Last Week in Medicine

Avsnitt

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  Catheter Directed Fibrinolysis for Acute PE (HI-PEITHO), NEWS2 Plus Procalcitonin Reduces Mortality (PRONTO) 06.04.2026 1h 1min

  Extra, extra, read all about it! We have two "NEWS" studies to talk about in this episode (bad pun). Does catheter directed thrombolysis improve outcomes in acute intermediate risk PE? Does adding procalcitonin to NEWS2 screening of ED patients really reduce mortality in patients with suspected sepsis?? The results may surprise you. Biostatistics ninja and critical care physician Dr. Brian Locke joins us to discuss! Ultrasound Facilitated Catheter Directed Fibrinolysis for Acute P...
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  Bleeding Risk with Apixaban vs Rivaroxaban for Acute VTE (COBRRA), Left Atrial Appendage Closure vs Medical Therapy for Atrial Fibrillation (CLOSURE-AF) 27.03.2026 35min

  We are back with a landmark trial -- COBRRA was finally published! Apixaban wins again, but is rivaroxaban done for good?? Also, is left atrial appendage occlusion safer than oral anticoagulation in patients with a high risk of stroke and a high risk of bleeding? Check it out! Apixaban vs Rivaroxaban for Acute VTE (COBRRA) Left Atrial Appendage Closure vs Medical Management (CLOSURE-AF) Music from Uppbeat (free for Creators!): https://uppbeat.io/t/soundroll/dope License code: NP8HLP5W...
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  2026 ACC/AHA Guidelines for Acute Pulmonary Embolism 10.03.2026 48min

  The ACC/AHA published new guidelines for managing acute PE on February 19, 2026. Today I'm joined by Dr. Scott Woller, MD, MACP, FCCP, who was co-chair of the American College of Chest Physicians Clinical Practice Guideline for antithrombotic therapy for venous thromboembolism, last updated in 2021. He also served as co-chair for the peer review committee for these new guidelines, and has lots of great insights into how to use them in clinical practice and research. 2026 ACC/AHA Guideli...
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  Hematopoietic Stem Cell Gene Therapy for Cystinosis 03.03.2026 41min

  In this episode I'm joined by senior author Dr. Stephanie Cherqui to talk about her recent publication in the New England Journal of Medicine on gene therapy for cystinosis. This is a very personal episode for me, because two of my children have cystinosis. The article is linked below. Thanks for listening! Hematopoietic Stem Cell Gene Therapy for Cystinosis Donate to the Cystinosis Research Foundation Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/sky-toes/industry-le...
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  Extended Apixaban for Provoked VTE (HI-PRO), Coffee and Atrial Fibrillation (DECAF), Age-Adjusted D-dimer for DVT, Beta Blockers after MI with Normal EF, Fish Oil for Dialysis (PISCES), Conservative Dialysis for AKI (LIBERATE-D) 24.02.2026 1h 11min

  In this episode, Dr. Austin Rupp and I try to answer the following questions: Should patients with provoked VTE be offered long term anticoagulation if they have persistent risk factors, like obesity? Does coffee make atrial fibrillation worse (or better??)? Is age-adjusted d-dimer safe to use in DVT? Should we prescribe beta blockers after acute MI if the EF is normal?Does fish oil improve cardiovascular outcomes in patients on dialysis?What's the best approach for dialysis in...
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  Semaglutide for CVD in Diabetes, PAD, and MASH, Semaglutide vs Tirzepatide, Normal Saline vs Lactated Ringer's, Oxygen Targets for Intubated Patients, Platelet Transfusion Guidelines, Apixaban vs Rivaroxaban 17.06.2025 1h 5min

  Today we do a round-up of some of the recent semaglutide trials. Does semaglutide ever miss? But what about tirzepatide, which causes even more weight loss? We also review two new critical care trials, FLUID and the UK-ROX, new platelet transfusion guidelines, and a new retrospective study of apixaban vs rivaroxaban vs warfarin. Oral Semaglutide for Diabetes with Cardiovascular Disease or CKD (SOUL) Semaglutide for Peripheral Artery Disease (STRIDE) Semaglutide for MASH (ESSENCE) Semagl...
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  Hydrocortisone for Severe Pneumonia (REMAP-CAP), Intensive BP Control in Diabetes (BPROAD), Aldosterone Synthase Inhibitors for Hypertension (ADVANCE-HTN), Reduced-dose Apixaban for Cancer Associated Thrombosis (API-CAT) 24.04.2025 56min

