Recap of random pearls and highlights from SGIM19 Day 1 including: Kidney stone treatment (roller coasters, sex and tamsulosin), aspirin, SGLT2 inhibitors to reduce kidney events, oral antibiotics for endocarditis, preferred physician attire, sexual harassment, writing letters of recommendation, triple therapy for COPD, DAPT for stroke, and more! Special thanks to the Society for General Internal Medicine for their hospitality. Full show notes available at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written, produced, and cohosted by: Paul Williams MD, Matthew Watto MD, Justin Berk MD, Carolyn Chan MD, Shreya Trivedi MD, Abby Spencer MD, MS, Nora Taranto MS4 (soon to be MD!) Edited by: Matthew Watto MD Special Guest: Abby Spencer MD, MS  Time Stamps and Links are included below 00:00 Intro and Disclaimer 02:33 Abby explains what it means to attend SGIM 04:35 Tips for writing letters of recommendation 08:54 How to handle lapses of professionalism in a trainee 10:30 How to address sexual harassment 12:42 Oral antibiotics after 10 days of IV antibiotics are noninferior for left sided endocarditis in non-IVDU (NEJM 2019) 14:22 Patients prefer physicians to dress in more formal attire. (BMJ Open 2018) 16:29 Kidney stone passage occurs more frequently when sitting in the back car of a roller coaster (J Am Osteopath Assoc 2018) 18:00 Sexual intercourse three times weekly improves rate of kidney stone passage (Urology 2015) 18:58 Vancomycin coverage for hospital acquired pneumonia can safely be stopped after four days if cultures remain negative for MRSA (Chest 2019) 20:00 Notes that contain stigmatizing language are associated with negative provider feelings and less aggressive pain management (JGIM 2018) 21:10 Medication errors are less frequent if the medication reconciliation is performed at time of ICU discharge (Ann Intensive Care 2018) 21:56 Five of six pediatricians found Lego heads in their stool after intentional ingestion (J Paediatric Child Health 2018). 24:40 Canagliflozin (SGLT2 inhibitor) improved renal outcomes and cardiovascular events (Credence trial, NEJM 2019; Check out the Freely Filtered (NephJC podcast coverage)) Triple therapy for COPD with LAMA/LABA/ICS is superior to dual therapy (IMPACT trial NEJM 2018) 27:20 The ASCEND trial of aspirin for primary prevention in patients with diabetes contained 97 percent white patients and showed similar NNT to NNH for cardioprotection and bleeding respectively (ASCEND trial NEJM 2018) 28:45 Consider a short course of dual antiplatelet therapy for minor stroke or high risk TIA (BMJ 2018) 30:07 Omega-3 fatty acids decreased cardiovascular events in patients whose triglycerides remained elevated despite statin therapy (REDUCE-IT trial NEJM 2019) 30:24 Tamsulosin did not help pass stones under 5 mm, but might be effective for stones >5 mm (J Fam Pract 2018) 31:06 Trainees who are stressed during residency tend to stay stressed (I was unable to quickly locate this citation. Sorry. -Dr. Watto) 32:02 How does our team choose their pearls for the recap show 35:21 A needs assessment at University of Michigan found that female residents want to learn skills on leadership, negotiation and giving pitches to prepare them for careers in medicine (Poster by Dr Jennifer Lukela). 36:57 Abby Spencer received an AAIM Innovations grant: “Key steps to rise for women trainees in leadership development”. 38:42 Outro