Podcasts by Category
- 140 - Podcast 94: Dr. Megha Poddar on Obesity
Dear Listeners,
In this episode we are talking with Dr. Megha Poddar about evidence based approach in treatment of Obesity. Dr. is an Endocrinologist and Obesity medicine specialist in Toronto, Ontario. She is a diplomate of the American Board of Obesity Medicine and an Assistant Professor (Adjunct) in the Department of Medicine at McMaster University.
Dr. Poddar serves as the Medical Director of the Medical Weight Management Centre of Canada (MWMCC) and the Clinical Director of the LMC Weight Management Program. As a lead author and co-author, she has contributed to various resources on obesity education, including the McMaster textbook of internal medicine and the 2020 Canadian Adult Obesity Clinical Practice Guidelines. She is dedicated to mentoring healthcare providers in obesity management and clinical development, both nationally and globally, and is a passionate advocate for patients living with obesity.
Hope you enjoy!
Cheers,
Dr. Dimitre
Listen to the podcast hereSun, 21 Apr 2024 - 139 - Podcast 93: Dr. Puneet Seth on AI in Primary Care in 2024
Dear Listeners,
In this episode we are talking to Dr. Puneet Seth about his predictions about advancements on AI in primary care in 2024. These advancements will impact administrative staff, patients, clinicians, medical students and the entire novel medical ecosystem.
Dr. Seth is a medical doctor and technologist, recognized for pioneering digital health tools and advancing AI in healthcare. He led InputHealth as President and CMO, developing the Collaborative Health Record, and later contributed to AI integration at TELUS Health. Currently, he advises health AI startups, engages in teaching, conducts clinical research and writes about the intersection of AI and medicine.
Hope you enjoy!
Cheers,
Dr. Dimitre
Listen to the podcast hereThu, 07 Mar 2024 - 138 - Podcast 92: Dr. Munk and Urgent Calls From Distant Places
Dear Listeners,
On today’s podcast we talk to Marc-David Munk, a Canadian/American emergency physician and healthcare executive.
Over the past decade, he has held leadership roles at various nontraditional healthcare delivery organizations in the US and abroad. He began his career as a professor of emergency medicine and as the medical director for the Qatari national ambulance service.
He later became a senior executive at high-performing physician groups in the US and abroad. He is also the author the the upcoming book Urgent Calls From Distant Places about his experience as an air ambulance physician with the Flying Doctors.
Hope you enjoy!
Cheers,
Dr. Dimitre
Listen to the podcast here
Fri, 09 Feb 2024 - 137 - Podcast 91: Dr. Stephen Sharpe of Aroga Health
On today’s podcast, we will be talking to Dr. Stephen Sharpe, a fellow family physician and the Medical Director of Aroga Health, one of the fastest growing Lifestyle Medicine Clinics in Canada.
There is no longer any serious doubt that daily habits and actions profoundly affect health and quality of life. This concept is supported by literally thousands of research articles and incorporated in multiple evidence-based guidelines for the prevention and/or treatment of chronic metabolic diseases. The study of how habits and actions affect both prevention and treatment of diseases has coalesced around the concept of “lifestyle medicine.” Lifestyle medicine interventions include nutrition, physical activity, stress management, sleep hygiene, social support, and smoking cessation.
Given the current climate around health care, this outcome-driven approach is vital for the future of both patients and health caregivers.
Enjoy!
Dr. Dimitre
Access the podcast episode here!Thu, 04 Jan 2024 - 136 - Podcast 90: What is Virtual Hallway?
Dear Listeners,
On today’s podcast we talk to Dr. Luke Napier, the founder of Virtual Hallway.
Virtual Hallway (virtualhallway.ca) is a platform that bridges the gap between primary care providers and specialists, making peer-to-peer phone call consultations swift and efficient via their innovative platform modelled after the traditional “hallway consult”.
This digital solution saves time for both physicians and patients while enhancing healthcare outcomes.
It is being used robustly in Nova Scotia and Prince Edward Island health authorities and is now available in Ontario.
Cheers,
Dr. Dimitre
Access the podcast episode here!Fri, 15 Dec 2023 - 18min - 135 - Podcast 89: Dr. Joseph Antoun on Benefits of Fasting
Dear Listeners,
In this episode of the primary medicine podcast, we will talk about the benefits of intermittent fasting and the alternative fasting mimicking diet with the CEO of L-Nutra, Dr. Joseph Antoun. Fasting is a popular dietary strategy that involves alternating periods of eating and fasting. It has been shown to have various positive effects on the body, such as improving blood sugar levels, reducing inflammation, enhancing brain function, and promoting weight loss. We will discuss how it works, what are the different types of fasting protocols, and how to implement them safely and effectively including using a fasting mimicking strategy. Stay tuned for an informative and engaging conversation with Dr. Antoun, a leading authority on dietary and metabolic health.
