Addiction Medicine #12 - Listener Q & A on Substance Use Disorders

Addiction Medicine #12 - Listener Q & A on Substance Use Disorders

Put on your Primary Care Cat-Hat

We are thrilled to be back to kick off season 2! Carolyn Chan, MD (@CarolynAChan) soon to be at the University of Cincinnati, Shawn Cohen MD (@ShawnCohen_MD) at Yale University, Kenneth Morford MD at Yale University, and Natalie Stahl MD (@NanouTheNomad) at Greater Lawrence Family Health Center are back and on this episode, they answer burning questions submitted by listeners. We cover topics such as targeted naltrexone, increasing buprenorphine doses, treating kratom dependence, and so much more!

Claim free CME for this episode at curbsiders.vcuhealth.org!

By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.

Episodes | Subscribe | Spotify | Swag! | iTunes | CurbsidersAddictionMed@gmail.com | Free CME!

Credits

  • Producer, Show Notes: Kenneth Morford, MD
  • Infographic and Cover Art: Carolyn Chan, MD, MHS
  • Hosts: Carolyn Chan MD, MHS, Shawn Cohen MD, Kenneth Morford MD, Natalie Stahl MD, MPH
  • Reviewer: Payel Jhoom Roy, MD
  • Showrunner: Carolyn Chan, MD, MHS
  • Technical Production: PodPaste

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#463 Tofurkey-cakes: A Hypertension Triple Pill, Arm Position & BP, early TAVR, Liberal vs Restrictive Transfusions, New Periop Guidelines

#463 Tofurkey-cakes: A Hypertension Triple Pill, Arm Position & BP, early TAVR, Liberal vs Restrictive Transfusions, New Periop Guidelines

Join us as we review recent practice-changing articles on a new triple pill for hypertension, how arm position affects blood pressure, early TAVR for asymptomatic patients with severe AS, liberal versus restrictive transfusion strategy in patients with acute brain injury, and a quick overview of the 2024 ACC/AHA perioperative medicine guidelines. Fill your brain hole with a delicious stack of tofurkey cakes! Featuring Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), Jen DeSalvo (@drjendesalvo), and Matt Watto (@doctorwatto). Claim CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! |Mailing List | Contact | CME! Credits Written and Hosted by: Rahul Ganatra MD, MPH; Jen DeSalvo MD; Paul Williams, MD, FACP, Matthew Watto MD, FACP Cover Art: Matthew Watto MD, FACP Reviewer: Rahul Ganatra MD, MPH Technical Production: Pod Paste Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Show Segments Intro, disclaimer A new triple pill for hypertension How arm position affects blood pressure Early TAVR for asymptomatic patients with severe AS Liberal versus restrictive transfusion strategy in patients with acute brain injury A quick overview of the 2024 ACC/AHA perioperative medicine guidelines Outro Sponsor: Freed You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month. Sponsor: AquaTru Today listeners receive 20% off any AquaTru purifier! Just go to AquaTru.com and enter code “CURB“ at checkout. Sponsor: Uncommon Goods To get 15% off your next gift, go to uncommongoods.com/curb.

25 Nov 202449min

#462 Male Hypogonadism Pearls with Dr. Bradley Anawalt: Insights on Testosterone Deficiency

#462 Male Hypogonadism Pearls with Dr. Bradley Anawalt: Insights on Testosterone Deficiency

Risks/benefits in older males, when to test, fertility considerations, and more. Master male hypogonadism diagnosis and management. Discover when and how to test, how to tackle confounding conditions, and why lifestyle changes may be more effective than testosterone therapy in certain patients. We are joined by Dr. Brad Anawalt, an expert in endocrine care, to guide us through the essentials. Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Case 1 History and Physical  Laboratory Testing  Effect of Lifestyle on Testosterone Case 2 Prostate and Cardiovascular risk Treatment Options and Considerations Secondary Causes of Hypogonadism Case 3 Testicular Size and Klinefelter Syndrome hCG and Clomiphene Monitoring and Follow-Up Take-Home Points 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 D. Anawalt MD Sponsor: Freed You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.  Sponsor: Pattern With huge discounts for doctors in training, now is truly the best time to request your disability insurance quotes with Pattern at patternlife.com/curbsiders. Sponsor: Litter Robot As a special holiday offer, Whisker is offering up to $100 off Litter-Robot bundles. AND, as a special offer to listeners, you can get an additional $50 off when you go to stopscooping.com/CURB.

