#407 DIGEST: Bempedoic acid and cardiac risk, Alpha-Gal Syndrome, Orforglipron, Zuranolone, DOACs for VTE of Malignancy, mAbs for Dementia, New Med for Smoking Cessation, Kiwis and Constipation

In this special bonus episode, Dr. Linda Blustein (Bendy Bodies https://bit.ly/m/BendyBodies) addresses listener questions about Ehlers-Danlos syndrome (EDS) and hypermobility spectrum disorders. 00:00 – Introduction 00:59 – Can PCPs diagnose hEDS without a geneticist? 03:19 – Limitations of the Beighton Score 05:40 – 2017 hEDS criteria & upcoming revisions 10:29 – How to find a knowledgeable provider 12:52 – SVT vs POTS in a patient with EDS family history 19:53 – How to ask your provider if they’re comfortable treating dysautonomia 22:17 – MTHFR variants and hEDS 29:23 – Celiac, gluten sensitivity & EDS 31:48 – Food allergy vs sensitivity testing 34:11 – Lipoedema and hypermobility 39:00 – LDN, Ketotifen, and Cromolyn 43:41 – Medication sensitivity in EDS/POTS/MCAS patients 45:47 – Wrap up and resources ​FIGS Get 15% off your first order at wear figs.com with the code FIGSRX Locumstory ​Locumstory.com is simply a free, unbiased educational resource about locum tenens Grammarly Download Grammarly for free at Grammarly.com/PODCAST

7 Aug 51min

We have a classic Curbsiders episode for you. Expert guest Dr. Elliot Tapper (@ebtapper) shares his framework for approaching NAFLD/MASLD and the treatment tools he recommends including lifestyle modifications and medications.

4 Aug 1h 14min

An age-friendly approach to arthralgias. Attack arthralgias with ease! Learn how to evaluate and manage common joint complaints in older adults. We’re joined by Dr Una Makris, @unamakris.bsky.social (UT Southwestern). Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Case 1 from Kashlak General approach to joint pain in older adults Diagnosing osteoarthritis Management of osteoarthritis in older adults Non-pharmacological interventions Pharmacological interventions: topicals, orals, injectables When to refer for joint replacement Case 2 from Kashlak Diagnosis of Late onset rheumatoid arthritis (LORA) Differential Diagnosis and Distinguishing features Lab work/Imaging When to refer to rheumatology Approach to managing LORA The 5Ms framework Initial treatment with glucocorticoids Ageism as a driver of undertreatment in older adults Treating to target Key takeaways  Outro  Credits Producers, Writers and Show Notes: Joseph (Lee) Young, MD, Leah Witt, MD, Rachel Miller, MD Cover Art and Infographic: Leah Witt, MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto, MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Dr. Una Makris Disclosures Dr. Makris reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. Sponsor: Heart of Care If you care about patient safety, team performance, and building a culture of readiness, subscribe to In the Heart of Care. Available now, wherever you get your podcasts. Sponsor: FIGS Curbsiders listeners can get 15% off. Just go to wearFIGS.com and use code FIGSRX.

28 Jul 1h 13min

Here is a classic Curbsiders episode with one of our favourite guests of all time, Dr Joel Topf. Learn how to manage diabetes and hypertension in chronic kidney disease with expert tips from Kidney Boy, Kashlak’s Chief of Nephrology, Dr. Joef Topf @kidney_boy.  Finerenone is FDA approved for managing CKD in patients with diabetes. **Update as of July 2025: The non-steroidal mineralocorticoid recepter antagonist, finerenone is now FDA approved to treat heart failure with LVEF at or above 40% based on results of the FINEARTS-HF trial. ** Claim CME for this episode at curbsiders.vcuhealth.org! Heart of Care If you care about patient safety, team performance, and building a culture of readiness, subscribe to In the Heart of Care. Available now, wherever you get your podcasts. Quince Go to Quince.com/curb for free shipping on your order and three hundred and sixty-five -day returns.