Cheers,
Dr. Dimitre
Access the podcast episode here!Mon, 30 Oct 2023 - 30min - 134 - Podcast 88: Dr. Weill on Organ Transplants
Dear Listeners,
Please join us for a fascinating, behind-the-scenes look at organ transplants and what it’s like to work as a lung transplant physician confronted with critical decisions on a daily basis. Our guest is transplant consultant Dr. David Weill, who is the former Director of the Center for Advanced Lung Disease and the Lung Transplant Program at Stanford. He’s also the author of a gripping memoir entitled, “Exhale: Hope, Healing and A Life in Transplant”. His website is https://davidweillmd.com/about/.
Cheers,
Dr. Dimitre
Access the podcast episode here!Tue, 26 Sep 2023 - 25min - 133 - Podcast 87: Michael Dutra a few words on Disability Insurance
In today’s bonus episode we talk to Michael Dutra, the CEO of Michael Dutra Real Estate Planning and Insurance, about Disability Insurance. This is perhaps the most important insurance policy for professionals during their working careers.
Mon, 28 Aug 2023 - 18min - 132 - Podcast 86: Dr. Seth on Generative AI in Medicine
Dr Seth is a leader and a practitioner of generative AI in improving healthcare for both patients and healthcare practitioners. We will discuss what generative is AI, what its currently capable of, and how it can be used practically used by doctors to enhance their practice, their mental health, and their patients experience.
Fri, 28 Jul 2023 - 42min - 131 - Podcast 85: Dr. Mannan Shah on sublingual immunotherapy (SLIT)
Dear Listeners,
Welcome back to the Primary Medicine Podcast. In this episode, we will talk about sublingual immunotherapy, or SLIT, for allergic rhinoconjunctivitis. SLIT is a form of allergy treatment that involves placing allergen extracts under the tongue to gradually desensitize the immune system.
We will discuss how SLIT works, what are its benefits and risks, and who can benefit from it. Stay tuned for an informative and engaging conversation with our guest expert, Dr. Mannan Shah, a board-certified allergist and immunologist and also co-creator on Wyndyl, an innovative company that offers personalized SLIT delivered directly to patients.
Enjoy!
Sincerely,
Dr. Dimitre
Listen to the podcast here!Mon, 15 May 2023 - 25min - 130 - Podcast 84: Dr. Kevin on Micro and Macroscopic Hematurea
Dear Listeners,
We are lucky to have Dr. Kevin back on the podcast.
Micro and macroscopic hematurea are common incidental findings in primary care. They are often of a bening nature, but it is important to have a thorough method in investigating their differential so as not to miss rare but serious causes of bleeding in the urinary tract.
Dr. Kevin and Dr. Dimitre go over an updated approach to this condition.
Happy Learning,
Dr. Dimitre
Listen to the podcast here!Tue, 21 Mar 2023 - 24min - 129 - Podcast 83: Dr. Jordan Frey on Breast Reconstruction Surgery
Dear Listeners,
Approximately 25% of all women diagnosed with breast cancer will require a mastectomy. Breast reconstruction is a currently underutilised (less than 50%) option for these patients that provides psychological, social, emotional, and functional improvements, including improved psychological health, self-esteem, sexuality, and body image.
To cover this topic, we are very lucky to have Dr. Jordan Frey as a guest on the podcast today. Dr. Frey is a plastic surgeon based in Buffalo, New York. He also runs the Prudent Plastic Surgeon blog where he shares his financial journey and helps full time physicians to achieve financial security.
Happy Learning,
Dr. Dimitre
Listen tothe podcast here!Thu, 02 Feb 2023 - 17min - 128 - Podcast 82: Dr. David Stewart on Why Cancer Still Sucks
We are honoured to have Dr. David J. Stewart the author of “A Short Primer On Why Cancer Still Sucks”, an excellent book that tackles the big questions for patients and for doctors.
Sun, 06 Nov 2022 - 35min - 127 - Podcast 81: Dr. Malcom Ogborn on Physician Leadership
Dear Listeners,
Having healthcare led by people with a deep understanding of the nature and challenges of clinical work is a key component of a resilient healthcare system. Yet leadership is a challenging skill that is rarely, if ever, nurtured and encouraged in physicians.
We are thus fortunate today to have Dr. Malcolm Ogborn (https://www.optimisticdoc.com/) talk to us about Physician Leadership.
