anticoagulation

Today we are joined by Dr. Brian Locke, recently graduated pulmonary-critical care fellow, who takes us on a journey of avoiding statistical fallacies. Does metformin reduce the likelihood of long COVID? Should we give platelet transfusions to thrombocytopenic patients before central line placement? Did the CANVAS trial change practice in cancer associated thrombosis? Should patients with a stroke due to atrial fibrillation start oral anticoagulation earlier or later? We discuss all these questions on more on today's episode. Check it out!

Metformin for Long COVID
Definition of Post Acute Sequelae of Sars-CoV-2 Infection
Platelet Transfusion before CVC Placement in Thrombocytopenia
DOACs vs LMWH in Cancer Associated VTE
Early vs Late Anticoagulation for Stroke with AF







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Today we have a special guest, Dr. Joel Topf, board-certified nephrologist and medical educator extraordinaire. Our listeners will likely recognize Dr. Topf from his prolific tweeting @Kidney_boy, as well as his numerous appearances on the Curbsiders podcast. He is a co-founder of the NephJC on Twitter, and host and founder of the NephJC podcast Freely Filtered. He is also host of the podcast Channel Your Enthusiasm, a deep dive monthly recap of the nephrology textbook Clinical Physiology of Acid Base and Electrolyte Disorders by Dr. Burton Rose (who, incidentally, is the creator of the original UpToDate). Dr. Topf wrote his own book on fluids, electrolytes and acid-base homeostasis.  He's the co-editor for the fourth edition of Nephrology Secrets and the first edition of The Handbook of Critical Care Nephrology.

Dr. Topf joined us to talk about a new paper he co-authored on osmotic demyelination syndrome and hyponatremia.

I'm also joined by Dr. Mita Hoppenfeld, hospitalist at the University of Utah, to talk about a new DOAC vs warfarin trial in On-X aortic valves, whether it's better to avoid hypertension or hypotension around time of surgery, and the diagnostic accuracy of CT abdomen scans without contrast. Check it out!

Osmotic Demyelination and Hyponatremia
Apixaban vs Warfarin for On-X Aortic Valve
Perioperative Blood Pressure Strategies
Diagnostic Accuracy of CT Abdomen Without Contrast







Music from Uppbeat (free for Creators!):

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This week we have special guest, Dr. Adam Spivak, to talk about the new study on doxycycline post-exposure prophylaxis for STIs. Dr. Spivak is an infectious disease expert and works in both an HIV clinic and a free PrEP clinic.

I also review the latest COVID-19 anticoagulation trial and a paper looking at rates of fracture non-union in people who receive bisphosphonates. Check it out!


Doxycycline Post-exposure Prophylaxis for STIs
High dose prophylactic anticoagulation in COVID-19
Bisphosphonate and Rates of Fracture Non-unions





Music from Uppbeat (free for Creators!):

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In this episode, Vikramjit Mukherjee, MD, and Cameron Smith, MPAS, PA-C, answer audience questions on how best to care for hospitalized patients with COVID-19 from a live, virtual question and answer webinar. This episode includes expert insights on:

• Supportive care management such as oxygen support, glycemic control, and anticoagulation
• Escalation of therapy in patients with worsening oxygen requirements
• Use of remdesivir in patients with renal dysfunction
• Brief commentary on long COVID

Presenters:

Vikramjit Mukherjee, MD
Assistant Professor  
Division of Pulmonary, Critical Care, & Sleep Medicine  
New York University School of Medicine  
Director
Medical Intensive Care Unit
Bellevue Hospital
New York

Cameron Smith MPAS, PA-C
Lead Advanced Practice Provider
Medical Intensive Care Unit
Bellevue Hospital
New York Health and Hospitals  
New York, New York

Content based on an online program supported by an independent educational grant from Gilead Sciences, Inc.
bit.ly/3z52c00

In this episode, David S. Kountz, MD, discusses with Keith C. Ferdinand MD, FACC, FAHA, a patient case in which health disparities affected NVAF care and provides patient, provider, and health-system level strategies to address these disparities to improve NVAF-related cardiovascular outcomes.

Presenters

Keith C. Ferdinand, MD, FACC, FAHA 
Professor of Medicine
Tulane Heart and Vascular Institute
Tulane University School of Medicine
New Orleans, Louisiana

David S. Kountz, MD
Professor of Medicine
Department of Medicine
Hackensack Meridian School of Medicine
Nutley, New Jersey

Link to full program:
https://bit.ly/3xn238i

In this episode, Keith C. Ferdinand MD, FACC, FAHA, discusses with David S. Kountz, MD, a patient case in which health disparities affected NVAF care and provides strategies to address low health literacy and patient access to direct-acting oral anticoagulant to improve NVAF-related cardiovascular outcomes.

Presenters

Keith C. Ferdinand, MD, FACC, FAHA 
Professor of Medicine
Tulane Heart and Vascular Institute
Tulane University School of Medicine
New Orleans, Louisiana

David S. Kountz, MD
Professor of Medicine
Department of Medicine
Hackensack Meridian School of Medicine
Nutley, New Jersey

Link to full program: 
https://bit.ly/3xn238i

In this episode, David S. Kountz, MD, discusses with Keith C. Ferdinand MD, FACC, FAHA, a patient case in which health disparities affected NVAF care and provides patient, provider, and health-system level strategies to address these disparities to improve NVAF-related cardiovascular outcomes.

