JAMA Clinical Reviews

JAMA Clinical Reviews

jama.jamanetwork.com/journal.aspx
Author interviews that explore the latest clinical reviews.


Guns and Suicide
Jul 16 • 27 min
Using firearms to commit suicide is one of the most common causes of firearm related deaths. This can happen even in families where it seems highly unlikely to occur. In this podcast, we tell the story of a policeman’s daughter who got a hold of his…
Subclinical Hypothyroidism
Jul 9 • 16 min
Subclinical hypothyroidism is common, but it is not clear how best to treat it. Anne R. Cappola, MD, ScM, professor of medicine at the University of Pennsylvania, explains how to manage this important clinical condition. Read the article: Subclinical…
The Clinical Ramifications of Dense Breasts
Jul 2 • 23 min
There are now 36 states and recent federal legislation that require that clinicians inform women about breast density results from mammography. Consequently, clinicians must be aware of the clinical ramifications of dense breasts and what to do about…
California’s Attempt to Improve Measles Vaccination Rates
Jul 2 • 19 min
California enacted 3 aggressive laws between 2014 and 2016 in an effort to improve measles vaccination rates. To a large extent these laws were effective in increasing vaccination rates, but some of the improvements were offset by clinicians granting…
Reducing the Intensity of Antiplatelet Therapy Following Coronary Stent Procedures
Jun 25 • 11 min
A conversation with Greg Curfman, MD, JAMA Deputy Editor and a cardiologist, who reviews 2 new studies showing that a short duration of dual antiplatelet therapy may not result in more myocardial ischemic events. Read the article: Effect of 1-Month…
The Gabby Giffords Shooting
Jun 11 • 32 min
Over the span of less than a minute, a gunman with a history of mental health issues turned a Safeway parking lot into the scene of a mass shooting, killing 6 and wounding 13 in 20 seconds. In this inaugural episode of the In Our Lane podcast series,…
Abnormal Uterine Bleeding
Jun 4 • 34 min
Andrew M. Kaunitz, MD, from the Department of Obstetrics and Gynecology at the University of Florida, Jacksonville, explains how to diagnose and treat various patterns of abnormal uterine bleeding. Read the article: Abnormal Uterine Bleeding in…
Menopausal Hormone Therapy
May 30 • 29 min
Jan L. Shifren, MD, from the department of obstetrics and gynecology, Massachusetts General Hospital, and Harvard Medical School discusses menopausal symptoms such as hot flashes and how they can be effectively treated by the administration of…
Cervical Cancer Screening
May 28 • 9 min
George F. Sawaya, MD, professor of obstetrics and gynecology at the University of California, San Francisco, discusses cervical cancer screening in the modern era. Read the article: Cervical Cancer Screening: More Choices in 2019 Read the transcript…
Treating Nonmetastatic Breast Cancer in 2019
May 7 • 29 min
Breast cancer outcomes continue to improve. Treatments for the disease are very effective and continually evolving. We spoke with Patricia A. Ganz, MD, from UCLA about what is new in breast cancer treatment. Read the article here.
JAMA Women’s Health Series Introduction by Dr Carolyn Crandall
May 7 • 2 min
Dr Carolyn Crandall, professor of medicine at the David Geffen School of Medicine at UCLA and JAMA Associate Editor, introduces JAMA’s new series of articles on women’s health.
Beyond the Rhetoric: Gun Control That Works, Part 3
Apr 9 • 25 min
Congressman Mike Thompson chairs the US House Gun Violence Prevention Taskforce. He spoke with us about what the House has done to address gun violence and what you can do to help them see necessary legislation make it into law. We also talk with…
How to Reduce Maternal Mortality Rates in the United States
Apr 2 • 27 min
Maternal mortality rates in most of the United States are high. These rates were successfully lowered in the United Kingdom and also in California. Many of these deaths are preventable. In this podcast we interview Elizabeth A. Howell, MD, MPP, from…
Beyond the Rhetoric: Gun Control That Works, Part 2
Mar 26 • 26 min
Almost nothing is more controversial than gun control in the United States. Yet while passions flare and legislators posture but do little, deaths from gun violence are all too common. Almost every proposal put forward to address gun violence…
Update on Atrial Fibrillation: Review of the New AHA/ACC/HRS Treatment Guidelines
Mar 15 • 42 min
Cardiologist and JAMA Deputy Editor Greg Curfman, MD, discusses the many changes in the new AHA/ACC/HRS atrial fibrillation guidelines with University of Chicago cardiologists Gaurav Upadhyay, MD, and Francis Alenghat, MD, PhD. Major changes include…
Beyond the Rhetoric: Gun Control That Works, Part 1
Mar 12 • 27 min
Almost nothing is more controversial than gun control in the United States. Yet while passions flare and legislators posture but do little, deaths from gun violence are all too common. Almost every proposal put forward to address gun violence…
Is It Safe? What Happens When Your Surgeon Is Not Actually Doing Some of Your Operation?
