REBOOT #458 Heart Failure with Reduced Ejection Fraction - Kittleson Rules Outpatient Heart Failure Volume 1

Take the ache out of those joint aches! Learn about inpatient diagnosis and management of crystalline arthropathies as well as a brief conversation about those rheumatology NOS cases. We’re joined by Dr. Kimberly Trotter, MD (University of Chicago).  Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Rapid fire questions/Picks of the Week Case 1 Differential Diagnosis of arthropathy Risk factors for Gout Diagnostic Evaluation  Acute Treatments  Long-term Treatments Transitions of Care for Crystalline Arthropathy Case 2 History and Physical Exam Diagnostic Work up Treatment Outro Credits Writer, Producer, Show Notes, Hosts: Meredith Trubitt MD, Monee Amin MD   Infographic, Cover Art: Caroline Coleman, MD Reviewer: Sai Achi MD, MBA, FACP Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Kimberly Trotter, MD  Disclosures Dr. Trotter reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.  Sponsor: Bombas Head over to Bombas.com and use code CURB for 20% off your first purchase. 

Join us as we review recent practice-changing articles on the effect of combination statin and ezetimibe in reducing myalgias, male partner treatment for BV, semaglutide for MASH/liver fibrosis, exercise and cancer risk, and cytisinicline for smoking cessation. Fill your brain hole with some delicious apps and entrees from our spring Digests! Featuring Paul Williams (@PaulNWilliamz), Nora Taranto (@norataranto), special guest epidemiologist Alexander Chaitoff (@alexchaitoff) and Matt Watto (@doctorwatto). Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Credits Written and Hosted by: Nora Taranto MD; Alexander Chaitoff MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP, Alex Chaitoff MD MPH  Cover Art: Nora Taranto MD Reviewer: Leah Witt MD  Technical Production: Pod Paste Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Show Segments Intro, disclaimer Self-collected HPV tests for cervical cancer screening  Semaglutide for MASH/Liver Fibrosis Male Partner Treatment for BV  Statins plus ezetimibe versus high-dose statins alone for statin-associated muscle symptoms  Exercise and Colon Cancer Risk  Cytisinicline for Smoking Cessation  Outro Sponsor: FIGS Curbsiders listeners can get 15% off. Just go to wearFIGS.com and use code FIGSRX Sponsor: Quince Go to Quince.com/curb for free shipping on your order and 365 day returns.  Sponsor: Continuing Education Company Curbsiders listeners get 45% off select online courses with promo code Curb45, through July 30. You can also use Curb30 for 30% off all webcasts and on demand replay courses. Check it all out at CMEmeeting.org/curbsiders.

Dive into practical, evidence-based approaches to managing pain in patients with opioid use disorder, bust common myths, and explore strategies to support patients. This episode will enhance your skills in providing holistic, patient-centered care. We’re joined by Dr. Jessica Merlin, @JessicaMerlinMD (University of Pittsburgh).  Claim CME for this episode at curbsiders.vcuhealth.org! By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education. Episodes | Subscribe | Spotify | iTunes | [email protected] | CME! Credits Producer, Show Notes, Infographics: Carolyn Chan MD, MHS Hosts: Carolyn Chan, MD, MHS and Shawn Cohen MD Reviewer: Payel Jhoom Roy MD, MSc Showrunner: Carolyn Chan, MD, MHS Technical Production: PodPaste Guest: Jessica Merlin MD, PhD, MBA Sponsor: JournalFeed Try JournalFeed free for 7 days — and get 20% off your first year with code CURB25 at journalfeed.org/curb. Sponsor: Freed Usecode: CURB50 to get $50 off your first month when you subscribe at freed.ai Sponsor: Mint Mobile Get your summer savings and shop premium wireless plans at MINTMOBILE.com/CURB

Get confident supporting your patients with infertility in primary care! We cover who needs a workup, how to evaluate both partners, and when to refer—plus tips on coding, counseling, and emotional support. Reproductive endocrinologist Dr. Brindha Bavan shares practical insights to empower PCPs on the front lines of fertility care. Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Case from Kashlak Definitions of infertility Male factor infertility evaluation History Semen analysis lifestyle Female factor infertility evaluation Anatomical approach Basic testing More advanced testing Unexplained infertility treatment Success of infertility treatments Financial impact/advocacy Oocyte preservation Outro Credits Producer, Writer, Show notes, Cover Art, Infographics: Molly Heublein MD Hosts: Molly Heublein MD, Era Kryzhanovskaya MD Reviewer: Emi Okamoto MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Brindha Bavan MD Disclosures Dr. Brindha Bavan reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.  Sponsor: Grammarly Download Grammarly for free at Grammarly.com/PODCAST. Sponsor: FIGS We’ve teamed up with FIGS, and now Curbsiders listeners can get 15% off. Just go to wearFIGS.com and use code FIGSRX. Sponsor: Panacea Financial  Learn more at PanaceaFinancial.com. 

