title

The Rounds Table

Dr. Kieran Quinn MD MSc FRCP(C)

8
Followers
10
Plays
The Rounds Table
The Rounds Table

The Rounds Table

Dr. Kieran Quinn MD MSc FRCP(C)

8
Followers
10
Plays
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About Us

The Rounds Table is a free weekly medical podcast covering the latest and most important research from major medical journals. It is intended for all practicing healthcare professionals and aims to to help them keep up to date in the care of their patients.

Latest Episodes

The Grand Finale of The Rounds Table

This week we bring you a very special episode, the final episode of The Rounds Table podcast. This episode is dedicated to honouring the show and its development over the past five seasons. The show has had an incredibly successful past five years – the podcast has reached an international audience and has been downloaded in 152 countries with over 320,000 downloads to date. During this time, we have developed an evaluations committee, created interview-based special segments, hosted author engagement interviews, and become available across multiple streaming platforms. This past year we have expanded the show to include multiple international co-hosts spanning Australia to the United Kingdom to North America. The Rounds Table has been an opportunity for students and professionals in a variety of fields (health care, technology, and more) to come together, share and appraise medical literature. More than this, it has become a hub of creativity, entertaining on-air personalities, an...

32 MINJUN 28
Comments
The Grand Finale of The Rounds Table

REPLAY: Sugar and Spice – Canagliflozin and Renal Outcomes and Quality of Life in Atrial Fibrillation

Kieran Quinn, general internist and palliative care physician in Toronto, is joined by Emily Hughes, the producer of the show and soon-to-be Internal Medicine resident at the University of Toronto on this weeks episode of The Rounds Table!Together they are covering canagliflozin and renal outcomes, and quality of life among patients with atrial fibrillation receiving catheter ablation versus medical therapy. Type 2 diabetes mellitus is a leading cause of kidney failure; our current treatments include blockade of the renin-angiotensin-aldosterone system. Sodium-glucose transport protein 2 (SGLT2) inhibitors initially designed for glycemic control may provide additional benefits, such as renal protection. Emily discusses the CREDENCE trial, which was designed to assess the effects of canagliflozin compared to placebo on renal outcomes in patients with type 2 diabetes mellitus and albuminuric chronic kidney disease. Patients with atrial fibrillation seek medical attention often if they are symptomatic.When catheter ablation was first introduced it was a final resort therapy but now it is more widely used for treatment of atrial fibrillation. Kieran covers an important companion paper on quality of life outcomes for the CABANA trial discussed on a previous episode on the show. He reviews quality of life among patients with atrial fibrillation receiving catheter ablation compared with medical therapy. Finally,the Good Stuff segment. Emily shares an article on using the Butterfly iQ ultrasound probe that connects to an iPhone designed to bring point-of-care ultrasound to Ugandan communities. Kieran highlights a prosthetic voice that decodes what the brain plans to say and creates intelligible sentences from this. Like what you hear? Rate us on iTunes! Chat with us on Twitter at @roundstable and tweet at Kieran Quinn @kieranlquinn and Emily Hughes @emmy_hughes. Interested in helping us evaluate our podcast episodes? We’re currently recruiting a panel of residents to serve as regular reviewers for the show. If you’re interested, emailwkwong@qmed.ca. The Papers 1.CREDENCE Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1811744 2. CABANA Trial: https://jamanetwork.com/journals/jama/article-abstract/2728675 Good Stuff 1.Phones as Ultrasound Scanners - https://www.nytimes.com/2019/04/15/health/medical-scans-butterfly-iq.html 2. Artificial Speech – https://www.nytimes.com/2019/04/24/health/artificial-speech-brain-injury.html Music Credits The Rounds Table Theme Music by Brendan Quinn, Creative Director and Composer, Vapor RMW

27 MINJUN 21
Comments
REPLAY: Sugar and Spice – Canagliflozin and Renal Outcomes and Quality of Life in Atrial Fibrillation

Fire It Up: Delayed tPA, Lipids and Cardiovascular Outcomes, Stroke Prevention, and Fournier’s Gangrene with SGLT2 Inhibitors