Dr. Ogborn is a professional physician coach and leadership development consultant with a special focus in partnering with early career leaders and leaders working in remote and rural areas. He is also the Vice Chair of the Canadian Physician Coaches Network. He has worked for thirty-eight years in leadership positions in clinical care, research, and academics. He coaches with individual professionals and organisations in the areas of Emotional Intelligence, career development, conflict management, and leadership.
He has also recently published Sudden Leadership: A Survival Guide for Physicians, an excellent resource for any physician aspiring to a leadership role.
Sincerely,
Dr. Dimitre
Listen to the podcast here!
Posted on 20/06/2022 by Dr. DimitreTue, 21 Jun 2022 - 56min - 126 - Podcast 80: Dr. Mailo on Falls in the Elderly
Dear Listeners,
We’re very excited to share that our national conference on wealth creation for physicians resumes this year!
Physician Empowerment is returning to Toronto June 3 to 5 with Canada’s top MD voices in the field:
https://www.physempowerment.ca/live
Beyond attending in person, we’ve got a great livestream option and all registrants enjoy unlimited access to the recordings.
Use promo code RANEV to enjoy $150 off.
Now onto our latest release…
I’m interviewing my co-host, emergency physician, Dr. Kevin Mailo on approaches to assessing and managing falls in the elderly.
In summary, falls are the leading cause of injury-related visits to emergency departments in North America and the primary etiology of accidental deaths in persons over the age of 65 years. Outpatient evaluation of a patient who has fallen includes a focused history with an emphasis on medications (Beers Criteria), a directed physical examination and simple tests of postural control and overall physical function. Treatment is directed at the underlying cause of the fall and can return the patient to baseline function.
Sincerely,
Listen to the podcast here!
Posted on 14/05/2022 by Dr. DimitreSat, 14 May 2022 - 41min - 125 - Dr. Tran on Cannabis in the Elderly
Dear Listeners,
We are lucky to have Dr. Vu Kiet Tran back on the podcast.
Dr. Tran is an Emergency, Family Medicine, and Long-term Care physician with over 20 years of clinical experience in Canada. He has vast clinical knowledge in elderly care and is currently running a facility with over 200 residents.
A 2020 survey from Better Aging Canada estimated that about 30% of patients over 50 years of age have been using cannabis since it was legalised, most of them for medical reasons. Of the 70% who were not using cannabis, about half were interested in trying it in the future.
It is thus important to have a clear, science-focused picture of cannabis and its medical properties.
Dr. Tran and Dr. Dimitre address this in a thorough, evidence-based discussion.
Please visit the membership page!
Posted on 09/04/2022 by Dr. Dimitre
Sat, 09 Apr 2022 - 40min - 124 - Podcast 78: Dr. Gharbi on the Future of Medicine
Dear Listeners,
For our latest podcast, I was fortunate enough to talk to Dr. Sam Gharbi. Dr. Gharbi is an Internal Medicine Doctor currently practising in Vancouver, British Columbia. He is an accomplished clinician, author, educator, and most importantly, an innovator and problem solver. He is also Co-Founder of the Arya EHR, a system that aims to help doctors manage their patient’s records in a simple, intuitive and efficient manner.
Dr. Gharbi and I spend a good hour talking about the current issues in Healthcare, some innovative solutions to them and the future of the profession. We touch on topics such as virtual care, patient centred medical records, and AI diagnostics.
Talking to Dr. Gharbi was indeed a much-needed shot of optimism given the challenges this field is facing on a daily basis in the waning months of the COVID crisis.
Please visit the membership page!
Posted on 17/02/2022 by Dr. DimitreFri, 18 Feb 2022 - 1h 00min - 123 - Dr. Tran on Metacognition and Minimizing Medical Error
Metacognition is the awareness and understanding of one’s own thought process
Dear Listeners,
Metacognition is the process of being aware of one’s own thinking, learning, and diagnostic processes and how they can shape our decisions when it comes to patient care. This self-awareness is very important in avoiding medical error yet it is rarely developed during medical training.
This podcast is meant to remedy this.
Dr. Vu has a lot of experience with medical error due to his role as an auditor for the College of Physicians and Surgeons of Ontario. During this podcast, we talk about the many common cognitive biases and thinking errors that he has encountered and how they lead us astray. We conclude the discussion with multiple strategies to minimise these frequent medical errors.
Please visit the membership page!
Posted on 05/12/2021 by Dr. DimitreMon, 06 Dec 2021 - 1h 13min - 122 - Dr. Tran on Ageism in Western Medicine
Dear Listeners,
We are very fortunate to have Dr. Vu Kiet Tran back this month to talk about Ageism.