Brush up on your high-value care by exploring four Things We Do For No Reason with experts Dr. Tony Breu (@tony_breu, Harvard University) and Dr. Lenny Feldman (@DocLennyF, Johns Hopkins University). Follow along as they explore lactate-guided resuscitation in shock, beta blocker use with cocaine, holding anticoagulation in patients with fall risk, and discharge before noon. Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Picks of the Week Part 1: Things We Do for No Reason™: Using lactate as our resuscitation guide in sepsis Part 2: Things We Do for No Reason™: Discontinuing β-blockers in patients who use cocaine Part 3: Things We Do for No Reason™: Discontinuing anticoagulation in older patients with atrial fibrillation and a high risk of falls Part 4: Things We Do for No Reason™: Discharge before noon Outro Credits Producers: Caroline Coleman MD, Monee Amin MD, Meredith Trubitt MD  Writers:  Monee Amin MD and Meredith Trubitt MD Show Notes, Infographic, Cover Art: Caroline Coleman, MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Lenny Feldman, MD and Tony Breu, MD Disclosures Dr. Breu and Dr Feldman report no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.  Sponsor: FIGS Curbsiders listeners can get 15% off. Just go to wearFIGS.com and use code FIGSRX Sponsor: Freed Usecode: CURB50 to get $50 off your first month when you subscribe at Freed.ai Sponsor: Locumstory Learn about locums and get insights from real-life physicians, PAs and NP sat Locumstory.com Sponsor: Continuing Education Company Curbsiders listeners get 45% off select online courses—that’s the biggest discount CEC has ever offered, and it’s exclusive to you with promo code Curb45, through July 30. You can also use Curb30 for 30% off all webcasts and on demand replay courses. Check it all out at CMEmeeting.org/curbsiders.

Join us as we review recent practice-changing articles on the effect of vitamin D3 and omega-3 fatty acids on physical performance, gabapentin and falls, gepotidacin for uncomplicated UTI, and intermittent fasting for weight loss. Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), special guest Laura Glick (@LauraRGlick) and Matt Watto (@doctorwatto). Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Credits Written and Hosted by: Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP Cover Art: Rahul Ganatra MD, FACP Reviewer: Sai S Achi, MD,MBA,FACP Technical Production: Pod Paste Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Show Segments Intro, disclaimer Vitamin D3 vs omega-3 fatty acids and physical performance Gabapentin vs duloxetine and risk of falls Gepotidacin vs nitrofurantoin for uncomplicated UTI Intermittent fasting vs daily calorie restriction for weight loss Outro Sponsor: Bombas Head over to Bombas.com/curb and use code curb for 20% off your first purchase.

This episode doesn't sugarcoat the truth about tricky diabetes management! Wrangle wild blood sugars among older adults, pregnant individuals, and those taking corticosteroids! Join our Kashlak resident endocrinologist Dr. Jeff Colburn, as we dive into diabetic dilemmas. We will help you dodge dangerous lows and navigate tricky treatment traps in these special populations. Get the un-sugar-coated truth on managing complex diabetes cases!  Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Diabetes in Older Adults (Geriatrics) General Approach Risks of Hypoglycemia 4Ms Framework Insulin Management Oral Medications Diabetes in Pregnancy Preconception Counseling Eye Health Monitoring Insulin Therapy During Pregnancy Postpartum Care Steroid-Induced Hyperglycemia General Approach Postprandial Insulin Adjustment NPH Insulin Usage Initiating Insulin Role of GLP-1RA and SGLT2-inhibitors Take-home Points Outro Credits Producer, Writer, and Show Notes: Isabel Valdez, PA-C Infographic and Cover Art: Zoya Surani, BA, MS Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Leah Witt, MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Jeff Colburn, MD Disclosures Dr. Jeff Colburn reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.  Sponsor: Continuing Education Company Special offer for Curbsiders listeners: Save30%on all online courses and live webcasts with promocodeCURB30. Visit www.CMEmeeting.org/curbsiders to explore all offerings and claim your discount.  Sponsor: Freed Visit Freed.ai and Usecode: CURB50 to get $50 off your first month when you subscribe.  Sponsor: Quince Go to Quince.com/curb for free shipping on your order and 365 day returns.