  What do you do when most trials suggest benefit for an intervention, but then a new trial suggests harm? We thought steroids in pneumonia was a settled question, but REMAP-CAP had other plans! We also review a new RCT for BP targets in patients with hypertension and diabetes, a new aldosterone synthase inhibitor for hypertension, and reduced dose apixaban for cancer-associated thrombosis. Hydrocortisone for Severe CAP (REMAP-CAP) Predicting Benefit of Corticosteroids in Pneumonia Intens...
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  Half Dose DOAC for Long Term VTE Prevention, Biomarker Guided Antibiotics for Sepsis, GPT-4 Assistance for Physicians, Optimal Vasopressin Initiation for Shock, DOAC vs No AC for A fib After Intracerebral Hemorrhage, HFNC vs NIV for Respiratory Failure 26.03.2025 1h 32min

  For this episode we are joined by EBM guru, Dr. Brian Locke, who deftly breaks down all of our statistics questions. Is half dose DOAC as good as full dose DOAC for preventing VTE, and does it reduce bleeding risk? Can procalcitonin reduce duration of antibiotics for infections without compromising mortality rates? Can LLMs like GPT-4 help physicians manage patients better? Can reinforcement learning models predict when to start vasopressin in patients with septic shock? What is the ris...
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  7 vs 14 Days of Antibiotics for Bacteremia, Factor XI Inhibition for Atrial Fibrillation, ACEi or ARB Before Elective Surgery, GLP-1 Agonist for HFpEF and Obesity 07.02.2025 1h 6min

  We're back, after a brief hiatus! Today we talk about duration of therapy for bacteremia, Factor XI inhibition for atrial fibrillation, whether to stop ACEi or ARB before elective surgery, and whether GLP-1 agonists are beneficial in heart failure with preserved ejection fraction. Go to minute 7:30 to skip the banter. 7 vs 14 Days of Antibiotics for Bacteremia (BALANCE) Abelacimab vs Rivaroxaban for Atrial Fibrillation (AZALEA-TIMI-71) Asenduxian vs Apixaban for Atrial Fibri...
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  Anticoagulation in AF with Cirrhosis, Trends in Anticoagulation for Acute PE, Beta Blockers for Acute MI with Normal EF, Finerenone for HFpEF, Continuous vs Intermittent Infusion for Antibiotics, Cefepime vs Piperacillin-Tazobactam for Sepsis 23.09.2024 1h 5min

  It's been a long time, but we are back! Apologies on the audio quality from Dr. Jenkins. Apparently he was recording from inside a cardboard box. Today we talk about important, practice changing studies in internal medicine from the last several months. What's the best anticoagulant in patients with cirrhosis and atrial fibrillation? Why do doctors use so much unfractionated heparin for acute PE? Should we still be using beta blockers in patients with acute MI? Does finerenone improve outco...
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  Metformin and Long COVID, Central Lines and Thrombocytopenia, DOACs vs LMWH in Cancer Associated Thrombosis, Early vs Late Anticoagulation after Stroke with Atrial Fibrillation 27.06.2023 59min

  Today we are joined by Dr. Brian Locke, recently graduated pulmonary-critical care fellow, who takes us on a journey of avoiding statistical fallacies. Does metformin reduce the likelihood of long COVID? Should we give platelet transfusions to thrombocytopenic patients before central line placement? Did the CANVAS trial change practice in cancer associated thrombosis? Should patients with a stroke due to atrial fibrillation start oral anticoagulation earlier or later? We discuss all these que...
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  Osmotic Demyelination Syndrome and Hyponatremia with Dr. Joel Topf, Apixaban vs Warfarin for On-X Aortic Valve, Perioperative Blood Pressure Strategies, Diagnostic Accuracy of CT Abdomen Without Contrast 24.05.2023 1h 8min

  Today we have a special guest, Dr. Joel Topf, board-certified nephrologist and medical educator extraordinaire. Our listeners will likely recognize Dr. Topf from his prolific tweeting @Kidney_boy, as well as his numerous appearances on the Curbsiders podcast. He is a co-founder of the NephJC on Twitter, and host and founder of the NephJC podcast Freely Filtered. He is also host of the podcast Channel Your Enthusiasm, a deep dive monthly recap of the nephrology textbook Clinical Physiology of ...
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  Doxycycline Post-Exposure Prophylaxis for STIs (DoxyPEP), High Dose Prophylactic Anticoagulation for COVID-19 (ANTICOVID), Rates of Fracture Non-union and Bisphosphonates 27.04.2023 46min

  This week we have special guest, Dr. Adam Spivak, to talk about the new study on doxycycline post-exposure prophylaxis for STIs. Dr. Spivak is an infectious disease expert and works in both an HIV clinic and a free PrEP clinic. I also review the latest COVID-19 anticoagulation trial and a paper looking at rates of fracture non-union in people who receive bisphosphonates. Check it out! Doxycycline Post-exposure Prophylaxis for STIs High dose prophylactic anticoagulation in COVID-19 Bispho...
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  Thiazides for Kidney Stones, Hydrocortisone for Severe Pneumonia (CAPE COD), 2023 GOLD COPD Guidelines, Real World Use of Oral Antibiotics for Infective Endocarditis 24.03.2023 1h 19min