Michael Fralick and John Fralick, general internists in Toronto, are back on The Rounds Table and they are covering four articles in a rapid-fire style. They discuss the use of tissue plasminogen activator (tPA) up to 9 hours after stroke onset, nonfasting versus fasting lipids and cardiovascular outcomes, the use of dabigatran for stroke prevention, and sodium-glucose cotransporter-2 (SGLT2) inhibitors and the risk of Fournier’s gangrene. The gold standard for ischemic stroke is intravenous thrombolysis or tPA if patients present within four and a half hours of symptom onset. After this, there are worse outcomes and risk of bleeding. Perfusion imaging has allowed identification of areas of brain that may be salvageable. John covers an article on thrombolysis guided by perfusion imaging up to nine hours after onset of stroke, compared to placebo, assessing outcomes including score on the modified Rankin scale and safety profile. Guidelines have recommended routine testing of nonfas...

31 MINJUN 14
Comments
Fire It Up: Delayed tPA, Lipids and Cardiovascular Outcomes, Stroke Prevention, and Fournier’s Gangrene with SGLT2 Inhibitors

Slow Motion: Magnesium in Afib and Fall-Related Injuries with Sleep Aids

Christopher Giuliano, clinical pharmacist, is hosting this week’s episode of The Rounds Table alongside Insaf Mohamad, ambulatory care clinical pharmacist in Internal Medicine. Together they are covering treatment of atrial fibrillation with rapid ventricular response with magnesium and falls risk with trazadone and benzodiazepines in patients with insomnia. Atrial fibrillation is the most common cardiac arrhythmia. Patients with rapid ventricular response can be challenging to manage with multiple pharmacologic options. Chris shares the LOMAGHI study on low-dose versus high-dose magnesium versus placebo in the management of atrial fibrillation, comparing the improvement in meeting goal ventricular rate. Managing insomnia is difficult in older adults especially given the side effects associated with certain prescribed sleep aids. Insaf highlights an article evaluating fall-related injuries (emergency visits or hospitalizations) in patients residing in a nursing home when newly pres...

31 MINJUN 7
Comments
Slow Motion: Magnesium in Afib and Fall-Related Injuries with Sleep Aids

A Shock to The Heart: Risk Factors and Cardiovascular Events in T2DM and Cardioversion in AFib

Andre Maddison, General Internal Medicine (GIM) fellow at Western University, is hosting this week’s episode on The Rounds Table alongside his wife, Emily Wilson, family physician in London and adjunct professor at Western University.Together they are covering risk factors, death, and cardiovascular events in patients with type 2 diabetes mellitus (T2DM) and early or delayed cardioversion in new atrial fibrillation. Patients with T2DM are at a higher risk for myocardial infarction and cerebrovascular events.Interventions are targeted at modifying the key risk factors that lead to such events. Emily shares an article that examines the excess risk of death and cardiovascular events in patients with type 2 diabetes mellitus with risk factors modified to the acceptable ranges, compared to the general population. There are practice variations in terms of how to best manage acute, symptomatic, new-onset but stable atrial fibrillation in the Emergency Department. Next, Andre discusses an ...

20 MINMAY 31
Comments
A Shock to The Heart: Risk Factors and Cardiovascular Events in T2DM and Cardioversion in AFib

A Total Eclipse: Treatment of Status Epilepticus and Aclidinium Bromide in COPD

Freddy Frost, research fellow in cystic fibrosis in Liverpool, and Alex Pickard, trainee in acute and emergency medicine in South London, are back on The Rounds Table this week.They are covering treatment of paediatric convulsive status epilepticus and the effect of aclidinium bromide on cardiovascular events and exacerbations in patients with chronic obstructive pulmonary disease (COPD) who are high-risk. Convulsive status epilepticus in the paediatric population is managed using the Advanced Paediatric Life Support (APLS) algorithm. After two doses of benzodiazepines, in the APLS algorithm the next step is second-line treatment. There is a gap in high-quality literature to support second-line agents and these medications have differences in terms of ease of administration, preparation, and drug interactions. Alex summarizes the EcLiPSE trial, comparing the efficacy and safety of levetiracetam to phenytoin for second-line treatment for status epilepticus in the paediatric populatio...

