Medical Rewrites

The rewrite today is for Edward Scissorhands. The deep dive is about prevention of infection from skin injuries.Movie suggestion form: https://tinyurl.com/8pa8sveyReferences used in this episodeTopical antibiotic sourcesEffectiveness of calamine lotion as an adjunctive therapy to mometasone furoate ointment in the treatment of infant eczema: A retrospective study. Medicine (Baltimore). 2022 Sep 2;101(35):e30237.. https://pubmed.ncbi.nlm.nih.gov/36107506/The value of prophylactic antibiotics for simple lacerations. Surg Gynecol Obstet. 1983 Feb;156(2):212-6.. https://pubmed.ncbi.nlm.nih.gov/6337421/The natural history of streptococcal skin infection: prevention with topical antibiotics. J Am Acad Dermatol. 1985 Aug;13(2 Pt 1):207-12. https://pubmed.ncbi.nlm.nih.gov/2995463/Prospective evaluation of topical antibiotics for preventing infections in uncomplicated soft-tissue wounds repaired in the ED. Acad Emerg Med. 1995 Jan;2(1):4-10. https://pubmed.ncbi.nlm.nih.gov/7606610/A prospective, randomized pilot evaluation of topical triple antibiotic versus mupirocin for the prevention of uncomplicated soft tissue wound infection. Am J Emerg Med. 2004 Jan;22(1):1-3. https://pubmed.ncbi.nlm.nih.gov/14724869/Tetanus sourcesTetanus. Lancet. 2019 Apr 20;393(10181):1657-1668. https://pubmed.ncbi.nlm.nih.gov/30935736/ACIP recommendations on TdP vaccine 2019 https://pubmed.ncbi.nlm.nih.gov/31971933/ACIP recommendations on Td prevention and vaccination in 2018 https://pubmed.ncbi.nlm.nih.gov/29702631/Tetanus surveillance CDC https://www.cdc.gov/tetanus/php/surveillance/index.html

The rewrite today is for The Menu. The deep dive is about infections associated with eating dry aged meat.Movie suggestion form: https://tinyurl.com/8pa8sveyReferences used in this episodeSymposium review: An abundance of replacement heifers: What is the economic impact of raising more than are needed? https://pubmed.ncbi.nlm.nih.gov/32037180/ Eating and cooking retired dairy cow: https://livefrankly.co.uk/sustainable-food/what-is-retired-dairy-beef-how-to-cook-the-chefs-secret-weapon-at-home/ Investigating Bacterial Penetration of the Blood-Brain Barrier for the Pathogenesis, Prevention, and Therapy of Bacterial Meningitis. https://pubmed.ncbi.nlm.nih.gov/31805229/ Post-splenectomy Sepsis: A Review of the Literature. https://pubmed.ncbi.nlm.nih.gov/32195065/ Acute bacterial meningitis in adults. https://pubmed.ncbi.nlm.nih.gov/27265346/ Exploring the microbiological quality and safety of dry-aged beef: A cross-sectional study of loin surfaces during ripening and dry-aged beef steaks from commercial meat companies in Belgium. https://pubmed.ncbi.nlm.nih.gov/34809945/ Dry-aged beef manufactured in Japan: Microbiota identification and their effects on product characteristics. https://pubmed.ncbi.nlm.nih.gov/33648250/ Metabolic and microbial analyses of the surface and inner part of wet-aged and dry-aged beef. https://pubmed.ncbi.nlm.nih.gov/37807472/ Microbiota associated with commercial dry-aged beef in France. https://pubmed.ncbi.nlm.nih.gov/38448091/ National Outbreak Reporting System (NORS) https://wwwn.cdc.gov/norsdashboard/