Ageism is discriminating or stereotyping someone based on their age. It is very much prevalent in Western medical culture. It presents in insidious ways, such as the observed tendency for doctors to dismiss patients and pathologies in seniors due to old age; the severe lack of geriatric specialists in many provinces; and the fact that seniors spend less time talking to their physicians than any other age group.
Dr. Tran and Dr. Dimitre conclude that being aware of our inherent ageism is the first step in combating it.
If you want to learn more from Dr Tran, please visit his podcast page, and his website.
Also note that we were featured on: https://blog.feedspot.com/canadian_medical_podcasts/. It is an extensive database that can help with finding new and existing podcasts.
Happy Learning,
Dr. DimitreWed, 25 Aug 2021 - 48min - 121 - Dr. Tran on caring for your Lifeforce and preventing burnout
Dear Listeners,
We are very fortunate to have Dr. Vu Kiet Tran as a guest on our podcast this month.
Dr. Tran is an emergency medicine doctor, a Life and Financial Coach to healthcare professionals, and the host of the excellent “How is my Financial Health, doc?” podcast.
Dr. Tran talks about the importance of understanding that we as healthcare professionals trade our lifeforce to generate income and how ignorance of this can lead us down the painful road of professional burnout. He goes on to talk about how realizing what we can control and what we can’t control can lead to true internal wellness.
If you want to learn more from Dr, Tran, please visit his podcast page and his website.
Happy Learning,
Dr. DimitreSat, 17 Jul 2021 - 22min - 120 - Dr. Chadha from the beyond MD podcast
As host of beyond the MD podcast, Dr. Chada interviews experts on topics covering insurance, finance, tax management and law. During this episode, he is kind enough to share his wisdom about topics ranging from disability insurance, to incorporation, to investments.
Fri, 18 Jun 2021 - 23min - 119 - Podcast 73: Colchicine in Cardiovascular Disease Prevention
The bulb-like corms of C. autumnale contain colchicine, a useful drug for inflammatory conditions.
Dear listeners,
Colchicine has been used as an anti-inflammatory medication for centuries. The plant source of colchicine, the autumn crocus, was indeed used in Ancient Egypt as a treatment for rheumatism and swelling.
Currently, colchicine is indicated for treatment of inflammatory conditions such as gout, pericarditis, and Mediteranian fever. Based on a few recent studies, its use will likely be expanded to treat an even more common and serious inflammatory condition; cardiovascular disease.
During this podcast, we will go over the evidence supporting the use of low dose, daily colchicine in both primary and secondary prevention of cardiovascular disease.
Posted on 10/02/2021 by Dr. DimitreSun, 09 May 2021 - 13min - 118 - Physician Empowerment: You Are More than an Empty Vessel
This month, we are very excited to bring you a preview of our upcoming conference for Physician Empowerment. This year, our focus is on personal resilience and practice management. On today's episode, Kevin shares a remarkably refreshing view on wellness within our profession. To find out more, visit us at https://www.physempowerment.ca/banff.
Wed, 07 Apr 2021 - 16min - 117 - Podcast 72: Dr. John Crosby on preventing physician burnout
Dear Listeners,
We are very honoured to have Dr. John Crosby join us and share the wisdom he has gained during his lifetime as a Family Doctor in Canada.
Dr. Crosby is an author, blogger, consultant, and mentor. He is a regular contributor to the Medical Post and a peer reviewer for the College of Physicians & Surgeons of Ontario. Most remarkably, after over 40 years, he is still practising medicine with enthusiasm and kindness.
He shares timeless and inspirational advice about physician wellness and ways to avoid burnout.
If you are interested in learning more about professional well being, please join us in person or virtually at the Physician Empowerment Conference in beautiful Banff, Alberta May 12th to 17th.
Sincerely,
Dr. Kevin
Posted on 23/03/2021 by Dr. DimitreWed, 24 Mar 2021 - 23min - 116 - Podcast 71: Diabetic Kidney Disease
It is estimated that about 40% of patients with type 1 or type 2 diabetes will have diabetic kidney disease. The suggested progression of this disorder is glomerular hyperfiltration due to a high-pressure state caused by elevated blood sugar, proteinuria due to glomerular damage, and chronic renal failure to renal hypoperfusion. Recent studies show that this progression is not always linear. Given the prevalence of this disease in diabetics, it is best practice to screen for diabetic kidney disease on a yearly basis with a urinary albumin to creatinine ratio and a serum creatine. Treatment is based on slowing the progression of diabetic kidney disease by controlling the blood glucose levels, targeting blood pressure below 130/80, inhibiting the RAAS, and inhibiting SGLT activity.