30 MINMAY 24
Comments
A Total Eclipse: Treatment of Status Epilepticus and Aclidinium Bromide in COPD

Infectious Love: Coronary Angiography in Out-of-Hospital Cardiac Arrest and Risk of HIV Transmission in Serodifferent Gay Couples

Jonathan Gravel, family medicine resident at the University of Toronto and soon-to-be emergency medicine resident, is joined by Max Deschner, a resident in Internal Medicine at Western University. Together they are covering coronary angiography after cardiac arrest without ST-elevation (COACT trial) and the risk of HIV transmission through condomless sex in serodifferent gay couples. Ischemic heart disease is one of the leading causes of out-of-hospital cardiac arrest. Patients with out-of-hospital cardiac arrest undergo complex management and consideration of coronary angiography.Immediate PCI (percutaneous coronary intervention) in patients with STEMI (ST-elevation myocardial infarction) improves mortality but how about beyond STEMI, who should undergo PCI?Max shares the COACT trial, which compared immediate versus delayed coronary angiography in patients following out-of-hospital cardiac arrest without STEMI; survival at 90 days was analyzed. Previous literature has provided info...

37 MINMAY 17
Comments
Infectious Love: Coronary Angiography in Out-of-Hospital Cardiac Arrest and Risk of HIV Transmission in Serodifferent Gay Couples

Sugar and Spice: Canagliflozin and Renal Outcomes and Quality of Life in Atrial Fibrillation

Kieran Quinn, general internist and palliative care physician in Toronto, is joined by Emily Hughes, the producer of the show and soon-to-be Internal Medicine resident at the University of Toronto on this weeks episode of The Rounds Table!Together they are covering canagliflozin and renal outcomes, and quality of life among patients with atrial fibrillation receiving catheter ablation versus medical therapy. Type 2 diabetes mellitus is a leading cause of kidney failure; our current treatments include blockade of the renin-angiotensin-aldosterone system. Sodium-glucose transport protein 2 (SGLT2) inhibitors initially designed for glycemic control may provide additional benefits, such as renal protection. Emily discusses the CREDENCE trial, which was designed to assess the effects of canagliflozin compared to placebo on renal outcomes in patients with type 2 diabetes mellitus and albuminuric chronic kidney disease. Patients with atrial fibrillation seek medical attention often if they...

27 MINMAY 10
Comments
Sugar and Spice: Canagliflozin and Renal Outcomes and Quality of Life in Atrial Fibrillation

REPLAY: Are Your Vitamins Vital? Cardiorespiratory Fitness on Mortality and Vitamin Supplementation for Prevention of Cancer and Cardiovascular Disease

Katie Wiskar, fellow in General Internal Medicine at the University of British Columbia, and Kate Shoults, general internist in the Greater Vancouver Area, are joining us on The Rounds Table this week! They are covering the association between cardiorespiratory fitness and long-term mortality, and vitamin D and omega-3 fatty acids and the prevention of cancer death and cardiovascular disease. Cardiorespiratory fitness is linked to better health – but does this always hold true that the more exercise the better?Kate covers an article on this in a cohort of patients who underwent exercise stress testing primarily for obstructive coronary artery disease. She discusses all-cause mortality as it relates to cardiorespiratory fitness and whether or not this plays a role as a prognostic variable. It is known that vitamin D is good for bone health and osteoporosis. It has been suggested that in regions with the most sun exposure, there may be lower incidences of cancer and cardiovascular disease; however there have not been any randomized control trials on this. Moreover, the Canadian Cardiovascular Society recommends omega-3 fatty acids for patients with heart failure. What is the evidence behind this? Katie walks listeners through two articles (VITAL trial) on vitamin D supplementation and omega-3 fatty acids compared to placebo and the prevention of cancer and cancer death and major cardiovascular events. Finally, the Good Stuffsegment. Kate shares an article in The Washington Post on the importance of understanding probability and the accuracy of tests that we rely so heavily on in medicine. Katie shares a blog post that summarizes the top 50 innovative ideas in medicine brought forth at a four-day gathering called the Exponential Medicine 2018. Like what you hear? Rate us on iTunes! Chat with us on Twitter at @roundstable and tweet at Katie Wiskar @katiewiskar. Interested in helping us evaluate our podcast episodes? We’re currently recruiting a panel of residents to serve as regular reviewers for the show. If you’re interested, emailwkwong@qmed.ca. The Papers 1.Fitness: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2707428 2. VITAL: https://www.nejm.org/doi/full/10.1056/NEJMoa1809944 Good Stuff 1.What the tests don’t show: https://www.washingtonpost.com/news/posteverything/wp/2018/10/05/feature/doctors-are-surprisingly-bad-at-reading-lab-results-its-putting-us-all-at-risk/?noredirect=onandamp;utm_term=.80217dfb1858 2. Exponential Medicine 2018: http://www.gregoryschmidt.ca/writing/exponential-medicine-2018-top-50-ideas Music Credits The Rounds Table Theme Music by Brendan Quinn, Creative Director and Composer, Vapor RMW

