Management of Chronic Stable Angina in 2020
7 min

Controversy exists regarding how to best manage chronic stable angina. Intuitively, it seems that because it is usually caused by coronary artery lesions, addressing those lesions either via percutaneous coronary angiography or coronary artery bypass operations would be the best way to manage this problem. Several studies have suggested that this is not the case and that results of these interventions are no better than optimal medical management. Recently, a very large trial examining this clinical question has provided results suggesting that any approach works about the same. We interviewed Donald Lloyd-Jones, MD, chair of the department of preventive medicine at Northwestern University, during the recent American Heart Association meeting about this issue.

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Coronary Microvascular Dysfunction Causing Cardiac Ischemia in Women

Acupuncture as Adjunctive Therapy for Chronic Stable Angina: A Randomized Clinical Trial

Charting Pediatrics
Charting Pediatrics
Children's Hospital Colorado
Rebroadcast: COVID-19 Taking Care of Adult Patients During the Pandemic with Aaron Manning, MD and Steven Humphrey, MD (S3:E49)
Join us for our bi-weekly COVID-19 Virtual Provider Town Hall series featuring updates from Children's Infectious Diseases team and live Q&A: https://bit.ly/3qiKGzV - our next Town Hall is on Thursday, December 3, 2020 from 6-7:30p.m. MST. With COVID-19 cases surging across the United States and Europe we hope this episode is a timely refresher for any of our pediatric colleagues who are being called into service to care for adult patients. In this rebroadcast of S3:E49, we have a case discussion around functional and high-yield adult medicine topics that might be useful for pediatricians helping to care for adult patients in the middle of the pandemic. You can go back and listen to our previous coverage on the COVID-19 Pandemic on Season 3 & 4 of the podcast. Today we are fortunate to be joined by Dr. Aaron Manning and Dr. Steven Humphrey. Steven is a pediatric hospitalist at Children’s Hospital Colorado and Instructor of Pediatrics at the University of Colorado School of Medicine. Aaron is also a pediatric hospitalist at Children’s Colorado and is Assistant Professor of Hospital Medicine at the University of Colorado School of Medicine. * POPCoRN (Pediatric Overflow Planning Contingency Response Network): https://www.popcornetwork.org/. This site is a multi-institutional collaboration that was created during the COVID-19 pandemic as a vehicle for optimizing adult care in pediatric environments. It contains many “one-pagers” which review the management of a variety of common adult conditions, links to adult protocols shared by various institutions, and recommendations regarding care of patients with COVID-19 among others. * Adult medicine guidebooks: Several organizations have made available their adult medicine guidebooks free of charge. * UCSF Department of Medicine Hospitalist Handbook (currently free in the Apple and Google App Stores) * MGH Resource Guide for Commonly-Encountered Inpatient Topics (available via the POPCoRN website) * Society for Hospitalist Medicine: Non-Hospitalist Onboarding. This resource offers a step by step guide to preparing non-hospitalists for the inpatient management of adult care (available via the POPCoRN website) * University of Pennsylvania Hospitalists Primer. A resource meant to prepare non-hospitalists for the care of hospitalized adults (http://pennhspprimer.com/) Do you have thoughts about today's episode or suggestions for a future topic? Write to us, chartingpediatrics@childrenscolorado.org
40 min
Bedside Rounds
Bedside Rounds
Adam Rodman, MD, MPH, FACP
59 - Cry of the Suffering Organs
Diagnosis is arguably the most important job of a physician. But what does it actually mean to make a diagnosis? In this episode, we’ll explore this question by tracking the development of the “classical” model of diagnosis and pathological anatomy and discussing three cases over three hundred years. Along the way, we’ll ponder the concept of the lesion, iatromechanistic theories of the human machine, the birth of the International Classification of Diseases, and the rise and decline of the autopsy. You can sign up for the iMED Digital Education conference at cmeregistration.hms.harvard.edu/digitaleducation. Sources: * Hooper R, The Physician’s Vade-Mecum: Containing the Symptoms, Causes, Diagnosis, Prognosis and Treatment of Diseases. 