Thu, 11 Feb 2021 - 15min - 115 - Podcast 70: Proteinuria in Children
Dear Listeners,
An estimated 10% of school-aged children will have proteinuria. About 0.1% of them will have persistent hematuria requiring further investigation.
Transient proteinuria can be caused by stress, exercise, cold exposure, dehydration, and orthostasis.
Persistent proteinuria can be caused by Glomerular or Tubular Disease. Glomerular disease is most common with differential including infections (Strep Throat, Mono), collagen vascular diseases (HSP, SLE), glomerulopathies and malignancies. Tubular disease is usually caused by exposure to medications such as NSAIDs, or antibiotics.
A positive dipstick or urinalysis should always be verified with a morning sample to rule out orthostatic or transient proteinuria. If persistence is noted, this should be followed up with a Protein/Creatinine ratio to assess severity of the disease. A Renal ultrasound is helpful in ruling out structural causes such as malignancy and PCKD. Treatment is variable and diagnosis dependent. It will be usually be decided by a nephrologist or a paediatrician.
Please visit the membership page!
Posted on 03/12/2020 by Dr. DimitreFri, 04 Dec 2020 - 17min - 114 - Podcast 69: C-Reactive Protein and Erythrocyte Sedimentation Rate
The C-Reactive Protein and the Erythrocyte Sedimentation Rate are both lab tests used to measure inflammation in the body. They are usually elevated during infectious, inflammatory, and malignant diseases.
Sun, 11 Oct 2020 - 15min - 113 - Podcast 68: Treatment of Male Hypogonadism
As a follow up to podcast 67, Eric Harvey, a 3rd year Mcgill medical student, is joining the Primary Medicine Podcast to go over the treatment approach for male hypogonadism.
It is important to consider both benefits and risks of testosterone therapy, before initiating treatment. The clearest benefit is to men with abnormally low serum testosterone levels who present with sexual dysfunction. The clearest risks are erythrocytosis, cardiac, and prostate disease. It is important to do routine testosterone, lipids, hematocrit, and PSA levels.
There are many different forms of testosterone therapy ranging from oral to intramuscular. The choice of medication is based on patient preference, cost, and side effect profile.
We end the podcast with a brief discussion about Eric and his classmate’s experiences during the COVID shutdown. A situation without a recent historical precedent.Thu, 06 Aug 2020 - 41min - 112 - Episode 67: Late-onset hypogonadism
In podcast 67, Dr. Dimitre will cover the diagnostic approach to late-onset hypogonadism also known as andropause. Late-onset hypogonadism (LOH), causes a gradual yearly decrease in testosterone levels of 1 to 2% in men over the age of 40. While this condition is commonly known as Andropause there is no cessation of hormone production. However, just like menopause, this change in hormone levels can lead to a significant reduction in the quality of life of patients.
Sun, 21 Jun 2020 - 16min - 111 - Episode 66: Constipation in the Elderly with Dr. Kevin
Dear Listeners,
Constipation, or decrease in stool frequency and hardening in stool consistency, is a common issue in the elderly and can affect their quality of life significantly.
Dr. Kevin has a 4 step approach to constipation in the elderly. Step one is making the diagnosis, remembering that constipation is a symptom with an underlying cause. Step two is ruling out any red flags, including ones that suggest a malignancy. Step three is identifying any contributing factors, including any physical barriers for the patient to go to the bathroom. Finally, step four is to treat the whole patient.
A word of warning for the pun averse, avoid the last 1 minute of the podcast.
Link to Physician Empowerment
Please visit the membership page!
Posted on 30/03/2020 by Dr. Dimitre
This Podcast is eligible for 0,50 Mainpro Non-Certified credits. Login to CFPC to claim them.Tue, 31 Mar 2020 - 35min - 110 - Episode 65: Secondary Headaches with Dr. Kevin
Betty Boop is having a horrid secondary headache!
Dear Listeners,
A headache is considered secondary when it is related to an underlying medical condition. About 10% of patients presenting with headache are suffering from a secondary cause.
Dr. Kevin’s approach to secondary headaches is anatomical in nature. Moving from the outside in, he suggests considering environmental causes (Carbon Monoxide Poisoning), hypertensive disorders, infections of the upper respiratory tract, ocular diseases, and issues inside the skull.
Dr. Kevin reminds us that primary headaches are a diagnosis, while secondary headaches are a symptom. Many medical conditions can cause headache, but there are usually clues in the medical history or examination to suggest secondary headache. These include visual changes, abrupt onset, onset after 50 years of age, and fever.
Please visit the membershippage!