18 Nov 20241h 31min

#461: Facial Nerve Follies:  Understanding Bell's Palsy

#461: Facial Nerve Follies: Understanding Bell's Palsy

A Bell-Ringer of a Presentation Is it a stroke or is it botox? No, it’s Bell’s palsy! Learn how to differentiate facial palsy from other sinister diagnoses. Join us as Dr. Jordan Amar (Assistant Professor of Clinical Neurology at USC Keck School of Medicine) gives us Bell’s palsy pointers (and a great mnemonic, if there is such a thing). Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Introduction Rapid fire questions and Reflex Hammers Case #1: Ms. Melanie Framework for Bell's Palsy Bell's Palsy vs Stroke: How to Differentiate  Approach to History and Physical Exam  Case #2: Mr. Lopez Red Flags in Facial Palsy (GROWLS FACE) Workup: From Imaging to Labs and What Not to Do Treatment: The Role of Steroids and Antivirals Supportive Care, Complications and Prognosis Take-Home Points Outro Credits Producer and Writer: Isabel Valdez, PA-C  Show Notes: Paul Wurtz MD, Ben Furman MPH MS3, Isabel Valdez, PA-C Infographic and Cover Art: Zoya Surani, MS2 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: Jordan Amar, MD Sponsor: Beginly Health Ready to take control of your job search? Visit beginlyhealth.com/curbsiders to get started Sponsor: OpenEvidence  If you haven't tried it out yet check it out, it will save you time and help you make better decisions go to openevidence.com/curbsiders Sponsor: Freed You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.

11 Nov 20241h 7min

#460 HFpEF: Heart Failure with Preserved Ejection Fraction

#460 HFpEF: Heart Failure with Preserved Ejection Fraction

Preserve your sanity while treating heart failure with preserved ejection fraction.  Dr Michelle Kittleson @MKittlesonMD (Cedars Sinai) illuminates this confounding cardiac condition. Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments 00:00 Introduction and Advice for Physicians 02:24 Case Presentation 04:16 Understanding HFpEF 08:11 Differential Diagnosis of Dyspnea and Edema 11:30 Diagnosing HFPEF: H2F-PEF Score and Testing 17:07 Managing Comorbidities in HFpEF 20:54 Non-Pharmacological Interventions: Weight Loss and Exercise 23:16 Understanding the Challenges of HFpEF 25:08 Medications 30:13 Promising Results of GLP-1 Receptor Agonists 36:38 Managing Salt and Water Intake Credits Writer and Producer: Deborah Gorth MD, PhD Infographic and Cover Art: Zoya Surani 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: Michelle Kittleson MD, PhD Sponsor: Freed You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.  Sponsor: Bombas Head over to Bombas.com/curb and use code curb for 20% off your first purchase. Sponsor: Beginly Health Ready to take control of your job search? Visit beginlyhealth.com/curbsiders to get started

4 Nov 202449min

#459 DIGEST: Finerenone for Heart Failure, PCV21 and the latest Pneumonia Vaccine Recs, 24-hour vs 15-hour Oxygen Therapy, and PREVENT vs PCE for Cardiovascular Risk Estimation

#459 DIGEST: Finerenone for Heart Failure, PCV21 and the latest Pneumonia Vaccine Recs, 24-hour vs 15-hour Oxygen Therapy, and PREVENT vs PCE for Cardiovascular Risk Estimation

Join us as we review recent articles and news featured in The DIGEST issues #56 and #57, including finerenone for heart failure, the skinny on pneumonia vaccines and the latest, PCV21, long-term oxygen therapy (the REDOX trial), and the PREVENT vs PCE cardiovascular risk equations.  Fill your brain hole with a fully digestible meal! Featuring Alex Chaitoff (@alexchaitoff), Rahul Ganatra (@rbganatra), Nora Taranto (@norataranto), and Matt Watto (@doctorwatto).  Note: **Update on Pneumonia Vaccine from ACIP: After we recorded and just before we published this episode, the CDC updated its vaccine guidance to include pneumonia vaccination for all adults aged 50 years and older to receive either PCV20, PCV21, or the combination of PCV15 followed by PPSV23 one year later (CDC site accessed 24 Oct 2024).** Claim CME for this episode at curbsiders.vcu health.org! Episodes | Subscribe | Spotify | Swag! |Mailing List | Contact | CME! Credits Written and Hosted by: Nora Taranto MD; Rahul Ganatra MD, MPH, Alex Chaitoff MD, MPH, Matthew Watto MD, FACP Cover Art: Matthew Watto MD  Reviewer: Emi Okamoto MD  Technical Production: Pod Paste Showrunners: Matthew Watto MD, FACP  Show Segments Introduction + Pun  Exploring Finerenone in Heart Failure Pneumonia Vaccines: The PCV21 Trial Long-Term Oxygen Therapy: The REDOX Trial Cardiovascular Risk Calculators: The PREVENT Equation Sponsor: Freed You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.  Sponsor: Quince Go to Quince.com/curb for free shipping on your order and 365-day returns. Sponsor: Beginly Health Ready to take control of your job search? Visit beginlyhealth.com/curbsiders to get started

