An (old) New Weapon to Fight Leg Cellulitis

August 12th, 2020

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Acute Severe Hypertension - part 1

April 28th, 2020

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Acute Severe Hypertension - part 2

April 28th, 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.

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Acute Severe Hypertension - part 3

April 27th, 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.

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Acute Severe Hypertension - part 4

April 25th, 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.  

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A Plea For The Middle Ground With Covid19

April 24th, 2020

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Interesting Studies, Facts, & Opinions - April 2020 edition

April 23rd, 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 - December 13, 2019

 

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Balkan Reflections Forged By A Virus Lockdown

April 23rd, 2020

World War I was partly triggered by powerful allies of various nationalities being dragged into a Balkan conflict (nationalism, of course, was another major factor). The more recent Balkan conflict is even more preposterous - and here is my attempt to humorously explain the unexplainable.  

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Recent Interesting Internal Medicine Studies and Facts - December 2019

December 10th, 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) - it matters. 

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Anemia of Inflammation - finally understand this common anemia that accomplished doctors often can’t explain

September 30th, 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.

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Anemia of Inflammation - part 2

September 30th, 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.

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Anemia of Inflammation - part 3

September 30th, 2019

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Creatine - part 1

August 20th, 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 it 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.

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Creatine - part 2

August 6th, 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.

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Creatine - part 3

August 5th, 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.

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Medicare for All? (or maybe you call it Universal Healthcare or Single-Payer)

July 1st, 2019

Are you surprised that GoFundMe and crowdfunding are not the solution to a family healthcare crisis? How about Medicare for All? Hmmmm.....

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Part 5 of Muscle and Strength Gaining Tips - The Emotional Connection and Overcoming Temporary Pain

April 8th, 2019

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Clostridium Difficile - part 1

January 25th, 2019

A deceivingly difficult topic. Not so obvious points are made about asymptomatic carriers, transmission, and who to test.

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Clostridium Difficile - part 2

January 23rd, 2019

Specific initial treatment regimens are discussed. Topics include fulminant disease, Vancomycin, Fidaxomicin, Metronidazole, and recurrence rates/regimens.

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Clostridium Difficile - part 3

January 23rd, 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.

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Live From My Basement Bathroom

December 23rd, 2018

Experiences that taught me some lessons. 

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Type 2 Diabetes Treatment - Part 7 - GLP-1 Agonists and DPP-4 Inhibitors

December 17th, 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). 

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Type 2 Diabetes Treatment - Part 6 - SGLT2 Inhibitors

September 26th, 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.

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Type 2 Diabetes Treatment - Part 5 - HgA1C

August 26th, 2018

There is a lot more to understanding HgA1C then most realize (particularly the quality industry and big corporations).

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Type 2 Diabetes Treatment - Part 4 - Metformin

May 27th, 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.

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Type 2 Diabetes Treatment - Part 3 Glucagon

May 16th, 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.

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Type 2 Diabetes Treatment - Part 2 - Reversing The Disease With Lifestyle Changes

May 1st, 2018

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Type 2 Diabetes Treatment - Part 1

May 1st, 2018

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Internal Medicine Pearls #5

April 3rd, 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).

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Some Recent Studies Worth Knowing About - February 2018

February 1st, 2018

Some new stuff about Vitamin D & Calcium supplementation, another about the timing of hip fracture surgery, etc

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Forcing Atheist Doctors to Play With God

December 22nd, 2017

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Internal Medicine Pearls #4

November 14th, 2017

Checking glucose levels in Type 2 Diabetes, ACE Inhibitors for women, and using Azithromycin in Asthma.

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Medical Podcasts, Skiing, and Imperfect Relationship Advice

October 4th, 2017

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Patent Foramen Ovale Evaluation and Closure After a Stroke - part 2

September 26th, 2017

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Patent Foramen Ovale Evaluation and Closure After a Stroke - part 1

September 22nd, 2017

Six Trials of Patent Foramen Ovale Closure for Stroke with Results Published in the Journal. #EBM

 

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The Overhead Airplane Request for Medical Assistance - A No Win Situation

September 20th, 2017

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A Severe Case of Healthcare Violence 2 Years Later

August 31st, 2017

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Bedbugs 4 The Dark Night Returns

August 31st, 2017

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Bedbugs 3 Live Free and Die Hard

August 10th, 2017

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Bedbugs 2 Fast and 2 Furious

July 30th, 2017

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Bedbugs - part 1

July 15th, 2017

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Urine Drug Testing - Misinterpretation is Very Common

May 28th, 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.

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The death of Chris Cornell and calling my doctor

May 22nd, 2017

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Internal Medicine Pearls #3

May 11th, 2017

A look at some new data: COPD and Oxygen use - low serum creatinine levels - BMI considerations - the RDW - the age of blood.

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Let’s do this! Simple changes to healthcare that nearly everyone can agree on.

April 30th, 2017

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Vocational Confrontation and Political Rumination

April 5th, 2017

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I’m a nerd looking at the world and shamelessly speaking my mind

March 7th, 2017

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Renal and Ureteral Stones (Nephrolithiasis - Kidney Stones) - part 4

February 22nd, 2017

Oxalate intake reduction, thiazide diuretics, and tamsulosin are some of the therapies discussed in this lecture. 

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Renal and Ureteral Stones (Nephrolithiasis - Kidney Stones) - part 3

February 15th, 2017

Stone analysis, labs, calcium & fluid intake, sodium in the diet, and beverage choices.

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Renal and Ureteral Stones (Nephrolithiasis - Kidney Stones) - part 2

February 13th, 2017

A few words about the proximal ureter, I.V. Fluids, colic, and hematuria.

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