The rewrite today is for We’re the Millers. The deep dive is about management of tarantula attack. Movie suggestion form: https://tinyurl.com/8pa8sveyReferences used in this episodeTarantula bite referencesA verified spider bite and a review of the literature confirm Indian ornamental tree spiders (Poecilotheria species) as underestimated theraphosids of medical importance. Toxicon. https://pubmed.ncbi.nlm.nih.gov/24215987/Wessel's tiger ornamental tarantula bite envenomation: A case report and venom analysis. https://pubmed.ncbi.nlm.nih.gov/36592763/A Case Report on Generalised Muscle Spasms After Ornamental Tarantula Bites That Responded Well to Intravenous Calcium Gluconate Treatment. Cureus. https://pubmed.ncbi.nlm.nih.gov/37692640/Tarantulas: eight-legged pharmacists and combinatorial chemists. https://pubmed.ncbi.nlm.nih.gov/15066413/Animal Venom Peptides as a Treasure Trove for New Therapeutics Against Neurodegenerative Disorders. https://pubmed.ncbi.nlm.nih.gov/30378475/Urticaria caused by tarantula hairs. https://pubmed.ncbi.nlm.nih.gov/4684884/The optical imaging of tarantula hair corneal injury: One case report and review of the literature. https://pubmed.ncbi.nlm.nih.gov/28736046/“Spider bite” infections"Spider bite" lesions are usually diagnosed as skin and soft-tissue infections. https://pubmed.ncbi.nlm.nih.gov/19939602/A clone of methicillin-resistant Staphylococcus aureus among professional football players. https://pubmed.ncbi.nlm.nih.gov/15689585/Treatment of spider venom-associated muscle crampsMuscle spasms - A common symptom following theraphosid spider bites? https://pubmed.ncbi.nlm.nih.gov/33493497/Differential block of sodium and calcium channels by chlorpromazine in mouse neuroblastoma cells. https://pubmed.ncbi.nlm.nih.gov/2157837/Chlorpromazine (thorazine) in the treatment of intractable hiccups. https://pubmed.ncbi.nlm.nih.gov/13221413/Chlorpromazine in the treatment of stubborn hiccup. https://pubmed.ncbi.nlm.nih.gov/14374117/Pharmacologic Interventions for Intractable and Persistent Hiccups: A Systematic Review. https://pubmed.ncbi.nlm.nih.gov/29079070/

Welcome back to Medical Rewrites. Let’s call this Season 2. That makes the unplanned sabbatical from last year feel purposeful. At the time of launching the podcast last Summer, I had written several episodes and had what I thought was a lot of runway. I was able to continue to write during the Fall semester. But when Spring semester hit, I was in the weeds. The other parts of my job like teaching and patient care are my priorities and they get the best version of myself. The podcast got the left overs. The writing felt burdensome and the creativity was inadequate. So I sacrificed the podcast until I was ready to write again. Which was this summer. I went to my Grandparents cabin, sat on the porch – which is the best spot to be able to steal wifi from the neighbors – I started writing again and made a plan for the year.This is the plan: episodes will be released every 4 weeks. There are bonus episodes as well but those dates have not been finalized.Thank you for your patience. Thank you for keeping Medical Rewrites in your podcast rotation. I hope you find lots of clinical pearls because I have been shucking a lot of oysters.

The rewrite today is for Trainwreck. The deep dive is about drug-drug interactions between alcohol and antibiotics. Movie suggestion form: https://tinyurl.com/8pa8sveyReferences used in this episodeFact versus Fiction: a Review of the Evidence behind Alcohol and Antibiotic Interactions https://pubmed.ncbi.nlm.nih.gov/31871085/ Doxycycline PK after whiskey or wine https://pubmed.ncbi.nlm.nih.gov/7113712/  Doxycycline + rifampin for Brucellosis infection in rats fed alcohol https://pubmed.ncbi.nlm.nih.gov/16323439/  Doxycycline + rifampin PK changes in human Brucellosis infections https://www.ncbi.nlm.nih.gov/pmc/articles/PMC188288/     Long-term alcohol consumption and half-life of erythromycin and doxycycline https://pubmed.ncbi.nlm.nih.gov/1002368/  Tyramine concentrations in alcohol https://pubmed.ncbi.nlm.nih.gov/28824206/, https://pubmed.ncbi.nlm.nih.gov/34655830/  Linezolid and tyramine and increase in SBP https://pubmed.ncbi.nlm.nih.gov/11361052/                    Cephalosporin induced disulfiram-like reaction: a retrospective review of 78 cases. https://pubmed.ncbi.nlm.nih.gov/24670024/  Cephalosporin induced hypoprothrombinemia due to side chains of N-methylthiotetrazole (latamoxef, cefmenoxime, cefoperazone, cefotetan, cefamandole) https://pubmed.ncbi.nlm.nih.gov/3350995/   Metronidazole plus alcohol in rats https://pubmed.ncbi.nlm.nih.gov/10798595/ RCT metronidazole plus alcohol in humans https://pubmed.ncbi.nlm.nih.gov/12022894/ Retro case-control of pts admitted after ethanol who received metronidazole https://pubmed.ncbi.nlm.nih.gov/37494646/  Z-drugs adverse reactions https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8077048/ Zolpidem plus alcohol and ICU admission https://pubmed.ncbi.nlm.nih.gov/20458214/ 