1812. * Holdman L et al, The Value of the Autopsy in Three Medical Eras. N Engl J Med 1983; 308:1000-1005. * Cabot RC et al. CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITALANTE-MORTEM AND POST-MORTEM RECORDS AS USED IN WEEKLY CLINICO-PATHOLOGICAL EXERCISES. Case 9431. Boston Med Surg J 1923; 189:595-599. * Shojania KG and Burton EC, The Vanishing Nonforensic Autopsy. N Engl J Med 2008; 358:873-875 * Morgagni GB. The seats and causes of diseases investigated by anatomy in five books, containing a great variety of dissections, with remarks. To which are added ... copious indexes. 1769. Retrieved online: https://openlibrary.org/works/OL15821973W/The_seats_and_causes_of_diseases_investigated_by_anatomy * Castiglioni A, GB Morgagni and the Anatomico-pathological Conception of the Clinical. Proceedings of the Royal Society of Medicine, November 7, 1934. * Thiene G, Padua University: The role it has played in the History of Medicine and Cardiology and its position today. European Heart Journal, Volume 30, Issue 6, March 2009, Pages 629–635. * Zampieri F et al, Origin and development of modern medicine at the University of Padua and the role of the “Serenissima” Republic of Venice. Glob Cardiol Sci Pract. 2013; 2013(2): 149–162. * Conner, Annastasia (2017) "Galen’s Analogy: Animal Experimentation and Anatomy in the Second Century C.E.," Anthós: Vol. 8: Iss. 1, Article 9. * Zampieri F et al. The clinico-pathological conference, based upon Giovanni Battista Morgagni's legacy, remains of fundamental importance even in the era of the vanishing autopsy. Virchows Arch. 2015 Sep;467(3):249-54. * Ghosh SK, Giovanni Battista Morgagni (1682-1771): father of pathologic anatomy and pioneer of modern medicine. Anat Sci Int. 2017 Jun;92(3):305-312. * O’Neal JC, Auenbrugger, Corvisart, and the Perception of Disease. Eighteenth-Century Studies Vol. 31, No. 4, The Mind/Body Problem (Summer, 1998), pp. 473-489 * Brown TM, THE COLLEGE OF PHYSICIANS AND THE ACCEPTANCE OF IATROMECHANISM IN ENGLAND, 1665-1695. Bulletin of the History of Medicine Vol. 44, No. 1 (JANUARY-FEBRUARY 1970), pp. 12-30 * Roos AM, Luminaries in Medicine: Richard Mead, James Gibbs, and Solar and Lunar Effects on the Human Body in Early Modern England. Bulletin of the History of Medicine Vol. 74, No. 3 (Fall 2000), pp. 433-457 (25 pages) * Frith J, History of Tuberculosis. Part 1 – Phthisis, consumption and the White Plague. JMVH. 2014; 22(2). * World Health Organization, History of the development of the ICD. https://www.who.int/classifications/icd/en/HistoryOfICD.pdf * Laennec RTH, A treatise on diseases of the chest and on mediate auscultation. 1834. Retrieved from: https://archive.org/details/b21987002. * Marinker M, Why make people patients? J Med Ethics. 1975 Jul; 1(2): 81–84. * King LS, Medical Thinking: A Historical Preface. Princeton University Press, 2016.
43 min
Diabetes Core Update
Diabetes Core Update
American Diabetes Association
Diabetes Core Update – December 2020
Diabetes Core Update is a monthly podcast that presents and discusses the latest clinically relevant articles from the American Diabetes Association’s four science and medical journals – Diabetes, Diabetes Care, Clinical Diabetes, and Diabetes Spectrum. Each episode is approximately 20 minutes long and presents 5-6 recently published articles from ADA journals. Intended for practicing physicians and health care professionals, Diabetes Core Update discusses how the latest research and information published in journals of the American Diabetes Association are relevant to clinical practice and can be applied in a treatment setting. This issue will review: * Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure * Impact of Comorbidities and Glycemia at Admission and DPP-4 Inhibitors in Patients With Type 2 Diabetes With COVID-19 * Diabetes as a Risk Factor for Poor Early Outcomes in Patients Hospitalized With COVID-19 * Changes in Statin Use Among U.S. Adults With Diabetes * Dapagliflozin in Patients with Chronic Kidney Disease Study For more information about each of ADA’s science and medical journals, please visit www.diabetesjournals.org. Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health John J. Russell, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Director, Family Medicine Residency Program, Chair-Department of Family Medicine, Abington Jefferson Health
24 min
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