31 MINMAY 3
Comments
REPLAY: Are Your Vitamins Vital? Cardiorespiratory Fitness on Mortality and Vitamin Supplementation for Prevention of Cancer and Cardiovascular Disease

Left my Heart in CABANA: TAVRs, Atrial Fibrillation, and Acute Coronary Syndrome

Michael Fralick and John Fralick, both general internists in Toronto, are on The Rounds Table this week. In classic fashion, they are covering four articles in a rapid-fire style. They discuss transcatheter aortic valve replacement (TAVR) in low surgical risk patients, antiplatelet and anticoagulants in atrial fibrillation (AF) and acute coronary syndrome (ACS) with percutaneous coronary intervention (PCI), catheter ablation for AF, and determining the 99thpercentile of high sensitivity troponin for a hospital population. TAVR is superior to surgical valve replacement in high risk surgical patients with severe, symptomatic, aortic stenosis. TAVR is non-inferior in intermediate surgical risk patients. John covers an article examining the safety of TAVR compared to surgical aortic valve replacement in low surgical risk patients. For patients with AF and ACS requiring PCI, what antithrombotic therapy should they remain on? Mike shares the AUGUSTUS trial examining this population to ans...

26 MINAPR 26
Comments
Left my Heart in CABANA: TAVRs, Atrial Fibrillation, and Acute Coronary Syndrome

Latest Episodes

The Grand Finale of The Rounds Table

This week we bring you a very special episode, the final episode of The Rounds Table podcast. This episode is dedicated to honouring the show and its development over the past five seasons. The show has had an incredibly successful past five years – the podcast has reached an international audience and has been downloaded in 152 countries with over 320,000 downloads to date. During this time, we have developed an evaluations committee, created interview-based special segments, hosted author engagement interviews, and become available across multiple streaming platforms. This past year we have expanded the show to include multiple international co-hosts spanning Australia to the United Kingdom to North America. The Rounds Table has been an opportunity for students and professionals in a variety of fields (health care, technology, and more) to come together, share and appraise medical literature. More than this, it has become a hub of creativity, entertaining on-air personalities, an...

32 MINJUN 28
Comments
The Grand Finale of The Rounds Table

REPLAY: Sugar and Spice – Canagliflozin and Renal Outcomes and Quality of Life in Atrial Fibrillation