Posted on 19/01/2020 by Dr. Dimitre
This Podcast is eligible for 0,50 Mainpro Non-Certified credits. Login to CFPC to claim them.Mon, 20 Jan 2020 - 28min - 109 - Episode 64: Aphthous Ulcers
Aphthous Ulcers, also known as canker sores, affect about 25% of the population. They are considered benign as long as they are small (less than 1 cm), self-limiting (resolve within 3-4 weeks), and not associated with any additional symptoms (such as fever). Consider the differential for mouth ulcers as being infectious or non-infectious. The most common infectious causes are herpes simplex, herpangina, and hand foot and mouth disease. Non-healing ulcers should be biopsied to rule out squamous cell carcinoma of the oral cavity. Treatment of benign ulcers is focused on pain relief with topical anaesthetic, steroids or antibiotics being the most effective.
Posted on 30/10/2019 by Dr. Dimitre
This Podcast is eligible for 0,25 Mainpro Non-Certified credits. Login to CFPC to claim them.
Thu, 31 Oct 2019 - 14min - 108 - Episode 63: Endocrine Emergencies with Dr. Pabani
Endocrine Emergencies are rare but deadly conditions that can be hard to diagnose and manage. This can lead to long treatment delays and potentially life-threatening complications.
In podcast 63, Dr Wahid and Dr. Dimitre will cover some of the most common emergencies relating to the thyroid (myxedema coma, thyroid storm, thyroiditis), adrenal glands (adrenal crisis, pheochromocytoma), and pancreas (diabetic ketoacidosis, hyperglycaemic hyperosmolar non-ketotic coma, euglycemic DKA.
Please visit the membership page!
Posted on 15/06/2019 by Dr. Dimitre
This Podcast is eligible for 0,5 Mainpro Non-Certified credits. Login to CFPC to claim themFri, 16 Aug 2019 - 30min - 107 - Episode 62: New Urinary Tract Infection Guidelines
Approximately 60% of women will experience a urinary tract infection if their lifetime. Up to twenty percent of them will experience multiple current episodes on a yearly basis.
For the first time, the American Urological Association (AUA) has issued a guidelinefor the diagnosis and treatment of uncomplicated recurrent urinary tract infections (UTIs), which emphasizes the importance of cultures and antibiotic stewardship.
In this podcast episode, Dr. Dimitre will summarize the recommendations of the guideline and discuss who to incorporate them into everyday family practice.
Please visit the membership page!
Posted on 15/06/2019 by Dr. Dimitre
This Podcast is eligible for 0,25 Mainpro Non-Certified credits. Login to CFPC to claim themSun, 16 Jun 2019 - 31min - 106 - Episode 61: Familial hypercholesterolemia with Dr. Pabani
Clogged Arteries due to LDL deposits
For podcast 61, Dr. Wahid makes a comeback to talk about Familial Hypercholesterolemia (FH) while Dr. Dimitre bemoans the weather in Ottawa yet again.
Familial Hypercholesterolemia (FH) is a condition that affects about 1 in 500 Canadians and is an important cause of early cardiovascular death yet it is relatively unknown by primary care physicians. Patients should be screened according to current lipid guidelines and if they present with a premature cardiovascular event, physical stigmata of hypercholesterolemia, or premature cardiovascular disease in their immediate family members. Formal diagnosis requires the use of the Dutch Criteria Cardiovascular risk is underestimated by the usual risk calculators. Consider all patients with FH as high risk and treat accordingly.
Posted on 18/04/2019 by Dr. Dimitre
This Podcast is eligible for 0,25 Mainpro Non-Certified credits. Login toCFPCto claim them.Thu, 18 Apr 2019 - 19min - 105 - Podcast 60: Aspirin in Primary Prevention for Cardiovascular Disease
Dear Listeners,
After a bit of an unplanned hiatus, we are back with podcast number 60 and with Dr Pabani, rural doc extraordinaire. Aspirin is having a really tough time lately with three studies taking the shine off its role in primary prevention of cardiovascular disease.
During the podcast, Dr. Dimitre and Dr. Wahid go over the ASCEND, ARRIVE, and ASPREE trial and discuss how they have changed their approach to using the venerable medication in their practice.
Please visit the membership page!
Posted on 24/02/2019 by Dr. DimitreMon, 25 Feb 2019 - 20min - 104 - Podcast 59: Marfan Syndrome
Dear Listeners,
For our last podcast of the year, Dr. Dimitre talks about Marfan syndrome.
It is an autosomal dominant disorder of the connective tissue that affects three major systems: cardiovascular, muskuloskeletal, and ocular.
