The Curbsiders Internal Medicine Podcast

#420 Recap Extravaganza: 2023 Highlights and Top Stories

4 snips

Dec 25, 2023

The podcast covers a range of interesting topics including menopause therapy, hemochromatosis, hematuria management, diabetes updates, xylazine overdose and withdrawal, primary aldosteronism, resistant hypertension, delirium, AKI risk, statin therapy in HIV patients, inpatient heart failure management, kratom use implications, and effectiveness of RSV vaccines.

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ADVICE

Practical Tips For Insulin Use

Use NPH as an affordable basal insulin option (two-thirds morning, one-third evening) and consider splitting degludec at low doses.
Watch for over‑basalization; add prandial insulin if basal exceeds ~0.5 U/kg.

INSIGHT

Xylazine Creates Naloxone‑Resistant Overdoses

Xylazine (tranq) is an alpha-2 agonist in the illicit supply that causes naloxone-resistant overdoses and unique wounds.
No rapid hospital test or reversal agent exists, complicating management and recognition.

ADVICE

Test Early For Primary Aldosteronism

Screen for primary aldosteronism in resistant hypertension; test with morning renin and aldosterone levels.
Low renin while on typical meds (ACE/ARB, diuretic, CCB) is a strong clue to primary aldosteronism.

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Join us as we recap various topics discussed throughout the year, including hormonal and non-hormonal therapy for menopause symptoms, hemochromatosis, evaluation and management of hematuria, updates in diabetes management (insulin, GLP1 agonists, SGLT2 inhibitors, hypoglycemia), xylazine overdose and withdrawal, primary aldosteronism, resistant hypertension, delirium, and its implications, the ACORN trial on AKI risk with pip-tazo vs. cefepime, the REPRIEVE trial on statin therapy in patients with HIV, inpatient heart failure management, the implications of kratom use, and the effectiveness of RSV vaccines. Plus, Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), Nora Taranto (@norataranto), and Matt Watto (@doctorwatto) share their picks of the year and take a moment to reflect on their gratitude for the fans and the opportunity to work on Curbsiders.

Our team needed a break so we did not make CME for this episode.

Show Segments

Time Stamps are for Patreon (Ad-Free) Version

00:00 Introduction and Overview
09:42 Hormonal and Non-Hormonal Therapy for Menopause Symptoms
14:20 Understanding Hemochromatosis
19:24 Evaluation and Management of Hematuria
25:00 Updates in Diabetes Management
29:35 Xylazine Overdose and Withdrawal
35:35 Primary Aldosteronism
39:36 Resistant Hypertension
44:12 Delirium and its Implications
46:29 The Acorn trial and AKI risk
49:47 HIV trial: Reprieve
51:11 Updates in hospital medicine
56:00 Kratom and its implications
59:11 RSV vaccines and their effectiveness
01:05:38 Reflections and Gratitude

Credits

Written, Produced, and Hosted by: Nora Taranto MD, Rahul Ganatra MD, MPH; Matthew Watto MD, FACP; Paul Williams MD, FACP
Cover Art: Matthew Watto MD, FACP
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste

Transcript Disclaimer
We've included a a free AI-generated transcript which has not been corrected by a human for accuracy or completeness. Please consider this a starting point for further research and consultation. We disclaim any liability for damages or losses resulting from this content.

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