Feb 26 • 24 min
Great controversy exists regarding the safety of surgery when the attending surgeon allows someone else to perform parts of the operation. These practices are necessary components of surgical training, but how safe this is for patients remains…
COPD: All You Need to Know in 20 Minutes
Feb 26 • 21 min
COPD is common enough that it is responsible for 3% of all clinic visits in the United States. Clinicians will undoubtedly deal with this disease in their practice. How to diagnose and manage it is reviewed by Frank C. Sciurba, MD, a professor of…
Next Generation Sequencing of Infectious Pathogens in Public Health and Clinical Practice
Feb 14 • 25 min
Next-generation sequencing is a catchall term for new, high-throughput technologies that allow rapid sequencing of a full genome. It can be used to sequence a patient’s DNA in diagnosing a genetic disorder or characterizing a cancer, but can also be…
Can I Believe the Results From Observational Studies? Using E-Values That Anyone Can Calculate for Evaluating the Risk of Confounding
Feb 12 • 28 min
E-values are a new tool that enables investigators to estimate the likelihood that some unmeasured confounder might overcome seemingly positive results. They are very easy to calculate and any reader of the medical literature can do this calculation…
Your Watch Can Tell You the Time and If You Are About to Die From a Cardiac Arrhythmia
Jan 29 • 14 min
Saved by a Fitbit. Technology is developing at a pace far exceeding its application in medical care. An exception is in consumer devices, which as long as they do not hold themselves out as diagnostic tools, can apply as many technologies to wearable…
Screening for Breast Cancer: Is It Worth It?
Jan 22 • 17 min
Breast cancer screening is debated passionately among those who advocate for very aggressive screening and other experts who believe that screening can be harmful. The arguments for all sides of the debate are best understood by knowing the numbers of…
Major Societies Agree – A New Approach to Penicillin Allergy Is Needed
Jan 15 • 35 min
Very few people who think they are allergic to penicillin actually are. Yet, even if someone reports a remote and vague history of penicillin allergy, these very useful medications will not be given. This forces many patients to use antibiotics that…
Medical Emergencies While Flying
Dec 21, 2018 • 29 min
When flying and they call “Is there a licensed medical professional on board,” should physicians respond? If so, what should they do? Are they liable if things go wrong? We interview Christian Martin-Gill, MD, MPH, Department of Emergency Medicine,…
Bayes for Clinicians Who Need to Know but Don’t Like Math
Dec 11, 2018 • 28 min
The statistical concept of Bayes comes up in clinical medicine all the time. It simply means that what you know about something factors into how you analyze it. This contrasts with the commonly used statistical approach called frequentist analysis of…
Battle of the Heart Societies, Part 2: Who Is Right – the US or Europe Regarding How to Manage Hypertension? Their Differences
Nov 20, 2018 • 38 min
Within the last 2 years, major guidelines have been issued from US-based and European organizations that differ in their recommendations for the diagnosis and treatment of hypertension. Experts from both sides of the Atlantic—Paul Whelton, MD, from…
A Family’s Struggle With Alcoholism
Nov 13, 2018 • 31 min
What is it like to go through alcohol withdrawal at home? What is it like for a mother to sit by her son’s side while he goes through withdrawal and supporting him? Why does someone who doesn’t have any particular reason to drink misuse alcohol? The…
Battle of the Heart Societies: Who Is Right – the US or Europe Regarding How to Manage Hypertension?
