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 3

February 11th, 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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Clostridium Difficile - part 2

January 29th, 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 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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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

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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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Renal and Ureteral Stones (Nephrolithiasis - Kidney Stones) - part 1

February 1st, 2017

This episode discusses symptoms, the importance of size, and a few other pearls.

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What is Taurine?

January 25th, 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.

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Part 4 of Muscle and Strength Gaining Tips for Men, Women, Bodybuilders, and Beginners

December 29th, 2016

Lifestyle, carbohydrates, protein, and eccentric weight training are part of the focus of this sermon. 

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Part 3 of Muscle and Strength Gaining Tips for Men, Women, Bodybuilders, and Beginners

December 23rd, 2016

This episode is part philosophy, part motivation, and a discussion of some traps men and women get caught in. 

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Part 2 of Muscle and Strength Gaining Tips for Men, Women, Bodybuilders, and Beginners

October 26th, 2016

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Muscle and Strength Gaining Tips for Men, Women, Bodybuilders, and Beginners - part 1

October 21st, 2016

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Pulmonary Embolism - Part 4

October 10th, 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.

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Pulmonary Embolism - part 3 - Massive PE

August 29th, 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. 

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Pulmonary Embolism - part 2

July 24th, 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.

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Pulmonary Embolism - part 1

June 3rd, 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.

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The Healthcare Consumer in a Fictitious Market

May 26th, 2016

A commentary.

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Iron Deficiency Anemia - part 3

May 15th, 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.

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Iron Deficiency Anemia - part 2

April 27th, 2016

This episode mostly centers around oral iron replacement.

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Iron Deficiency Anemia - etiology and diagnosis

March 3rd, 2016

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Natriuretic Peptides in Congestive Heart Failure

January 14th, 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.

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Healthcare Mergers and Acquisitions

December 8th, 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.

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