Changing the Tune: Post-operative Readmission and Music as Perioperative Therapy

Amol, general internal medicine resident at the University of Toronto, and Nathan, general surgery resident at the University of Toronto, discuss 2 recent studies: Does it matter which hospital patients return to after surgery? A large retrospective cohort study showed that when post-operative patients are re-admitted to the same hospital where they had their surgery,

Replay: Filtered Sunlight for Jaundice and Text Messages for Healthy Lifestyle

This week we are replaying one of our favourite episodes from earlier this season: Originally aired on October 3, 2015, Amol, general internal resident at the University of Toronto, and Fahad, Staff Internist at St. Michael’s Hospital in Toronto, discuss two papers. It’s phototherapy without the need for electricity. Fahad discusses how filtered sunlight is found to

Brain Week: Early Rehab for Stroke and Drug Interaction Increases Bleeding in Brain

Amol, general internal resident at the University of Toronto, and Raed Joundi, neurology resident at the University of Toronto, discuss 2 recent studies: Is early mobilization helpful for stroke patients? A randomized control trial showed that early aggressive rehabilitation for acute stroke patients resulted in worse outcomes. Amol and Raed speculate reasons behind this counter-intuitive

Replay: Resident Call Schedules in the ICU and Thyroid Nodules

This week we are replaying one of our favourite old episodes, due to many of our team members being away at the Canadian Society of Internal Medicine Conference. Originally aired on April 17, 2015, Nathan and Amol want you to understand the following: 1. There was no significant difference between three different call schedules in

Questioning Convention: Acetaminophen for Fever and Calcium for Fractures

Amol and Janice, general internal medicine residents at the University of Toronto, discuss 2 recent studies that challenge 2 widely accepted medical practices. Does using acetaminophen to treat fever improve outcomes? A randomized control trial found that giving acetaminophen to critically ill patients did lower their fever, but did not affect the number of ICU

Brave New World: Filtered Sunlight for Jaundice and Text Messages for Healthy Lifestyle

It’s phototherapy without the need for electricity. Fahad discusses how filtered sunlight is found to be equivalent to conventional phototherapy in treating infants with elevated bilirubin levels. The film that filters the sunlight is low cost and low-tech, yet has the potential for global impact. Amol discusses using text messages to battle cardiovascular disease. Semi-personalized motivational

Arithmetic Operations: Breast Cancer Screening Choices and Anticoagulation Bridging

Nathan discusses a randomized trial about breast cancer screening that found that sending women information about both the risks and the benefits of breast cancer screening resulted in more women making an “informed choice” and fewer wanting to undergo screening mammography. Amol discusses the BRIDGE trial, which found that not bridging patients’ anticoagulation around the

New Beginnings: Better Vagal Maneuvers for Arrhythmias and eCigarettes in Adolescents

Amol and Fahad discuss: 1. A randomized controlled trial shows that a new approach to vagal maneuvers for supraventricular tachyarrhythmia was shown to be significantly more effective than traditional maneuvers. 2. A survey in California adolescents shows that there is an association between eCigarette use and subsequent tobacco use, raising concerns about a ‘gateway’ effect. The

Season 2 Promo: “Good Stuff” from our great new team

Season 2 of The Rounds Table kicks off next week. To get things started, here’s a short episode with ‘good stuff’ recommendations from our excellent new team: Jennifer Peng, Anthony Maher, and Annie Wang. Good Stuff Jennifer: http://www.theatlantic.com/health/archive/2014/11/the-dutch-village-where-everyone-has-dementia/382195/  Anthony: http://blogs.plos.org/globalhealth/2013/11/jojewell2/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+plos%2Fblogs%2Fblogosphere+%28Blogs+-+Blogosphere%29 Annie: http://freakonomics.com/2015/08/27/are-you-ready-for-a-glorious-sunset-a-new-freakonomics-radio-episode/  Music Credits (Creative Commons): In your Robotic Heart – Nicolai Heidlas https://soundcloud.com/nicolai-heidlas/in-your-robotic-heart Drive – Nicolai Heidlas https://soundcloud.com/nicolai-heidlas/drive-fresh-upbeat-pop-background-music Piano