Nov 6, 2018 • 32 min
Within the last 2 years, major guidelines have been issued from US-based and European organizations that differ in their recommendations for the diagnosis and treatment of hypertension. Experts from both sides of the Atlantic—Paul Whelton, MD, from…
Observations From ICU Patients We Thought Were Asleep, but Were Not
Oct 23, 2018 • 25 min
What if the patient you are managing in the ICU is not asleep when you thought they were? Patients relate their very disturbing stories about what they experienced while in an ICU and their treating clinicians thought they were asleep.
An Update on the Diagnosis and Treatment of Venous Thromboembolic Disease
Oct 16, 2018 • 17 min
Venous thromboembolic disease is common. There are many steps necessary to establish a diagnosis or treat this disease. These are summarized in this JAMA Clinical Reviews podcast and interview with Philip S. Wells, MD, from the Department of Medicine,…
Alcohol Withdrawal Syndrome
Oct 2, 2018 • 20 min
Alcohol withdrawal is a serious problem that can lead to mortality. How to predict if it will occur when a patient who is misusing alcohol is admitted to the hospital is challenging. This Rational Clinical Examination article reports results of a…
Treating Appendicitis Without Surgery – 5-Year Follow-up From a Randomized Clinical Trial of Antibiotic Treatment
Sep 25, 2018 • 29 min
In 2015, JAMA published results of a randomized clinical trial showing that antibiotic treatment for acute appendicitis was feasible. Doubters of the efficacy of antibiotics for treating appendicitis were concerned about what the long-term recurrence…
Treating Lyme Disease in 2018, Part 2
Sep 18, 2018 • 29 min
There are new findings about another form of Borrelia: Borrelia miyamotoi. This form of Borrelia causes a relapsing fever but is spread in the same way that Lyme disease is. To help understand these new findings we spoke with Eugene Shapiro, MD, from…
Treating Lyme Disease in 2018, Part 1
Sep 11, 2018 • 24 min
In this JAMA Clinical Reviews podcast, we talk to Eugene D. Shapiro, MD, from Yale University School of Medicine for an update on Lyme disease, including new ideas about its diagnosis and treatment.
What you need to know about syphilis in 2018
Sep 4, 2018 • 30 min
Syphilis is on the rise despite prior successful efforts to control it. Why is it coming back and what needs to be done about it? Dr Charles Hicks from UC San Diego explains. This podcast coincides with updated syphilis screening recommendations from…
Treating Alcohol Use Disorder
Aug 28, 2018 • 23 min
Up to 7% of the entire US population has alcohol use disorder. It’s important for every clinician to understand how to approach patients to question them about their use of alcohol and to establish a diagnosis when alcohol use disorder is present….
Saving Lives by Stopping Bleeding
Aug 14, 2018 • 21 min
Bleeding is one of the most common preventable causes of death. It is common, yet most people don’t know what to do about it when they see it. The Stop the Bleed campaign is an effort to educate the public should they encounter people who are…
Working on the Precipice: On the Frontlines of the AIDS Epidemic at the CDC, Part II
Aug 1, 2018 • 26 min
As the AIDS crisis unfolded, each discovery seemed to lead to a new mystery. Who was at risk? Why was this disease of immune activation so hard for the body to fight? Most important, what could be done to stop it? In the conclusion of this JAMA…
Working on the Precipice: On the Frontlines of the AIDS Epidemic at the CDC, Part I
Jul 24, 2018 • 24 min
When AIDS first appeared in the gay community in 1981, it was terrifying for patients and clinicians alike. Nobody knew exactly what was going on. But using basic epidemiologic methods, a small team of public servants at the CDC raced against the…
Return of the IUD: Long-acting Reversible Contraception Is Safe and Effective
Jul 6, 2018 • 26 min
Misplaced fears about IUDs have caused them to be avoided by many women, despite the fact that they are very safe and among the most effective means for contraception. In this JAMA Clinical Reviews podcast, we review long-acting reversible…
Health Care Spending Gone Wild: Using Expensive Insulin Analogs With Few Clinical Advantages
Jun 23, 2018 • 27 min
Health care spending in the United States is out of control. The most significant aspect of medical care driving this spending is pharmaceuticals; within pharmaceuticals the greatest increases have been in spending for diabetes medications. The cost…
A Goal Too Far: Rethinking HbA1c Targets for Diabetes Treatment
Jun 19, 2018 • 29 min
The American College of Physicians just changed its guidance for how aggressively to treat type 2 diabetes, relaxing the HbA1c goal to something below 8 rather than 6.5 or 7 as other organizations recommend. This has stirred up substantial…
When Will It Stop? Clinicians Are Still Ordering Routine ECGs Despite Recommendations to the Contrary
Jun 12, 2018 • 22 min
For many years guidelines have recommended against obtaining ECGs for low-risk patients undergoing routine health examinations. Yet about a fifth of all patients having these exams get an ECG. Why? Are clinicians just stubborn or uninformed or are the…
Replacing the Trachea: An Exciting New Procedure; But How Do We Know It Really Works?