The rewrite today is for Knives Out. The deep dive is about pain management of musculoskeletal injuries.Movie suggestion form: https://tinyurl.com/8pa8sveyReferences used in this episode Clinical Practice Guidelines for Pain Management in Acute Musculoskeletal Injury by the Orthopaedic Trauma Association Musculoskeletal Pain Task Force https://pubmed.ncbi.nlm.nih.gov/30681429/ Nonpharmacologic and Pharmacologic Management of Acute Pain From Non-Low Back, Musculoskeletal Injuries in Adults: A Clinical Guideline From the American College of Physicians and American Academy of Family Physicians INFOGRAPHIC INCLUDED https://pubmed.ncbi.nlm.nih.gov/32805126/ Oxycodone vs ibuprofen vs. combo tx for the treatment of pain after abdominal or pelvic surgery in women RCT https://pubmed.ncbi.nlm.nih.gov/15763605/ RCT topical diclofenac/menthol vs. placebo for ankle sprain pain https://pubmed.ncbi.nlm.nih.gov/28345425/ RCT topical diclofenac gel, ibuprofen gel, and ibuprofen gel with levomenthol for musculoskeletal injuries https://pubmed.ncbi.nlm.nih.gov/31353997/ RCT: ketorolac 60 mg IM vs ibuprofen 800 mg PO for acute musculoskeletal pain https://pubmed.ncbi.nlm.nih.gov/7618770/ RCT: ketorolac 60 mg vs 15 mg for acute musculoskeletal pain https://pubmed.ncbi.nlm.nih.gov/34365063/ Post-market surveillance study of ketorolac and GI bleeds https://pubmed.ncbi.nlm.nih.gov/8569017/ Nested-case control for NSAID-associated heart failure admissions https://pubmed.ncbi.nlm.nih.gov/27682515/ Drug Information summary about ketorolac duration by Christie Denton, PharmD, BCPS https://dig.pharmacy.uic.edu/faqs/2022-2/september-2022-faqs/what-evidence-is-there-for-the-5-day-maximum-with-the-use-of-ketorolac/

Our medical rewrite today will be for Knocked Up. The deep dive will be about flatulence and conjunctivitis.Movie suggestion form: https://tinyurl.com/8pa8sveyReferences used in this episode Frequency of eye-related problems see in primary care https://pubmed.ncbi.nlm.nih.gov/1936738/ Microbiology of conjunctivitishttps://pubmed.ncbi.nlm.nih.gov/24150468/https://pubmed.ncbi.nlm.nih.gov/28535396/https://pubmed.ncbi.nlm.nih.gov/1936738/https://pubmed.ncbi.nlm.nih.gov/28499285/ Systematic review of signs and symptoms between viral and bacterial conjunctivitis https://pubmed.ncbi.nlm.nih.gov/35699701/ Research about gaseous components of fartshttps://pubmed.ncbi.nlm.nih.gov/18128419/https://pubmed.ncbi.nlm.nih.gov/32900799/https://pubmed.ncbi.nlm.nih.gov/31520080/https://pubmed.ncbi.nlm.nih.gov/24150797/ Story about farting on a blood agar platehttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1121900/https://www.abc.net.au/science/k2/homework/s312551.htm Rectal colonization of GAS by physician and post-partum outbreak https://pubmed.ncbi.nlm.nih.gov/1928189/ Virome review https://pubmed.ncbi.nlm.nih.gov/35753153/ Postulating about SARS-CoV-2 spread through farts https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7716952/

Our medical rewrite today will be for 28 Days. The deep dive will be about medical management of alcohol use disorder. Movie suggestion form: https://tinyurl.com/8pa8svey References used in this episode Mechanisms of medications used for alcohol use disorder https://pubmed.ncbi.nlm.nih.gov/35133639/ LiverTox of disulfiram https://www.ncbi.nlm.nih.gov/books/NBK548103/ COMBINE study comparing naltrexone vs. acamprosate and medication management vs. cognitive behavior intervention https://pubmed.ncbi.nlm.nih.gov/16670409/ Meta-analysis of naltrexone and acamprosate for alcohol use disorder https://pubmed.ncbi.nlm.nih.gov/24825644/ Meta-analysis of long-acting naltrexone injection vs placebo https://pubmed.ncbi.nlm.nih.gov/34033183/ CYP2D6 Overview https://www.ncbi.nlm.nih.gov/books/NBK574601/ Hydrocodone pain control in CYP2D6 slow metabolizers https://pubmed.ncbi.nlm.nih.gov/34423496/ Systematic review of naltrexone efficacy in women with alcohol use disorder https://pubmed.ncbi.nlm.nih.gov/28247556/ Sex differences and opioid use https://pubmed.ncbi.nlm.nih.gov/24508560/ Review on sex/hormone differences and opioid effects https://pubmed.ncbi.nlm.nih.gov/34995646/ Acamprosate efficacy based on sex https://pubmed.ncbi.nlm.nih.gov/21895717/