28 Okt 202454min

#458 HFrEF: Heart Failure with Reduced Ejection Fraction

#458 HFrEF: Heart Failure with Reduced Ejection Fraction

Kittleson Rules Outpatient Heart Failure Volume 1 Provide superb outpatient care for your patients with HFrEF. Identify underlying causes of heart failure and titrate medications with ease. Dr Michelle Kittleson @MKittlesonMD (Cedars Sinai) breaks down the nuances of treating this common cardiac condition.  Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments 00:00 Introduction  03:22 Case Presentation: Newly Diagnosed Heart Failure 07:26 Using Physical Exam Findings to Guide Diuresis 11:58 The Four Pillars of Guideline-Directed Medical Therapy for Heart Failure 15:07 Optimizing Therapy and Follow-Up in Heart Failure Patients 22:10 The Benefits of High-Intensity Initiation and Titration of Guideline-Directed Medical Therapy 28:02 Consideration of Other Medications 40:02 Referral to Advanced Heart Failure Specialist 49:11 Optimizing Therapy and Follow-Up 55:33 Conclusion and Book Recommendation Credits Writer and Producer: Deborah Gorth MD, PhD Infographic and Cover Art: Zoya Surani 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: Michelle Kittleson MD, PhD Sponsor: Freed You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.  Sponsor: Litter Robot Right now, Whisker is offering $75 off Litter-Robot bundles. AND, as a special offer to listeners, you can get an additional $50 off when you go to stopscooping.com/CURB. Sponsor: Beginly Health Ready to take control of your job search? Visit beginlyhealth.com/curbsiders to get started

21 Okt 20241h 4min

#457 Cold and Flu Season: Upper Respiratory Infections aka URIs

#457 Cold and Flu Season: Upper Respiratory Infections aka URIs

Treating colds, flu, and more with Dr Amber Bird! Dive deep into upper respiratory viral infections with Dr Amber Bird, MD (Penn).  Feel confident on when to order testing, recommend symptom relieving treatments, and avoid unnecessary antibiotics. Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments 00:00 Introduction and Setting the Agenda 03:07 Getting to Know the Guest and Rapid Fire Questions 05:51 Case from Kashlak: Mateo with Common Cold Symptoms 06:12 Defining and Diagnosing the Common Cold 09:08 Approach to History and Physical Exam 13:23 Viral Respiratory Testing and Its Indications 17:36 Symptomatic Treatment Options for the Common Cold 24:25 Managing Cough and Nasal Congestion 35:03 Home Remedies and natural products 42:16 Prescribing Antivirals for Influenza 46:33 Antibiotics and Counseling Patients 52:07 Contagiousness and Risk to Family Members 54:52 Recurring Colds and Risk Factors 59:38 Vaccination recommendations 01:01:23 Key Takeaways and Conclusion Credits Producer: Leah Witt, MD and Molly Heublein, MD Show Notes/CME: Molly Heublein, MD Cover Art and Infographic: Leah Witt, MD Hosts, writers: Leah Witt and Molly Heublein, MD   Reviewer: Fatima Syed, MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Amber Bird, MD Sponsor: Babbel Get up to 60% off at Babbel.com/CURB.  Sponsor: Freed You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month. Sponsor: Panacea Legal  Let Panacea Legal help you today at Panacea.Legal

14 Okt 20241h 6min

#456 Outpatient Oxygen Therapy

#456 Outpatient Oxygen Therapy

Supplemental oxygen is ubiquitous and yet there is a tremendous amount of uncertainty related to prescription and management in the outpatient setting. Have no fear, we’ve got your back! On this episode of The Curbsiders we host special guest Susan Jacobs, RN, MS who is a bonafide, world-class expert in outpatient oxygen therapy. How to prescribe? What’s out there? What do you do when your patient travels? She joins us to tackle these questions and so much more so make sure to tune in and snag some knowledge food for that old brain hole! Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Getting to know our guest Basics of oxygen prescribing and devices Caveats for the patient who only has exertional hypoxemia How to prepare for travel Key points & take aways Outro Credits Producer, Writer, Infographic and Cover Art Artist: Leah Witt, MD Show Notes: Cyrus Askin, MD Reviewer:  Fatima Syed, MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Susan Jacobs, RN, MS Sponsor: UVA Health To learn more about UVA Health, visit https://uvahealth.com/ Sponsor: Beginly Health Ready to take control of your job search? Visit beginlyhealth.com/curbsiders to get started. Sponsor: Freed AI You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month. View full show notes at thecurbsiders.com

7 Okt 20241h 12min

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