Hospital and Internal Medicine Podcast
von Gil Porat, M.D., FACP, CPT
- unregelmäßigErscheinungsrhythmus
- 11 mintypische Länge
- gesternletzte Folge
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.
Folgen
Good Intentions, Worse Outcomes: How Incentives Backfire
Well-intentioned policies and performance metrics that created perverse incentives and currently worsen patient outcomes.
Science vs. Hospital Habit: Why We Ignore the Data on Salt, Fluids, and Metformin
More trials show low-salt diets and restrictive fluid strategies do not improve heart-failure outcomes, while another shows continuing metformin in many hospitalized patients reduces hypoglycemia, mortality, readmissions, and new insulin st
Elevated Lactate vs Lactic Acidosis: Words That Change Care And Outcomes
This episode clarifies the difference between an elevated lactate level (hyperlactatemia) and true lactic acidosis, which requires evidence of metabolic acidosis (low pH or low bicarbonate). It discusses common causes of raised lactate, why
When Stool Turns to Stone: Manually Disimpact Again or Buy Coca Cola? Fecalomas, Risks, and Treatments
Fecalomas—rock‑hard impacted stool that cause obstruction, stercoral colitis, perforation, and even death—most often in immobile elderly patients or those on opioids. Standard treatments include aggressive bowel regimens, enemas, manual dis
Does Mouthwash Cause Oral Cancer? Does Mouthwash Eliminate The Benefits of Exercise?
This episode examines the concerns about mouthwash and oral cancer. While ethanol can form the carcinogen acetaldehyde, how worried should we be? Strong antiseptic rinses can alter the oral microbiome and may reduce bacteria that help produ
Recent Hyponatremia Correction Rate Data Is Becoming Harder to Ignore
Multiple studies in multiple journals are going against the norms and previous guidelines. The times they are a changing.
In the COBRRA Trial Apixaban Kicked The Asssssth of Rivaroxaban
For acute treatment of Venous Thromboembolism the debate of which direct oral anticoagulant to use appears to now be settled.
Heart Failure with Preserved Ejection Fraction (Diastolic CHF) and SGLT-2 Inhibitor Therapy
The double-blind, randomized phase III EMPEROR-Preserved trial showed a benefit of the sodium-glucose cotransporter-2 (SGLT2) inhibitor empagliflozin in patients with heart failure with preserved ejection fraction (HFpEF). Now let us dig a
Should You Postpone Interventions for INFECTED Necrotizing Pancreatitis?
An important recently published randomized control trial provides guidance on this controversy.
Diabetic Gastric Emptying Abnormalities (and sometimes normal) - Part 1
Almost nobody feels comfortable managing DELAYED gastric emptying (gastroparesis) and very few medical providers even think about RAPID gastric emptying in their diabetic patients. Even if you send these patients to GI specialists, your blo
Gastric Emptying Abnormalities - Part 2
Can we trust a nuclear study to nail the diagnosis? Are motor abnormalities really the cause of symptoms? What is a POP procedure?
Morphine for later stage COPD patients not on hospice
Does regular, low-dose, oral sustained-release morphine improve disease-specific health status or cause respiratory adverse effects in patients with moderate to very severe chronic breathlessness due to advanced chronic obstructive pulmonar
The JAMA controversy and loss of conversation in medicine
My take on what went down at the Journal of the American Medical Association. I disagree with the comment there isn't "structural racism in health care", but was the backlash against the Editor who didn't say it (and actually opposed the co
Understand Basic Epigenetic Changes in Medicine and Everyday Life
This lecture provides a basic understanding of how epigenetic changes influence infections/sepsis, vaccinations, cancer, future generations, your muscles, and (of course) those sweet tan-lines you are rocking. Every day you are living throu
Hyponatremia etiology by history and physical
Hyponatremia remains a challenging topic for many because they are trying to memorize algorithms and numbers. You can usually nail the etiology by history & physical and a brief chart review.
Cytokine Storm - part 1
If you use the term 'cytokine storm' and don't really know what you mean by it, you are far from unique. Let me help to try and clarify it for you just a bit.
Cytokine Storm - part 2
Do you know what CRP is (other than saying it is an inflammatory marker)? Should we always shut down cytokines? If so, how? Why should we avoid giving a glucocorticoid to a COVID patient before they develop an elevated CRP or hypoxia? So ma
Acute Severe Hypertension - part 2
Multiple treatment issues are discussed. This includes theoretical ideal blood pressure lowering rates, oral options (for hypertensive urgency and specific populations), intravenous options (for hypertensive emergency or NPO patients), spec
Acute Severe Hypertension - part 3
Did you know that intravenous labetalol and oral labetalol are not really similar? The great hydralazine debate. Things you must know about Clevidipine if you are going to use it.
Acute Severe Hypertension - part 4
Did you know systolic and diastolic blood pressure are NOT measured by automated BP cuffs? PRES (Posterior Reversible Encephalopathy Syndrome), also known as RPLS (Reversible Posterior Leukoencephalopathy Syndrome), is something you should
Interesting Studies, Facts, & Opinions - April 2020 edition
If you wonder why good food is more important than mortality and why ordering too many unnecessary consults worsens the food and doesn't impact mortality - this episode is for you. Tramadol is not well understood by many prescribers and the
Balkan Reflections Forged By A Virus Lockdown
World War I was partly triggered by powerful allies of various nationalities being dragged into a Balkan conflict (nationalism, of course, was another major factor). The more recent Balkan conflict is even more preposterous - and here is my
Recent Interesting Internal Medicine Studies and Facts - December 2019
Correcting Hypernatremia in adults (finally, a real study!). An option for that scary patient with hemoptysis. How many nephrons you have (and your patient has) - it matters.