Kieran Quinn, general internist and palliative care physician in Toronto, is joined by Emily Hughes, the producer of the show and soon-to-be Internal Medicine resident at the University of Toronto on this weeks episode of The Rounds Table!Together they are covering canagliflozin and renal outcomes, and quality of life among patients with atrial fibrillation receiving catheter ablation versus medical therapy. Type 2 diabetes mellitus is a leading cause of kidney failure; our current treatments include blockade of the renin-angiotensin-aldosterone system. Sodium-glucose transport protein 2 (SGLT2) inhibitors initially designed for glycemic control may provide additional benefits, such as renal protection. Emily discusses the CREDENCE trial, which was designed to assess the effects of canagliflozin compared to placebo on renal outcomes in patients with type 2 diabetes mellitus and albuminuric chronic kidney disease. Patients with atrial fibrillation seek medical attention often if they are symptomatic.When catheter ablation was first introduced it was a final resort therapy but now it is more widely used for treatment of atrial fibrillation. Kieran covers an important companion paper on quality of life outcomes for the CABANA trial discussed on a previous episode on the show. He reviews quality of life among patients with atrial fibrillation receiving catheter ablation compared with medical therapy. Finally,the Good Stuff segment. Emily shares an article on using the Butterfly iQ ultrasound probe that connects to an iPhone designed to bring point-of-care ultrasound to Ugandan communities. Kieran highlights a prosthetic voice that decodes what the brain plans to say and creates intelligible sentences from this. Like what you hear? Rate us on iTunes! Chat with us on Twitter at @roundstable and tweet at Kieran Quinn @kieranlquinn and Emily Hughes @emmy_hughes. Interested in helping us evaluate our podcast episodes? We’re currently recruiting a panel of residents to serve as regular reviewers for the show. If you’re interested, emailwkwong@qmed.ca. The Papers 1.CREDENCE Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1811744 2. CABANA Trial: https://jamanetwork.com/journals/jama/article-abstract/2728675 Good Stuff 1.Phones as Ultrasound Scanners - https://www.nytimes.com/2019/04/15/health/medical-scans-butterfly-iq.html 2. Artificial Speech – https://www.nytimes.com/2019/04/24/health/artificial-speech-brain-injury.html Music Credits The Rounds Table Theme Music by Brendan Quinn, Creative Director and Composer, Vapor RMW

27 MINJUN 21
Comments
REPLAY: Sugar and Spice – Canagliflozin and Renal Outcomes and Quality of Life in Atrial Fibrillation

Fire It Up: Delayed tPA, Lipids and Cardiovascular Outcomes, Stroke Prevention, and Fournier’s Gangrene with SGLT2 Inhibitors

Michael Fralick and John Fralick, general internists in Toronto, are back on The Rounds Table and they are covering four articles in a rapid-fire style. They discuss the use of tissue plasminogen activator (tPA) up to 9 hours after stroke onset, nonfasting versus fasting lipids and cardiovascular outcomes, the use of dabigatran for stroke prevention, and sodium-glucose cotransporter-2 (SGLT2) inhibitors and the risk of Fournier’s gangrene. The gold standard for ischemic stroke is intravenous thrombolysis or tPA if patients present within four and a half hours of symptom onset. After this, there are worse outcomes and risk of bleeding. Perfusion imaging has allowed identification of areas of brain that may be salvageable. John covers an article on thrombolysis guided by perfusion imaging up to nine hours after onset of stroke, compared to placebo, assessing outcomes including score on the modified Rankin scale and safety profile. Guidelines have recommended routine testing of nonfas...

31 MINJUN 14
Comments
Fire It Up: Delayed tPA, Lipids and Cardiovascular Outcomes, Stroke Prevention, and Fournier’s Gangrene with SGLT2 Inhibitors

Slow Motion: Magnesium in Afib and Fall-Related Injuries with Sleep Aids

Christopher Giuliano, clinical pharmacist, is hosting this week’s episode of The Rounds Table alongside Insaf Mohamad, ambulatory care clinical pharmacist in Internal Medicine. Together they are covering treatment of atrial fibrillation with rapid ventricular response with magnesium and falls risk with trazadone and benzodiazepines in patients with insomnia. Atrial fibrillation is the most common cardiac arrhythmia. Patients with rapid ventricular response can be challenging to manage with multiple pharmacologic options. Chris shares the LOMAGHI study on low-dose versus high-dose magnesium versus placebo in the management of atrial fibrillation, comparing the improvement in meeting goal ventricular rate. Managing insomnia is difficult in older adults especially given the side effects associated with certain prescribed sleep aids. Insaf highlights an article evaluating fall-related injuries (emergency visits or hospitalizations) in patients residing in a nursing home when newly pres...