  Today we have special guest, Dr. Sarah Gilligan, a nephrologist, to talk about the new study of thiazides for kidney stones. We all learn in medical school that thiazides reduce urinary excretion of calcium, but does that really translate to fewer kidney stones? We also have Dr. Brian Locke on to talk about the CAPE COD trial, a big new critical care paper on using hydrocortisone in severe pneumonia, as well as the latest COPD guidelines and a retrospective study of oral antibiotics for inf...
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  Antibiotic Duration for Febrile UTI in Males, Lower GI Bleeding Guidelines, Intravenous Contrast in Patients with Acute Kidney Injury 24.02.2023 45min

  Today we welcome special guest and fellow EBM lover Dr. Mita Hoppenfeld to talk about a new randomized controlled trial evaluating the best duration of antibiotics for febrile UTI in men. Is 7 days as good as 14 days? We also review the latest guidelines for lower GI bleeding and a new retrospective study on renal outcomes in patients with AKI who receive IV contrast. 7 vs 14 days of antibiotics for Febrile UTI in Men Lower GI Bleeding Guidelines IV Contrast in patients with AKI Music...
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  Early Vasopressors and Restrictive Fluids in Septic Shock (CLOVERS), Furosemide vs Torsemide in Heart Failure (TRANSFORM-HF), Aspirin vs Enoxaparin after Extremity Fracture (PREVENT CLOT), Haloperidol for ICU Delirium (AID-ICU) 31.01.2023 51min

  We're back with Season 4! Sorry for the unplanned hiatus. Today we talk about the CLOVERS trial, which tested the hypothesis that early vasopressors and restrictive fluid would be superior to liberal fluids plus rescue vasopressors. We also looked at the TRANSFORM-HF study, which compared torsemide and furosemide in congestive heart failure, the PREVENT CLOT study, which compared aspirin to enoxaparin for VTE prophylaxis after a traumatic fracture, and the AID-ICU study, which compared halo...
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  SGLT2 Inhibitors for Acute Heart Failure, SGLT2 Inhibitors vs Metformin, High Dose Dexamethasone for COVID-19 in ICU, Isolated Distal DVT, Monkeypox, Blood Donor Sex and Mortality, Outcomes in Surgeons Who Operate the Night Before 22.07.2022 44min

  Today we have a couple special guests under the age of 2. Birdie and Gus! Do SGLT2 inhibitors improve diuresis in acute heart failure? Are they better than metformin for reducing cardiovascular mortality? Is high dose dexamethasone better than standard dose in ICU patients with COVID? We also talk about outcomes in patients with isolated distal DVT compared to proximal DVT, a large case series of patients with monkeypox infection, blood donor outcomes and the outcomes for surgeons who ope...
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  Restrictive Fluids in Septic Shock, Short vs Standard Antibiotics in Neutropenic Fever, IV Vitamin C for Septic Shock, Hospitalist Workload and Patient LOS, Fluid Bolus for Intubation, General Internist Practice Choices 24.06.2022 54min

  Today we are joined by Dr. Brian Locke to talk about multiple new critical care trials, including the CLASSIC trial of a restrictive vs standard fluid strategy, the LOVIT trial of vitamin C in septic shock, and the PREPARE-II trial of fluid bolus at the time of intubation to prevent cardiovascular collapse. We also look at whether 72 hours of antibiotics are safe in patients with neutropenic fever, whether hospitalist workload affects patient length of stay, and what kind of careers general i...
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  Inpatient Management of Opioid Use Disorder, Hep C Treatment in IVDU, Final SOLIDARITY Results for Remdesivir, TAVI for Moderate Risk Severe AS, Mediterranean Diet vs Low Fat Diet, Steroids for IgA Nephropathy, GLP-1s and Gallbladder Disease 24.05.2022 58min

  Today we had Dr. Patricia Liu to talk about a new study from Journal of Hospital Medicine on the management of opioid use disorder in the hospital. And then we got a little carried away covering way too many articles! Inpatient Management of Opioid Use Disorder Hepatitis C Care for People Who Inject Drugs Final SOLIDARITY trial results for Remdesivir TAVI for Moderate Risk Severe Aortic Stenosis Mediterranean Diet vs Low Fat Diet for Secondary Prevention of CVD Steroids for IgA Nephro...
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  2022 AHA/ACC/HFSA Heart Failure Guidelines with Dr. James Fang, Guideline Committee Member 04.05.2022 32min

  Today, Dr. James Fang, Chief of Cardiovascular Medicine at the University of Utah, and AHA/ACC/HFSA Heart Failure Guideline Committee Member, joins us to talk about the new heart failure guidelines, published in April 2022. We talk about the new classifications, including HF with improved EF and HF with mildly reduced EF, and new recommendations for medical therapy for all the heart failure types. How do you start someone on GDMT? Who should get SGLT-2 inhibitors? How can we get more pe...