24 Jul 1h 3min

Combing through common dermatologic complaints in Primary Care Hone your framework for assessing generalized and patchy hair loss and learn how to counsel patients about the hair loss advice they hear on social media. We discuss useful tests and treatments, psychosocial factors in relation to hair loss, variations in hair types and mention relevant nail conditions.  Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Examination of hair and nails, ethnic hair types and cultural hair styles and practices. Lab tests- clinically useful tests, and those to avoid Telogen Effluvium Scaly itchy scalp, seborrheic dermatosis, psoriasis Androgenic alopecia and age-related hair loss Topical and oral treatments Examining the nails, conditions related to nail polishes and prosthetics Patchy hair loss, alopecia areata, Discoid Lupus Erythematosis Dr Pasieka’s take home points Outro Credits Written & Produced by: Kate Grant MBChB, MRCGP Show Notes, Infographic & Cover Art : Kate Grant MBChB, MRCGP  Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Leah Witt MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Helena Pasieka MD MS Disclosures Dr. Pasieka reports no relevant financial disclosures. Dr. Pasieka’s views are her own and do not represent those of her employer or the department of defense.  The Curbsiders report no relevant financial disclosures.  Sponsor: Continuing Education Company  Curbsiders listeners get 45% off select online courses—that’s the biggest discount CEC has ever offered, and it’s exclusive to you with promo code Curb45, through July 30. You can also use Curb30 for 30% off all webcasts and on demand replay courses. Check it all out at CMEmeeting.org/curbsiders.  Sponsor: FIGS Curbsiders listeners can get 15% off. Just go to wearFIGS.com and use code FIGSRX. Sponsor Freed Use code: CURB50 to get $50 off your first month when you subscribe!

21 Jul 1h 28min

Matt and Paul recap top pearls from a recent episode on Travel Medicine with Dr. Boghuma Titanji  (audio version) and share their picks of the week. Below are links to the original interview & show notes. #449 Travel Medicine Picks of the week: Paul recommends:  Clutch - Psychic Warfare; Harry Nilsson - The Point Watto - Mr. McMahon (Netflix Docuseries)

17 Jul 39min

Decode low neutrophils, recognize thalassemia without chasing iron, and sharpen your approach to bleeding disorders in primary care. Crack the code on confusing labs. Learn from Dr. Bradley Beeler, an academic hematologist, how to recognize thalassemia without over-ordering tests, why a low neutrophil count in a healthy patient might not be a problem, and how to tackle bleeding disorders in primary care. Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Case 1: Duffy-null associated neutrophil count Case 2: Bleeding disorders Case 3: Thalassemia  Outro Credits Written and produced by Paul Wurtz MD. Show notes, cover art, and infographic also created by Paul Wurtz MD. Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Sai S Achi MD, MBA, FACP Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Bradley Beeler MD Disclosures Dr. Beeler reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. Sponsor: Panacea Search The Podcast for Doctors (By Doctors) on Spotify, Apple Podcasts, or wherever you listen. Sponsor: Locumstory Locumstory.com is simply a free, unbiased educational resource about locum tenens. Sponsor: Continuing Education Company  Curbsiders listeners get 45% off select online courses — that’s the biggest discount CEC has ever offered, and it’s exclusive to you with promo code Curb45, through July 30. You can also use Curb30 for 30% off all webcasts and on demand replay courses. Check it all out at CMEmeeting.org/curbsiders.

14 Jul 1h 19min

Master the latest approaches for treating venous thromboembolism with expert tips on direct oral anticoagulant (DOAC) selection, dosing, and duration. Learn how to tailor anticoagulation for special populations, handle treatment failures, and navigate long-distance travel risks. We’re joined by Dr. Tara Lech, PharmD, CACP (Beth Israel Lahey Health, @AnticoagPharmD, @anticoagpharmd.bsky.social‬). Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Case 1 from Kashlak Choosing the right anticoagulant Distal deep vein thrombosis management Anticoagulation in special populations Case 2 from Kashlak Understanding treatment failure Anticoagulation reversal agents Outro Credits Producer, Writer, Show Notes, Infographic, Cover Art: Ben Furman  Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Leah Witt, MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Tara Lech, PharmD  Disclosures Dr. Lech reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.  Sponsor: Grammarly  Let Grammarly take the busywork off your plate so you can focus on high-impact work. Download Grammarly for free at Grammarly.com/PODCAST. Sponsor: Freed CURB50 to get $50 off your first month when you subscribe at freed.ai Sponsor: JournalFeed Try JournalFeed free for 7 days—and get 20% off your first year with code CURB25 at journalfeed.org/curb.

7 Jul 1h 24min