Join us at patreon.com/curbsiders today and save 20% on NEW Annual Memberships with promo code: UNLOCKED. *This offer expires at 3am EST on May 15, 2025. Matt and Paul recap top pearls from a recent episode on heart failure with reduced ejection fraction (HFrEF) and the importance of understanding the underlying causes of heart failure with Dr. Michelle Kittleson (video version). They also answer listener questions and share their picks of the week. Chapters: 00:00 Introduction and Humor 01:41 Understanding Heart Failure 04:50 Guideline-Directed Medical Therapy 09:57 Practical Approaches to Treatment 13:58 The Importance of Medication Adherence 16:22 Dietary Considerations in Heart Failure 18:24 ED Follow-Ups and Patient Management 20:38 SGLT2 Inhibitors and Infections 25:58 Patient Counseling and Preventative Care 26:33 Picks of the Week

We’re taking a break this week, but we’ll be back next week with a brand-new episode.  Provide superb outpatient care for your patients with HFrEF. Identify underlying causes of heart failure and titrate medications with ease. Dr Michelle Kittleson @MKittlesonMD (Cedars Sinai) breaks down the nuances of treating this common cardiac condition.  Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments 00:00 Introduction  03:22 Case Presentation: Newly Diagnosed Heart Failure 07:26 Using Physical Exam Findings to Guide Diuresis 11:58 The Four Pillars of Guideline-Directed Medical Therapy for Heart Failure 15:07 Optimizing Therapy and Follow-Up in Heart Failure Patients 22:10 The Benefits of High-Intensity Initiation and Titration of Guideline-Directed Medical Therapy 28:02 Consideration of Other Medications 40:02 Referral to Advanced Heart Failure Specialist 49:11 Optimizing Therapy and Follow-Up 55:33 Conclusion and Book Recommendation Credits Writer and Producer: Deborah Gorth MD, PhD Infographic and Cover Art: Zoya Surani Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Michelle Kittleson MD, PhD Sponsor: Mint Mobile  Get your summer savings and shop premium wireless plans at MINTMOBILE. com/CURB. Sponsor: American College of Physicians Order ACP MKSAP today at acponline.org. Curbsiders Listeners who use promo code  CORECS will receive a MKSAP gift pack with their subscription. Sponsor: Panacea Legal Learn more and schedule your free consultation at Panacea.Legal.

Highlights and Pearls from SHM’s Annual Meeting We recap the top pearls for the hospitalist from #SHM #Converge25 hitting updates in GI, stroke, anticoagulation, perioperative medicine, artificial intelligence, and more.  Note: There is no CME for this episode, but visit curbsiders.vcuhealth.org to claim credit for past episodes. Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Care of the Patient Experiencing Homelessness Updates in GI Delirium Adaptive Leadership Transgender Health Capacity Assessment Heart Failure Care of the Transplanted Kidney Precipitated Withdrawal IV contrast Alcohol Withdrawal MRSA Nares Swabs Bugs, Bite, and Fever Perioperative Medicine  Parkinson’s Disease Stroke  Outro Credits Producer, Writer, Show Notes: Meredith Trubitt MD, Monee Amin MD, Caroline Coleman MD  Cover Art: Caroline Coleman, MD Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Rahul Ganatra, MD MPH Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Michelle Brooks MD, Avital O’Glasser MD, Rahul Ganatra MD MPH Disclosures The Curbsiders report no relevant financial disclosures.  Sponsor: Freed Visit www.getfreed.ai and sse code: CURB50 to get $50 off your first month when you subscribe! Sponsor: Locumstory Learn about locums and get insights from real-life physicians, PAs and NPs at Locumstory.com. Sponsor: Grammarly  Download Grammarly for free at Grammarly.com/PODCAST. Sponsor: Continuing Education Company Special offer for Curbsiders listeners: Save 30% on all online courses and live webcasts with promo code CURB30. Visit www.CMEmeeting.org/curbsiders to explore all offerings and claim your discount.