Most individuals who have Marfan’s are asymptomatic until complications arise. Most commonly they will have aortic dilation, mitral valve prolapse, scoliosis and ectopia lentis.
Diagnosis is clinical and based on the Ghent criteria. This is a calculator that can simplify the process. With proper follow up and prevention individuals with this syndrome will live normal lives.
Please visit the membership page!
Posted on 29/11/2018 by Dr. DimitreFri, 30 Nov 2018 - 17min - 103 - Podcast 58: Irritable Child with Dr. Kevin
Dr. Kevin is back for our 58th podcast to talk about his approach to diagnosing inconsolable infants.
Unexplained irritability in the clinic setting needs to be assessed as an urgent medical presentation. Up to 5% of fussy children will have an organic cause to their distress.
As Dr. Kevin explains, there are a lot of badnesses lurking in the abdomen and head of an inconsolable crying infant including meningitis, trauma, intussusception, and appendicitis. Keep your differential broad and do a full physical exam even if you find a red tympanic membrane.
Please visit the membership page!
Posted on 30/10/2018 by Dr. Dimitre
Wed, 31 Oct 2018 - 35min - 102 - Podcast 57: Acquired Long QTc Syndrome
Dr. Dimitre is back with the 57th episode of the primary medicine podcast! Acquired long QTc syndrome is a disorder of the rhythm of the heart. It can lead to ventricular arrhythmias, such as Torsades de Pointe, and possibly ventricular fibrillation and death.
It is caused by QTc prolonging medications which include antidepressants, antibiotics, antibiotics, antipsychotics and antiarrhythmics. Acquired Long QTc syndrome can also be potentiated by hypokalemia and hypomagnesemia.
Diagnosis is based on the calculated interval time in a resting ECG. Consider ordering one in a patient who has 2 or more of the syndrome causing medications. Patients who are symptomatic (palpitations, presyncope and syncope) should be referred to cardiology.
Please visit the membership page!
Posted on 28/09/2018 by Dr. DimitreSat, 29 Sep 2018 - 15min - 101 - Podcast 56: Nocturnal Leg Cramps with Dr. Pabani
Dr. Wahid Pabani, rural doctor extraordinaire, is back for our 56th podcast to talk about Nocturnal Leg Cramps! OUCH!
This very common and distressing condition has many causes from the mundane (such as muscle fatigue) to the serious (such as peripheral vascular disease, or Parkinson Disease).
Thankfully, a focused history and physical exam can help rule out most worrisome etiologies. Unfortunately, Nocturnal Leg Cramps can be difficult to manage due uncertainties in optimal treatments. There is some limited evidence that exercise and stretching, vitamin B12 and Magnesium, and Calcium Channel blockers may be helpful.
Please visit the membership page!
Posted on 18/08/2018 by Dr. DimitreSun, 19 Aug 2018 - 21min - 100 - Podcast 55: Intussuception with Dr. Kevin
Dr. Kevin is back four our 55th podcast and he brought a surprise tiny guest. He will be talking about Intussusception. This is a life-threatening condition which mostly affects children below the age of three. It occurs when one part of the intestine slides into the adjacent part of the intestine. This causes bowel ischemia, obstruction, and possible perforation.
The cause of most cases of intussusception in children is unknown. Though rare in adults, most cases of adult intussusception are the result of an underlying medical condition, such as a tumor.
Please visit the membership page!
Posted on 17/06/2018 by Dr. DimitreMon, 16 Jul 2018 - 22min - 99 - Podcast 54: Subclinical Hypothyroidism
After a short hiatus, Dr. Dimitre is back to talk about subclinical hypothyroidism. Sometimes referred to as mild thyroid failure, it is diagnosed when peripheral thyroid hormone (T3 and T4) levels are within the normal range, but thyroid stimulating hormone (TSH) is mildly elevated.
It is common, occurring in 10% of the population, and carries a risk of progression to overt hypothyroidism of around 5% per year. There is no consensus on which patients should be treated, although there are some recommendations.
Please visit the membership page!
Posted on 17/06/2018 by Dr. DimitreMon, 18 Jun 2018 - 17min - 98 - Podcast 53: Spondylolisthesis with Dr. Kevin
Dr. Kevin is back for our 53rd podcast. This time we will be talking about Spondylolisthesis. Spondylolisthesis is anterior displacement of a vertebral body relative to the adjacent inferior vertebral body. It is a common condition of young athletes that can present with intermittent back pain.
Diagnosis is based on imaging with lumbar X-Ray being the gold standard. Be aware of the risks of imaging the spine, however. You have a high chance of findings that are not related to the patient’s symptoms.
Please visit the membership page!
