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.
Clostridium Difficile - part 3
February 11th, 2019
Clostridium Difficile - part 2
January 29th, 2019
Specific initial treatment regimens are discussed. Topics include fulminant disease, Vancomycin, Fidaxomicin, Metronidazole, and recurrence rates/regimens.
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.
Live From My Basement Bathroom
December 23rd, 2018
Experiences that taught me some lessons.
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).
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.
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).
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.
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.
Type 2 Diabetes Treatment - Part 2 - Reversing The Disease With Lifestyle Changes
May 1st, 2018
Type 2 Diabetes Treatment - Part 1
May 1st, 2018
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).
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
Forcing Atheist Doctors to Play With God
December 22nd, 2017
Internal Medicine Pearls #4
November 14th, 2017
Checking glucose levels in Type 2 Diabetes, ACE Inhibitors for women, and using Azithromycin in Asthma.
Medical Podcasts, Skiing, and Imperfect Relationship Advice
October 4th, 2017
Patent Foramen Ovale Evaluation and Closure After a Stroke - part 2
September 26th, 2017
Patent Foramen Ovale Evaluation and Closure After a Stroke - part 1
September 22nd, 2017
The Overhead Airplane Request for Medical Assistance - A No Win Situation
September 20th, 2017
A Severe Case of Healthcare Violence 2 Years Later
August 31st, 2017
Bedbugs 4 The Dark Night Returns
August 31st, 2017
Bedbugs 3 Live Free and Die Hard
August 10th, 2017
Bedbugs 2 Fast and 2 Furious
July 30th, 2017
Bedbugs - part 1
July 15th, 2017
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.
The death of Chris Cornell and calling my doctor
May 22nd, 2017
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.
Let’s do this! Simple changes to healthcare that nearly everyone can agree on.
April 30th, 2017
Vocational Confrontation and Political Rumination
April 5th, 2017
I’m a nerd looking at the world and shamelessly speaking my mind
March 7th, 2017
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.
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.
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.
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.
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.
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.
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.
Part 2 of Muscle and Strength Gaining Tips for Men, Women, Bodybuilders, and Beginners
October 26th, 2016
Muscle and Strength Gaining Tips for Men, Women, Bodybuilders, and Beginners - part 1
October 21st, 2016
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.
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.
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.
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.
The Healthcare Consumer in a Fictitious Market
May 26th, 2016
A commentary.
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.
Iron Deficiency Anemia - part 2
April 27th, 2016
This episode mostly centers around oral iron replacement.
Iron Deficiency Anemia - etiology and diagnosis
March 3rd, 2016
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.
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.
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.