Presenters

Keith C. Ferdinand, MD, FACC, FAHA
Professor of Medicine 
Tulane Heart and Vascular Institute
Tulane University School of Medicine
New Orleans, Louisiana

David S. Kountz, MD
Professor of Medicine
Department of Medicine
Hackensack Meridian School of Medicine
Nutley, New Jersey

Link to full program:
https://bit.ly/3MbIfZI

In this episode, Keith C. Ferdinand MD, FACC, FAHA, discusses with David S. Kountz, MD, a patient case in which health disparities affected NVAF care and provides strategies to address low health literacy and patient access to direct-acting oral anticoagulant to improve NVAF-related cardiovascular outcomes.

Presenters

Keith C. Ferdinand, MD, FACC, FAHA 
Professor of Medicine 
Tulane Heart and Vascular Institute
Tulane University School of Medicine
New Orleans, Louisiana

David S. Kountz, MD
Professor of Medicine
Department of Medicine
Hackensack Meridian School of Medicine
Nutley, New Jersey

Link to full program: 
https://bit.ly/3MbIfZI

This podcast is the third in a series of 3 featuring an expert multidisciplinary panel of faculty addressing the impact of social determinants of health on NVAF and CV-related outcomes and strategies to overcome these disparities. In this episode, Keith C. Ferdinand, MD, FACC, FAHA, details the effects of SDOH on anticoagulation prescribing in NVAF and provides an overview of areas for future study.

Review the downloadable slideset and the full program at:
https://bit.ly/3yYXP8e

This podcast is the first in a series of 3 featuring an multidisciplinary panel of expert faculty addressing the impact of social determinants of health on NVAF and CV-related outcomes and strategies to overcome these disparities. In this episode, David S. Kountz, MD, provides a detailed explanation of the atrial fibrillation paradox and data on the impacts of SDOH on NVAF CV-related outcomes.

Review the downloadable slideset and the full program at: 
https://bit.ly/3yYXP8e

This podcast is the second in a series of 3 featuring an expert multidisciplinary panel of faculty addressing the impact of social determinants of health on NVAF and CV-related outcomes and strategies to overcome these disparities. In this episode, Laura Ross PA-C, CLS, dives deeper into the impacts of SODH on NVAF care and provides strategies to address to improve patient care and clinical outcomes in NVAF.

Review the downloadable slideset and the full program at:   
https://bit.ly/3yYXP8e

This podcast is the first in a series of 3 featuring an multidisciplinary panel of expert faculty addressing the impact of social determinants of health on NVAF and CV-related outcomes and strategies to overcome these disparities. In this episode, David S. Kountz, MD, provides a detailed explanation of the atrial fibrillation paradox and data on the impacts of SDOH on NVAF CV-related outcomes.Review the downloadable slideset and full program at: PCE.is/NVAF.

Contributors:

Program Director
Keith C. Ferdinand, MD, FACC, FAHA,has disclosed that he has received consulting fees from Amgen, Boehringer Ingelheim, Medtronic, Novartis, and Sanofi.

Faculty
David S. Kountz, MD, has no relevant conflicts of interest to report.

Laura Ross, PA-C, CLS, has no relevant conflicts of interest to report.

This podcast is the third in a series of 3 featuring an expert multidisciplinary panel of faculty addressing the impact of social determinants of health on NVAF and CV-related outcomes and strategies to overcome these disparities. In this episode, Keith C. Ferdinand, MD, FACC, FAHA, details the effects of SDOH on anticoagulation prescribing in NVAF and provides an overview of areas for future study. Review the downloadable slideset and full program at: PCE.is/NVAF.

Contributors:

Program Director

Keith C. Ferdinand, MD, FACC, FAHA, has disclosed that he has received consulting fees from Amgen, Boehringer Ingelheim, Medtronic, Novartis, and Sanofi.

Faculty

David S. Kountz, MD, has no relevant conflicts of interest to report.

Laura Ross, PA-C, CLS, has no relevant conflicts of interest to report.

This podcast is the second in a series of 3 featuring an expert multidisciplinary panel of faculty addressing the impact of social determinants of health on NVAF and CV-related outcomes and strategies to overcome these disparities. In this episode, Laura Ross PA-C, CLS, dives deeper into the impacts of SODH on NVAF care and provides strategies to address to improve patient care and clinical outcomes in NVAF. Review the downloadable slideset and full program at: PCE.is/NVAF.

Contributors:

Program Director
Keith C. Ferdinand, MD, FACC, FAHA, has disclosed that he has received consulting fees from Amgen, Boehringer Ingelheim, Medtronic, Novartis, and Sanofi.

Faculty
David S. Kountz, MD, has no relevant conflicts of interest to report.

Laura Ross, PA-C, CLS, has no relevant conflicts of interest to report.

Somehow we got through 7 articles today, and none of them are about COVID-19!

Happy Thanksgiving!

Chlorthalidone in CKD

Milvexian for VTE Prevention

Risk of Recurrent VTE in Subsegmental PE

Rivaroxaban associated with higher rates of GI bleeding

Depression and Residency

Mental-Stress Induced Myocardial Ischemia

Patient Outcomes for Part Time Hospitalists







Music from Uppbeat (free for Creators!):

https://uppbeat.io/t/soundroll/dope

License code: NP8HLP5WKGKXFW2R

In this installment of our ASH Clinical Practice Guidelines and our COVID-19 series, Editor-in-Chief Dr. Laura Michaelis has a conversation with the Use of Anticoagulation in Patients with COVID-19 guideline panel co-chairs Dr. Adam Cuker and Dr. Reem Mustafa. They discuss the clinical importance of these guidelines as well as the process to track and respond to the ongoing emergence of new clinical data and evidence. For more information on these guidelines, and how you can get involved, visit www.hematology.org/VTEguidelines and for additional constantly-updated COVID-19 resources, visit www.hematology.org/covid-19. 

Music: “Jellyfish in Space” Kevin MacLeod (incompetech.com). Licensed under Creative Commons: By Attribution 3.0 creativecommons.org/licenses/by/3.0/