Our medical rewrite today will be for CODA. The deep dives will be about Dermatophyte infections – aka ring worm.Movie suggestion form: https://tinyurl.com/8pa8sveyReferences used in this episode Epidemiology and etiology of tinea infections· https://pubmed.ncbi.nlm.nih.gov/18478365/· https://pubmed.ncbi.nlm.nih.gov/33900539/· https://pubmed.ncbi.nlm.nih.gov/15097959/ Large case series of tinea scrotum https://pubmed.ncbi.nlm.nih.gov/37072674/ Effects of temperature and humidity on penetration of dermatophytes into human stratum https://pubmed.ncbi.nlm.nih.gov/14615792/ Tinea infections transmitted from sexual contact – MUST SEE PICTURES TO APPRECIATE SEVERITY· https://pubmed.ncbi.nlm.nih.gov/11913763/· https://pubmed.ncbi.nlm.nih.gov/26071391/· https://pubmed.ncbi.nlm.nih.gov/37347803/ British Association of Dermatologists' guidelines for the management of onychomycosis https://pubmed.ncbi.nlm.nih.gov/25409999/ UpToDate Dermatophyte infections https://www.uptodate.com/contents/dermatophyte-tinea-infections#H1217398057 Cochrane review of topical antifungal treatments for tinea cruris and tinea corporis https://pubmed.ncbi.nlm.nih.gov/25090020/ Superficial fungal infection review out of Australia from 2019 https://pubmed.ncbi.nlm.nih.gov/31569324/

The medical rewrite today is for Wedding Crashers. The deep dives will be about tetrahydrozoline, an active ingredient in eye drops and sugar alcohols. Please note that this podcast discusses the poisoning found in the movie Wedding Crashers.Movie suggestion form: https://tinyurl.com/8pa8sveyReferences Systemic absorption after topical administration of tetrahydrozoline https://pubmed.ncbi.nlm.nih.gov/21972870/ Alpha 2 agonism on the GI track https://pubmed.ncbi.nlm.nih.gov/6148675/ Absolutely wild toxicology study of tetrahydrozoline in 19 infants from 1956 https://pubmed.ncbi.nlm.nih.gov/13295960/ Case report and of CV toxicity after oral tetrahydrozoline https://pubmed.ncbi.nlm.nih.gov/15388224/ Tetrahydrozoline toxicity review of the literature https://pubmed.ncbi.nlm.nih.gov/24760708/ Use of tetrahydrozoline in sexual assault· https://pubmed.ncbi.nlm.nih.gov/22554870/· https://pubmed.ncbi.nlm.nih.gov/37278617/ Incredible reviews of Haribo Gummy Bears made with maltitol https://www.buzzfeednews.com/article/michaelrusch/haribo-gummy-bear-reviews-on-amazon-are-the-most-insane-thin Diarrhea dose finding study in adult males https://pubmed.ncbi.nlm.nih.gov/12548293/ Diarrhea dose finding study in adult females https://pubmed.ncbi.nlm.nih.gov/18797153/ Maltitol organic chemistry – making it a solution https://pubmed.ncbi.nlm.nih.gov/32698373/

Our medical rewrite today will be for Cast Away. The deep dives will be about dental abscesses and coral injuries. This podcast contains both plot spoilers and descriptions of medical problems found in Cast Away.Movie suggestion form: https://tinyurl.com/8pa8sveyReferences used in this episode Microbiology of dental infections:· https://pubmed.ncbi.nlm.nih.gov/34571794/· https://pubmed.ncbi.nlm.nih.gov/37294354/ Susceptibilities of oral pathogens https://pubmed.ncbi.nlm.nih.gov/35568274/ A beautiful review article – would be exception if the authors had cited primary literature. Clemence MA, Guerrant RL. Infections and Intoxications from the Ocean: Risks of the Shore. Microbiol Spectr. 2015 Dec;3(6). PMID: 27337286. https://pubmed.ncbi.nlm.nih.gov/27337286/ A case report that will make you think twice about romantic evenings in the ocean https://pubmed.ncbi.nlm.nih.gov/6490813/ Retrospective study comparing antibiotic regiments for treatment of Vibrio bloodstream infections. This is the best data I found on the topic. https://pubmed.ncbi.nlm.nih.gov/31188821/ Case series of Shewanella infections https://pubmed.ncbi.nlm.nih.gov/35573023/

