latest studies in the 2017-2018 timeframe are reviewed. The importance of looking at the eosinophil count on the CBC, probiotic future directions, microbiome transplant options, antibody treatment (bezlotoxumab), "penicillin allergic" patients, and a brief mention of available testing.
December 24, 2018
Experiences that taught me some lessons.
December 17, 2018
Glucagon-Like Peptide 1 (GLP-1) mimetics are also referred to as the GLP-1 receptor agonists. While this talk mostly focuses on GLP-1 mechanisms and actions, the hope is you will also better understand The Dipeptidyl Peptidase-4 (DPP-4) inhibitors  The current GLP-1 Agonists include Exenatide (Byetta), Liraglutide (Victoza), Dulaglutide (Trulicity), Abiglutide (Tanzeum), Lixisenatide (Adlyxin), Semaglutide (Ozempic). The current DPP-4 Inhibitors include Alogliptin (Nesina), Linagliptin (Tradjenta), Saxagliptin (Onglyza), Sitagliptin (Januvia).
September 26, 2018
Sodium-Glucose Transporter 2 Inhibitors decrease glucose re-absorbtion. The diuretic effect, weight loss, DKA, cardiac outcomes, blood pressure, genital infections and a whole bunch of other information is discussed. SGLT2s include Canagliflozin (Invokana), Dapagliflozin (Farxiga), Empagliflozin (Jardiance), Ertagliflozin (Steglatro), with more to be released in the future.
August 26, 2018
There is a lot more to understanding HgA1C then most realize (particularly the quality industry and big corporations).
May 27, 2018
Tackles - Vitamin B12, kidney disease, CHF, cancer, Impaired Glucose Tolerance (IGT), dosing, side-effects, lactic acidosis, cost, drinkers, hypoxic patients, glucose lowering, and a few other moments of erudation.
May 16, 2018
If you want to understand drug classes like DPP-4 inhibitors, GLP-1 (GLUCAGON-like peptide) therapies, treating hypoglycemia, and an important player among the many etiologies of Type 2 diabetes - then you must understand the basics about glucoagon.
April 3, 2018
Diuretic therapy for congestive heart failure treatment, antibiotics for diabetic osteomyelitis after foot surgery, and practical tips with new-onset seizures - is among the knowledge dropped (because, after all, school can't teach us everything).
February 1, 2018
Some new stuff about Vitamin D & Calcium supplementation, another about the timing of hip fracture surgery, etc
November 14, 2017
Checking glucose levels in Type 2 Diabetes, ACE Inhibitors for women, and using Azithromycin in Asthma.
May 28, 2017
You know all those people on social media wanting mandatory drug testing for welfare recipients? Perhaps, reasonable in theory, if the test wasn't frequently producing false-positives and false-negatives. Making accurate clinical decisions is always challenging, but particularly with urine drug testing. The consequences of misinterpretation can be awful.
May 11, 2017
A look at some new data: COPD and Oxygen use - low serum creatinine levels - BMI considerations - the RDW - the age of blood.
February 22, 2017
Oxalate intake reduction, thiazide diuretics, and tamsulosin are some of the therapies discussed in this lecture.
February 15, 2017
Stone analysis, labs, calcium & fluid intake, sodium in the diet, and beverage choices.
February 13, 2017
A few words about the proximal ureter, I.V. Fluids, colic, and hematuria.
February 1, 2017
This episode discusses symptoms, the importance of size, and a few other pearls.
January 25, 2017
You see it in energy drinks. It is in our food, supplements, it naturally occurs in multiple organs, and most people don't know anything about it.
December 29, 2016
Lifestyle, carbohydrates, protein, and eccentric weight training are part of the focus of this sermon.
December 24, 2016
This episode is part philosophy, part motivation, and a discussion of some traps men and women get caught in.
October 10, 2016
The use of Inferior Vena Cava (IVC) filters and the length of anticoagulation in unprovoked DVT/PE are considered. A rant about hyper-coagulable panels in provoked DVT/PE is opined.