Posted on 30/04/2018 by Dr. DimitreTue, 01 May 2018 - 21min - 97 - Podcast 52: Pruritis with Dr. Dimitre
For our latest podcast, Dr. Dimitre is itching to talk about itching! Pruritus is a challenging presentation for two reasons. Firstly, the differential is broad encompassing conditions both benign and malignant. Secondly, the patient is often suffering and looking for a quick solution to his problem. It is thus important to have a clear and efficient approach.
Generally, the differential can be divided into dermatological causes, which are many, and systemic causes, which are usually concerning. Consider that Hodgkin lymphoma has a strong association pruritus, which occurs in up to 30 percent of patients with the disease. Consider also that generalized itching in an older individual is considered a red flag for a serious medical issue. Prompt bloodwork and close follow up is highly suggested in those individuals.
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Posted on 28/03/2018 by Dr. DimitreWed, 28 Mar 2018 - 22min - 96 - Podcast 51: Concussion with Dr. Pabani
Its winter yet again in Canada. That means slippery ice, broken bones, and concussions! Rural Doc Extraordinaire Wahid is back to talk about concussions. It is a medical condition that has entered the entered the public consciousness with the recent NFL scandal and the aptly named Will Smith movie.
It is most often caused by head trauma experienced during falls (due to slippery Canadian ice), motor vehicle collisions, and sports injuries. The diagnosis is purely clinical and is based on physical and cognitive symptoms. Questionnaires such as the SCAT 5 and The Rivermead Post-Concussion Symptoms Questionnaire are extremely helpful with diagnosis and follow up.
Treatment is symptom-based and usually includes cognitive and physical rest. Most patients will get better within a month. Some will suffer from prolonged symptoms.
We also talk about the updated version of The 99 CFPC exam study guide which can be accessed at our website or on Amazon.
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Posted on 22/02/2018 by Dr. DimitreThu, 22 Feb 2018 - 28min - 95 - Podcast 50: Evidence Based Medicine with Dr. Ken Milne
Dr. Dimitre and Dr. Kevin are back after a short holiday break!
Our 50th podcast and now more than 5000 listeners monthly! What better way to celebrate than by bringing in someone much cleverer than ourselves to talk… Introducing Dr. Ken Milne – founder of the outstanding Skeptics Guide to Emergency Medicine. Visit SGEMS here at http://thesgem.com/
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Posted on 11/01/2018 by Dr. DimitreThu, 11 Jan 2018 - 34min - 94 - Episode 49: Syncope with Dr. Kevin
Episode 49 of our podcast showcases Dr. Kevin’s prowess with children as he presents his approach to syncope while taking care of his grouchy 12 mo! Syncope has many causes from the mundane to the deadly and requires a systematic detailed workup. Dr. Kevin takes the time to review the broad differential of this presentation. Not all syncope is vasovagal. All patients should have an ECG!
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Posted on 14/11/2017 by Dr. DimitreWed, 15 Nov 2017 - 41min - 93 - Episode 48: Beaver Fever with Dr. Pabani!
Dr. Wahid and Dr. Dimitre are back for podcast #48! Giardiasis, also known, as beaver fever is one of the most common parasitic human diseases globally. It usually presents with chronic diarrhea, abdominal pain, and weight loss. Symptoms may begin 2-4 weeks after initial exposure to the parasitic cyst and may last up to 4-6 weeks. It is diagnosed using stool tests and treated with Flagyl.
Please visit our membership page to access the podcast.
Posted on 09/10/2017 by Dr. DimitreTue, 10 Oct 2017 - 13min - 92 - Episode 47: Hand Foot and Mouth Disease!
Dr. Dimitre survived the plague that is hand foot and mouth disease and he is back to tell the tale. Hand foot and mouth disease is a summertime viral infection that presents with painful lesions on the palms, soles, and the oral cavity. It usually affects children under 10. Thankfully it rarely lasts more than a week and is usually treated with supportive management.
Please visit our membership page to access the podcast.
Posted on 05/08/2017 by Dr. Dimitre
Wed, 06 Sep 2017 - 13min - 91 - Episode 46: Nasal Fractures with Dr. Kevin!
Dr Mailo joins is back for our 46th podcast! The topic was inspired by one of our friends having a syncopal episode and breaking his noggin. The nasal bones are the most commonly fractured bony structures of the face. Patients with nasal fractures will often present to the emergency department with bleeding, swelling, and bruising. Furthermore, they may have septal hematomas which need to be drained or may cause severe cosmetic complications.
Please visit our membership page to access the podcast.
Posted on 05/08/2017 by Dr. DimitreSat, 05 Aug 2017 - 24min
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