Last Week in Medicine

Happy New Year and welcome to the first episode of 2020!  We've got some great articles to review today.  Can we save money by taking care of some acutely ill patients in their own homes?  Are patients admitted for "social" reasons at the same risk for adverse events as acutely ill patients?  Can NT-ProBNP level predict cardiovascular death and myocardial injury after non-cardiac surgery?  Does limiting alcohol intake reduce atrial fibrillation recurrence?  Listen to find out! Hospital Level Care at Home for the Acutely Ill Adverse Events in Patients Hospitalized Without Definite Medical AcuityPreoperative NT-ProBNP before Non-Cardiac SurgeryAlcohol Abstinence and Atrial Fibrillation Music from https://filmmusic.io"Sneaky Snitch" by Kevin MacLeod (https://incompetech.com)License: CC BY (http://creativecommons.org/licenses/by/4.0/)Music from Uppbeat (free for Creators!):https://uppbeat.io/t/soundroll/dopeLicense code: NP8HLP5WKGKXFW2R

Dr. Rupp is back! Today we talk about whether it's safe to give group 2 gadolinium based contrast agents to patients with CKD stage 4 and 5 and whether metoprolol can be used to prevent COPD exacerbations.  We also shine some more sunlight on the sunshine vitamin's inability to change any meaningful outcomes, and discuss some interesting data from the Intern Health Study. Risk of Nephrogenic Systemic Fibrosis in Patients with Stage 4 or 5 CKD Receiving Group II Gadolinium Based Contrast AgentMetoprolol for the Prevent of Acute Exacerbations of COPDEarly High-Dose Vitamin D3 for Critically Ill, Vitamin D-Deficient PatientsPolitical events and mood among young physiciansMusic from https://filmmusic.io"Sneaky Snitch" by Kevin MacLeod (https://incompetech.com)License: CC BY (http://creativecommons.org/licenses/by/4.0/)Music from Uppbeat (free for Creators!):https://uppbeat.io/t/soundroll/dopeLicense code: NP8HLP5WKGKXFW2R

This week we have a special guest host, Dr. Dani Babbel.  We talk about the new guidelines on upper GI bleeding, a new study on E-VALI, and the possible association of beta blockers with heart failure hospitalizations in heart failure with EF > 50%. Management of Upper GI Bleeding GuidelinesClinical presentation, treatment and short term outcomes of E-VALIAssociation of Beta-Blocker Use with Heart Failure Hospitalizations in HFpEFMusic from https://filmmusic.io"Sneaky Snitch" by Kevin MacLeod (https://incompetech.com)License: CC BY (http://creativecommons.org/licenses/by/4.0/)Music from Uppbeat (free for Creators!):https://uppbeat.io/t/soundroll/dopeLicense code: NP8HLP5WKGKXFW2R

Can you get away with a higher d-dimer value in patients with a low pre-test probability for PE?  Does working more days in a row improve patient outcomes?  How often are people inappropriately prescribing fluoroquinolones?  How often are people using systemic lytics vs catheter directed lytics in acute PE, and what are the outcomes?Music from https://filmmusic.io"Sneaky Snitch" by Kevin MacLeod (https://incompetech.com)License: CC BY (http://creativecommons.org/licenses/by/4.0/)Music from Uppbeat (free for Creators!):https://uppbeat.io/t/soundroll/dopeLicense code: NP8HLP5WKGKXFW2R

Today we talk about the effects of vitamin D in progression of CKD in people with diabetes, and whether SGLT-2 inhibitors like dapagliflozin can be used to treat heart failure with reduced ejection fraction in people without diabetes.  We also talk about ticagrelor monotherapy after three months of DAPT, rivaroxaban for the treatment of APS (don't do it!) and LDL targets for stroke prevention.  Music from https://filmmusic.io"Sneaky Snitch" by Kevin MacLeod (https://incompetech.com)License: CC BY (http://creativecommons.org/licenses/by/4.0/)Music from Uppbeat (free for Creators!):https://uppbeat.io/t/soundroll/dopeLicense code: NP8HLP5WKGKXFW2R

Lots of cardiology to discuss this week with the Apple Heart and COLCOT studies, both published in the New England Journal of Medicine.  We also talk about the 3 Wishes Project, the net clinical benefit of oral anticoagulation with aging over 75, the benefits of non-pharmaceutical treatment of agitation, and getting blood cultures before you give antibiotics. Music from https://filmmusic.io"Sneaky Snitch" by Kevin MacLeod (https://incompetech.com)License: CC BY (http://creativecommons.org/licenses/by/4.0/)Music from Uppbeat (free for Creators!):https://uppbeat.io/t/soundroll/dopeLicense code: NP8HLP5WKGKXFW2R

Should we add blood pressure medications or increase the dose while patients are in the hospital?  What are the risk factors and outcomes for people who receive antibiotics for asymptomatic bacteriuria?  And how does the DRIP score stack up against previous tools for identifying patients at high risk for drug resistant pneumonia? Music from https://filmmusic.io"Sneaky Snitch" by Kevin MacLeod (https://incompetech.com)License: CC BY (http://creativecommons.org/licenses/by/4.0/)Music from Uppbeat (free for Creators!):https://uppbeat.io/t/soundroll/dopeLicense code: NP8HLP5WKGKXFW2R