31 MINJUN 7
Comments
Slow Motion: Magnesium in Afib and Fall-Related Injuries with Sleep Aids

A Shock to The Heart: Risk Factors and Cardiovascular Events in T2DM and Cardioversion in AFib

Andre Maddison, General Internal Medicine (GIM) fellow at Western University, is hosting this week’s episode on The Rounds Table alongside his wife, Emily Wilson, family physician in London and adjunct professor at Western University.Together they are covering risk factors, death, and cardiovascular events in patients with type 2 diabetes mellitus (T2DM) and early or delayed cardioversion in new atrial fibrillation. Patients with T2DM are at a higher risk for myocardial infarction and cerebrovascular events.Interventions are targeted at modifying the key risk factors that lead to such events. Emily shares an article that examines the excess risk of death and cardiovascular events in patients with type 2 diabetes mellitus with risk factors modified to the acceptable ranges, compared to the general population. There are practice variations in terms of how to best manage acute, symptomatic, new-onset but stable atrial fibrillation in the Emergency Department. Next, Andre discusses an ...

20 MINMAY 31
Comments
A Shock to The Heart: Risk Factors and Cardiovascular Events in T2DM and Cardioversion in AFib

A Total Eclipse: Treatment of Status Epilepticus and Aclidinium Bromide in COPD

Freddy Frost, research fellow in cystic fibrosis in Liverpool, and Alex Pickard, trainee in acute and emergency medicine in South London, are back on The Rounds Table this week.They are covering treatment of paediatric convulsive status epilepticus and the effect of aclidinium bromide on cardiovascular events and exacerbations in patients with chronic obstructive pulmonary disease (COPD) who are high-risk. Convulsive status epilepticus in the paediatric population is managed using the Advanced Paediatric Life Support (APLS) algorithm. After two doses of benzodiazepines, in the APLS algorithm the next step is second-line treatment. There is a gap in high-quality literature to support second-line agents and these medications have differences in terms of ease of administration, preparation, and drug interactions. Alex summarizes the EcLiPSE trial, comparing the efficacy and safety of levetiracetam to phenytoin for second-line treatment for status epilepticus in the paediatric populatio...

30 MINMAY 24
Comments
A Total Eclipse: Treatment of Status Epilepticus and Aclidinium Bromide in COPD

Infectious Love: Coronary Angiography in Out-of-Hospital Cardiac Arrest and Risk of HIV Transmission in Serodifferent Gay Couples

Jonathan Gravel, family medicine resident at the University of Toronto and soon-to-be emergency medicine resident, is joined by Max Deschner, a resident in Internal Medicine at Western University. Together they are covering coronary angiography after cardiac arrest without ST-elevation (COACT trial) and the risk of HIV transmission through condomless sex in serodifferent gay couples. Ischemic heart disease is one of the leading causes of out-of-hospital cardiac arrest. Patients with out-of-hospital cardiac arrest undergo complex management and consideration of coronary angiography.Immediate PCI (percutaneous coronary intervention) in patients with STEMI (ST-elevation myocardial infarction) improves mortality but how about beyond STEMI, who should undergo PCI?Max shares the COACT trial, which compared immediate versus delayed coronary angiography in patients following out-of-hospital cardiac arrest without STEMI; survival at 90 days was analyzed. Previous literature has provided info...

37 MINMAY 17
Comments
Infectious Love: Coronary Angiography in Out-of-Hospital Cardiac Arrest and Risk of HIV Transmission in Serodifferent Gay Couples

Sugar and Spice: Canagliflozin and Renal Outcomes and Quality of Life in Atrial Fibrillation

Kieran Quinn, general internist and palliative care physician in Toronto, is joined by Emily Hughes, the producer of the show and soon-to-be Internal Medicine resident at the University of Toronto on this weeks episode of The Rounds Table!Together they are covering canagliflozin and renal outcomes, and quality of life among patients with atrial fibrillation receiving catheter ablation versus medical therapy. Type 2 diabetes mellitus is a leading cause of kidney failure; our current treatments include blockade of the renin-angiotensin-aldosterone system. Sodium-glucose transport protein 2 (SGLT2) inhibitors initially designed for glycemic control may provide additional benefits, such as renal protection. Emily discusses the CREDENCE trial, which was designed to assess the effects of canagliflozin compared to placebo on renal outcomes in patients with type 2 diabetes mellitus and albuminuric chronic kidney disease. Patients with atrial fibrillation seek medical attention often if they...