Summer Replay 4: Ezetimibe and clinical outcomes, BP lowering in diabetes and kidney disease

Amol and Reena want you to understand the following: 1. When added to moderate dose statin, the IMPROVE-IT randomized trial showed that ezetimibe improved clinical outcomes in patients after acute coronary syndrome. 2. A network meta-analysis showed that no blood pressure lowering therapy improved mortality in patients with diabetes and chronic kidney disease. The combination of ACE-inhibitors and

Summer Replay 3: Transcatheter Aortic Valve Replacements and Sugar Industry Influence on Research Priorities

Originally aired May 22, 2015. Amol and Janice want you to understand the following: 1. Several RCTs and observational studies suggest that Transcatheter Aortic Valve Replacement reduces mortality and improves symptoms in frail, elderly patients. 2. A historical analysis demonstrates that the sugar industry had heavy influence in setting national dental research priorities in the 1970s, which

Summer Replay 2: Reducing c-sections and prednisolone vs. pentoxifylline for alcoholic hepatitis

Amol and Nathan want you to understand the following: 1. A large randomized evaulation of a quality improvement intervention demonstrated a modest but significant reduction in rates of cesarean-section in Quebec. 2. A large double-blind randomized-controlled-trial of over 1100 patients showed that pentoxifylline is not beneficial in the treatment of alcoholic hepatitis and prednisolone may have mild

Summer Replay: Community Acquired Pneumonia and Skin Infections

Aired April 23: Empiric antibiotic choices for community acquired pnuemonia and clindamycin versus trimethoprim-sulfamethoxazole for skin and soft tissue infections. Fahad and Amol want you to understand the following: 1. A large, high quality RCT showed that there was no significant difference between an empiric treatment strategy of beta-lactam vs beta-lactam plus macrolide vs respiratory fluoroquinolone for

Season Finale: Dabigatran Reversal and Digoxin Mortality

Fahad and Amol want you to recognize that: 1. Idarucizumab as an agent that specifically reverses the hemostatic effects of dabigatran.  2. A post-hoc analysis of the ROCKET-AF study showed that digoxin is associated with increased mortality in patients with atrial fibrillation. The papers Idaracizumab for Dabigatran reversal. Digoxin use and mortality in ROCKET-AF. Good stuff http://www.smacc.net.au/about-us/welcome/ http://emupdates.com/wp-content/uploads/2015/06/Strayer-Opioid-Misuse-SMACC-Slideset.pdf

Flying Solo: Warfarin vs. New Oral Anticoagulants, what does the evidence say?

Amol wants you to: 1. Consider how the evidence helps us decide whether to prescribe a patient warfarin or a novel oral anticoagulant for stroke prevention in atrial fibrillation. Continuing Medical Education Internists can receive 0.5 hours of Continuing Medical Education credit for each podcast they listen to through the Canadian Society of Internal Medicine (MOC Category 1)

Repeat: Value Judgments – Whole exome sequencing and left atrial appendage closure devices

Originally Published December 5, 2014: Travis and Amol want you to recognize that: 1. Recognize whole exome sequencing is an important new method of identifying genetic mutations associated with disease. 2. Understand that the 4-year follow-up of the PROTECT AF study showed that left atrial appendage closure devices may be superior to warfarin in preventing strokes in patients

Debatable Landmarks: Ezetimibe and clinical outcomes, BP lowering in diabetes and kidney disease

Amol and Reena want you to understand the following: 1. When added to moderate dose statin, the IMPROVE-IT randomized trial showed that ezetimibe improved clinical outcomes in patients after acute coronary syndrome. 2. A network meta-analysis showed that no blood pressure lowering therapy improved mortality in patients with diabetes and chronic kidney disease. The combination of ACE-inhibitors and