Intended for the medical professional who enjoys learning for the sake of it. Dr. Porat is a practicing Colorado Hospitalist and Board Certified in Internal Medicine.
Here's the Latest Episode from Hospital and Internal Medicine Podcast – Gil Porat, M.D., FACP, CPT:
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.
Specific initial treatment regimens are discussed. Topics include fulminant disease, Vancomycin, Fidaxomicin, Metronidazole, and recurrence rates/regimens.
A deceivingly difficult topic. Not so obvious points are made about asymptomatic carriers, transmission, and who to test.
Experiences that taught me some lessons.
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).
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.
There is a lot more to understanding HgA1C then most realize (particularly the quality industry and big corporations).
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.
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.
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 new stuff about Vitamin D & Calcium supplementation, another about the timing of hip fracture surgery, etc
Checking glucose levels in Type 2 Diabetes, ACE Inhibitors for women, and using Azithromycin in Asthma.
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.
A look at some new data: COPD and Oxygen use - low serum creatinine levels - BMI considerations - the RDW - the age of blood.
Oxalate intake reduction, thiazide diuretics, and tamsulosin are some of the therapies discussed in this lecture.
Stone analysis, labs, calcium & fluid intake, sodium in the diet, and beverage choices.
A few words about the proximal ureter, I.V. Fluids, colic, and hematuria.
This episode discusses symptoms, the importance of size, and a few other pearls.
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.
Lifestyle, carbohydrates, protein, and eccentric weight training are part of the focus of this sermon.
This episode is part philosophy, part motivation, and a discussion of some traps men and women get caught in.
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.
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.
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.
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.
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.
This episode mostly centers around oral iron replacement.
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.
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.
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.
Imaging, fluid resuscitation, fine needle aspiration, determining sterile vs infected necrosis, and suggestions from the guidelines are discussed.
This episode addresses some of the debates regarding nutrition timing in acute pancreatitis. Methods such as nasogastric, nasojejunal, and oral feeding are compared.
Treatments that include hydration, cinacalcet, calcitonin, bisphosphonate, denosumab, and other options are reviewed.
Indications for parathyroidectomy, pre-operative localization issues, diagnosing hyperparathyroidism, and a brief summary of the guidelines are among the topics addressed in this episode.
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.
Pseudomonas aeruginosaand Legionella pneumophila bacterial lower respiratory tract disease are explored in depth.
Streptococcus pneumoniae is a frequent cause of pneumonia. What makes this organism unique? Listen and find out.
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.
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.
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.
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.
Resistance and virulence mechanisms are discussed. Clinical presentations as well as the difference between colonization and infection are considered.Screening, prevention, and understanding Community Acquired MRSA vs Healthcare Acquired MRSA strains can be challenging, so practical information is presented for the common questions patients, families, and health care workers will often have.
The problem with Acute Mitral Regurgitation is that it is frequently fatal unless quickly recognized. The listener will learn about organic and functional etiologies of this precipitator of acute respiratory distress. Lessons from the SHOCK trial are scrutinized to help guide therapy in the setting of myocardial ischemia.