27 MINMAY 10
Comments
Sugar and Spice: Canagliflozin and Renal Outcomes and Quality of Life in Atrial Fibrillation

REPLAY: Are Your Vitamins Vital? Cardiorespiratory Fitness on Mortality and Vitamin Supplementation for Prevention of Cancer and Cardiovascular Disease

Katie Wiskar, fellow in General Internal Medicine at the University of British Columbia, and Kate Shoults, general internist in the Greater Vancouver Area, are joining us on The Rounds Table this week! They are covering the association between cardiorespiratory fitness and long-term mortality, and vitamin D and omega-3 fatty acids and the prevention of cancer death and cardiovascular disease. Cardiorespiratory fitness is linked to better health – but does this always hold true that the more exercise the better?Kate covers an article on this in a cohort of patients who underwent exercise stress testing primarily for obstructive coronary artery disease. She discusses all-cause mortality as it relates to cardiorespiratory fitness and whether or not this plays a role as a prognostic variable. It is known that vitamin D is good for bone health and osteoporosis. It has been suggested that in regions with the most sun exposure, there may be lower incidences of cancer and cardiovascular disease; however there have not been any randomized control trials on this. Moreover, the Canadian Cardiovascular Society recommends omega-3 fatty acids for patients with heart failure. What is the evidence behind this? Katie walks listeners through two articles (VITAL trial) on vitamin D supplementation and omega-3 fatty acids compared to placebo and the prevention of cancer and cancer death and major cardiovascular events. Finally, the Good Stuffsegment. Kate shares an article in The Washington Post on the importance of understanding probability and the accuracy of tests that we rely so heavily on in medicine. Katie shares a blog post that summarizes the top 50 innovative ideas in medicine brought forth at a four-day gathering called the Exponential Medicine 2018. Like what you hear? Rate us on iTunes! Chat with us on Twitter at @roundstable and tweet at Katie Wiskar @katiewiskar. Interested in helping us evaluate our podcast episodes? We’re currently recruiting a panel of residents to serve as regular reviewers for the show. If you’re interested, emailwkwong@qmed.ca. The Papers 1.Fitness: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2707428 2. VITAL: https://www.nejm.org/doi/full/10.1056/NEJMoa1809944 Good Stuff 1.What the tests don’t show: https://www.washingtonpost.com/news/posteverything/wp/2018/10/05/feature/doctors-are-surprisingly-bad-at-reading-lab-results-its-putting-us-all-at-risk/?noredirect=onandamp;utm_term=.80217dfb1858 2. Exponential Medicine 2018: http://www.gregoryschmidt.ca/writing/exponential-medicine-2018-top-50-ideas Music Credits The Rounds Table Theme Music by Brendan Quinn, Creative Director and Composer, Vapor RMW

31 MINMAY 3
Comments
REPLAY: Are Your Vitamins Vital? Cardiorespiratory Fitness on Mortality and Vitamin Supplementation for Prevention of Cancer and Cardiovascular Disease

Left my Heart in CABANA: TAVRs, Atrial Fibrillation, and Acute Coronary Syndrome

Michael Fralick and John Fralick, both general internists in Toronto, are on The Rounds Table this week. In classic fashion, they are covering four articles in a rapid-fire style. They discuss transcatheter aortic valve replacement (TAVR) in low surgical risk patients, antiplatelet and anticoagulants in atrial fibrillation (AF) and acute coronary syndrome (ACS) with percutaneous coronary intervention (PCI), catheter ablation for AF, and determining the 99thpercentile of high sensitivity troponin for a hospital population. TAVR is superior to surgical valve replacement in high risk surgical patients with severe, symptomatic, aortic stenosis. TAVR is non-inferior in intermediate surgical risk patients. John covers an article examining the safety of TAVR compared to surgical aortic valve replacement in low surgical risk patients. For patients with AF and ACS requiring PCI, what antithrombotic therapy should they remain on? Mike shares the AUGUSTUS trial examining this population to ans...

26 MINAPR 26
Comments
Left my Heart in CABANA: TAVRs, Atrial Fibrillation, and Acute Coronary Syndrome