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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Acute Pancreatitis (part 3) - Pseudocysts, Pain Control, and a few other pearls

October 1st, 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. 

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Acute Pancreatitis (part 2) - Severe Pancreatitis, Pancreatic Necrosis, Antibiotic & Surgical Considerations

August 23rd, 2015

Imaging, fluid resuscitation, fine needle aspiration, determining sterile vs infected necrosis, and suggestions from the guidelines are discussed.

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Acute Pancreatitis - part 1

July 29th, 2015

This episode addresses some of the debates regarding nutrition timing in acute pancreatitis. Methods such as nasogastric, nasojejunal, and oral feeding are compared.

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Hypercalcemia Treatment

June 7th, 2015

Treatments that include hydration, cinacalcet, calcitonin, bisphosphonate, denosumab, and other options are reviewed.

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Hyperparathyroidism - Hypercalcemia part 3

June 6th, 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.

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Hypercalcemia - Clinical Symptoms and Diagnostic Testing

March 31st, 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.

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Hypercalcemia etiology - Vitamin D, Calcium Supplements, Diuretics, Malignancy, Sarcoidosis, and other causes

March 10th, 2015

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Memory - part 2 - Memory in disease and health

December 29th, 2014

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Memory - part 1 - Memory in disease and health

December 20th, 2014

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Ebola Virus Disease - part 3

October 31st, 2014

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Ebola Virus Disease - part 2

October 30th, 2014

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Ebola Virus Disease - part 1

October 29th, 2014

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Hospital Credentialing

October 5th, 2014

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Pneumonia part 5- Treatment of Healthcare Associated Pneumonia

August 14th, 2014

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Pneumonia part 4 - Ventilator Associated Pneumonia Prevention

August 3rd, 2014

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Pneumonia- part 3- Legionella & Pseudomonas

June 18th, 2014

Pseudomonas aeruginosa and Legionella pneumophila bacterial lower respiratory tract disease are explored in depth.

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Pneumonia - Part 2 - Pneumococcal Pneumonia

May 3rd, 2014

Streptococcus pneumoniae is a frequent cause of pneumonia. What makes this organism unique? Listen and find out.

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Pneumonia - Part 1

April 26th, 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.
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Acute Liver Injury From Drugs (other than acetaminophen)

April 6th, 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. 

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Influenza - part 4 - diagnostic testing for the the flu

January 2nd, 2014

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Influenza - part 3 - Avian H7N9 & H5N1 (Bird Flu)

January 1st, 2014

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Influenza - part 2 - Lessons From H1N1 Pandemics

December 30th, 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.
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Influenza - The Flu - part 1

December 29th, 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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Pancreatic Cancer - Pancreatic Ductal Adenocarcinoma

October 13th, 2013

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Internal Medicine Pearls - Part 2

August 11th, 2013


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