Our medical rewrite today will be for Wolf of Wall Street, the deep dives will be about cocaine and methaqualone.Movie suggestion form: https://tinyurl.com/8pa8sveyReferences used in this episode Cocaine and the cardiovascular system· Review https://pubmed.ncbi.nlm.nih.gov/28662796/· Review https://pubmed.ncbi.nlm.nih.gov/21156654/ Cocaine and sexual function systematic review https://pubmed.ncbi.nlm.nih.gov/37085960/ Rat study about nitric oxide and cocaine https://pubmed.ncbi.nlm.nih.gov/9657630/ Sexual behavior and cocaine/heroin use· Survey https://pubmed.ncbi.nlm.nih.gov/20545385/· Survey https://pubmed.ncbi.nlm.nih.gov/28471320/ Study of PD5 inhibitors and nitric oxide production https://pubmed.ncbi.nlm.nih.gov/19371941/ Methaqualone review https://pubmed.ncbi.nlm.nih.gov/36651763/

My name is Meghan Jeffres and I am the host of Medical Rewrites where we rewrite movie scenes with evidence-based medicine. More importantly it is about redemption. On this podcast we will fix the medical plot points that keep us up and night staring at the ceiling asking – why didn’t the script writers just call me? This podcast for the clinicians that can’t help but lean over to their neighbor in the theater and whisper “That is wrong” during every medical scene. We know they don’t care, but we just can’t help it. I am an Associate Professor at the University of Colorado Skaggs School of Pharmacy on the Anschutz Medical Campus where I teach infectious diseases and clinical problem solving. I have been hospital-based internal medicine and infectious diseases pharmacist since I completed my ID residency in 2006. My research focuses are antibiotic adverse reactions, allergies, and active learning. My plan is to work my way through the list of movies, that I genuinely adore, but have medical plot points that fall short of best practices. For each movie we will identify medical issues, do a deep dive on the topic, and rewrite the scene or dialogue. I goal is to release episodes every 2 weeks. The topics covered with be 50/50 mix of ID and internal med topics. I will be bringing in experts to take us on their own deep dives and rewrites.If you have a movie that needs a rewrite. I have a Google form on the website where you can release your rage about medical plot points that are responsible for your grey hair. The Medical Rewrites podcast would not have been possible without the support of my bosses at CU – shout out to Ralph Altiere and Doug Fish. I am also standing on the shoulders of podcast giants that came before me and offered their support - Lauren Biehle, Stacy Volk, Jamie Wagner, Julie Justo, and Erin McCreary – you are all the absolute best.

Our medical rewrite today will be for Bridesmaids. We have two deep dives today, tattoo infections and foodborne diarrhea. Please note that this podcast contains both plot spoilers and descriptions of infectious diseases found in the movie Bridesmaids.Movie suggestion form: https://tinyurl.com/8pa8sveyReferences2012 investigation of tattoo infections in Rochester New York: https://pubmed.ncbi.nlm.nih.gov/22913660/ 2019 investigation of tattoo infections in Miami: https://pubmed.ncbi.nlm.nih.gov/30452604/ Systematic review of tattoo infection pathogens: https://pubmed.ncbi.nlm.nih.gov/27788747/ Pharmacodynamic calculations: Cephalexin 1 g, will result in a peak of 30 mcg/mL in one hour, a 1 hour half-life, and an MIC for Strep or Staph of 4 mcg/mL, results in a percent time above MIC of around 50%.IDSA Guidelines on Infectious Diarrhea: https://pubmed.ncbi.nlm.nih.gov/29194529/Acute diarrhea review with rehydration recipes: https://pubmed.ncbi.nlm.nih.gov/35839362/Risks of antimotility medication after consumption of contaminated foods: https://pubmed.ncbi.nlm.nih.gov/15844055/ , https://pubmed.ncbi.nlm.nih.gov/22895383/RCT: loperamide vs. rifaximin vs. combination: https://pubmed.ncbi.nlm.nih.gov/17382603/TrEAT TD RCT: https://pubmed.ncbi.nlm.nih.gov/29029033/ESBL acquisition with antibiotic and travelers diarrhea: https://pubmed.ncbi.nlm.nih.gov/25613287/Resistance Map: https://resistancemap.onehealthtrust.org/ESBL acquisition with loperamide and antibiotics: https://pubmed.ncbi.nlm.nih.gov/26691898/