August 29, 2016
Understanding what causes hypotension in PE is essential to understanding the severity of the situation. The relevance of the stressed right ventricle is emphasized. Thrombolytic therapy for hypotension and other clinical scenarios resulting from pulmonary embolism are contemplated.
July 24, 2016
The treatment challenges of subsegmental pulmonary embolism, with emphasis on the 2016 guidelines are reviewed. Ventilation/perfusion (V/Q) scan interpretations in those unable to get a CT scan are considered.
June 3, 2016
The topics covered are D-Dimer testing, false positive over-diagnosis of PE on CT scanning, the ADJUST-PE study, and clinical signs and symptoms of a pulmonary embolism.
May 15, 2016
Various topics regarding intravenous iron are pondered, especially some of the new data available that has not yet seemed to obtain the influence that the information deserves.
April 28, 2016
This episode mostly centers around oral iron replacement.
January 14, 2016
BNP use as a lab and therapeutic are discussed. The episode also explores the PARADIGM-HF trial and Neprilysin inhibition. The novel combination medication sacubitril/valsartan (Entresto) for systolic CHF is evaluated in depth. Clinical tips for avoiding angioedema and other clinical pearls are provided.
December 8, 2015
If you think the seismic shift in U.S. healthcare is all a result of the Affordable Care Act, you may not be seeing a large part of the picture. This has become an era of "BIG MEDICINE" and that phenomenon is increasing through mergers and acquisitions. Some of these mergers are strategic, while others are defensive. Practical advice on how doctors and companies can improve their chances of merging successfully is provided. The lecture concludes with potential implications of the insurance-industry merger wave on patients and those working in the healthcare industry.
October 1, 2015
This episode offers some advice in thinking about the very difficult topic of pancreatic pseudocysts. Some philosophical waxing about pain control and some items not addressed in the previous episodes are also discussed.
August 23, 2015
Imaging, fluid resuscitation, fine needle aspiration, determining sterile vs infected necrosis, and suggestions from the guidelines are discussed.
July 29, 2015
This episode addresses some of the debates regarding nutrition timing in acute pancreatitis. Methods such as nasogastric, nasojejunal, and oral feeding are compared.
June 8, 2015
Treatments that include hydration, cinacalcet, calcitonin, bisphosphonate, denosumab, and other options are reviewed.
June 6, 2015
Indications for parathyroidectomy, pre-operative localization issues, diagnosing hyperparathyroidism, and a brief summary of the guidelines are among the topics addressed in this episode.
March 31, 2015
Special attention is paid to gastrointestinal, bone, and cardiovascular disease as a result of hypercalcemia. Laboratory interpretation of calcium and phosphorus levels is also discussed.
June 18, 2014
Pseudomonas aeruginosa and Legionella pneumophila bacterial lower respiratory tract disease are explored in depth.
May 4, 2014
Hospital & Internal Medicine lectures are intended for the medical professional who enjoys learning for the sake of it. Dr. Porat is a practicing Hospitalist and Board Certified in Internal Medicine.
April 26, 2014
Does the patient really have pneumonia? Differential diagnosis and mimics are considered in this common clinical problem. Dive deeper into how microbes and the immune system interact in lower respiratory infections.
April 6, 2014
Hepatotoxicity from antibiotics, NSAIDs, dietary supplements and other sources are explored. Idiosyncratic drug induced immune related and non-immune related injuries are differentiated, which can change treatment.
December 30, 2013
Was H1N1 accidentally released from a laboratory? Is it really a "swine flu"or is it a misnomer?What is this H3N2 swine flu we periodically hear about in the media?What makes a pandemic?Find these answers and more in this episode.
December 29, 2013
Some years the vaccine is better than others - but there is still good reason to get it. Let's discuss those reasons.How is flu transmitted?How do weather patterns influence the spread of influenza?Get these answers and more in this episode.
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