May 20, 2018 • 21 min
Many attempts to replace the trachea have failed in the past. The most spectacular failure was fraudulent research done in Europe by a high-profile surgeon who was eventually charged with scientific misconduct. JAMA now reports a clinical series of…
Update: New Recommendations for Prostate Cancer Screening
May 8, 2018 • 25 min
The controversy continues about the efficacy of PSA screening for prostate cancer. New recommendations were just issued from the USPSTF about who should be screened for prostate cancer and when. But not everyone agrees with these recommendations….
Peanut Allergy: The Recommendations Have Changed
Mar 6, 2018 • 19 min
Peanut allergy is common. But it is more common in countries that delay the introduction of peanuts into the diets of infants. Guidelines in the United States previously recommended delayed introduction of peanuts for infants, which resulted in an…
What Is New in Acute Respiratory Disease Syndrome?
Feb 20, 2018 • 30 min
Acute respiratory disease syndrome is characterized by respiratory failure that occurs after someone is acutely ill, usually from a disease that does not primarily involve the lungs. Its cause, diagnosis, and treatment are reviewed in this JAMA…
Medical Findings In U.S. Government Personnel Reporting Symptoms After Exposure To Sensory Phenomena in Havana, Cuba
Feb 14, 2018 • 29 min
Douglas H. Smith, MD, of the University of Pennsylvania’s Department of Neurosurgery and Center for Brain Injury and Repair, and Randel Swanson II, DO, PhD, of the University of Pennsylvania’s Physical Medicine and Rehabilitation department, summarize…
The Health of Players of American Football
Feb 1, 2018 • 30 min
The health risks associated with participation in American football have garnered increasing attention over the past several years. Particular focus has been on concussion and the association of repeated head trauma with chronic traumatic…
Gastric Sleeve Resection for Obesity: How good Is It?
Jan 16, 2018 • 29 min
Why is two-thirds of the US population overweight or obese? Obesity began to increase in 1980, and its incidence is still rising. One reason for this might be that the population has become tolerant of obesity and accepted it as the normal state. On…
Surveillance for Thyroid Cancer
Jan 2, 2018 • 16 min
The incidence of thyroid cancer is increasing. Like so many cancers, it is being diagnosed at earlier stages because of more aggressive screening and diagnostic testing. The aggressiveness of very early stage thyroid cancer is unknown and some of…
Diagnosis and First-Line Treatment of Chronic Sinusitis
Dec 19, 2017 • 30 min
Sinusitis is one of the most common conditions seen by clinicians. Despite its frequency, it is often misdiagnosed. In this podcast, we review the proper way to establish a diagnosis and treat both acute and chronic sinusitis. Related article
Managing Hypertension: Understanding the New AHA/ACC Hypertension Guideline, Part II
Dec 12, 2017 • 10 min
In November 2017, new guidelines were issued for hypertension treatment. They are a comprehensive overhaul of recommendations for both the diagnosis and treatment of hypertension. Last week, we discussed the guidelines’ specific recommendations with…
Managing Hypertension: Understanding the New AHA/ACC Hypertension Guideline
Dec 5, 2017 • 39 min
In November 2017, new guidelines were issued for hypertension treatment. The new guideline is a comprehensive overhaul of recommendations for both the diagnosis and treatment of hypertension. Based on years of work by dozens of individuals who…
Matching Drugs to Genetic Abnormalities to Precisely Treat Cystic Fibrosis
Dec 5, 2017 • 26 min
Cystic fibrosis is a common autosomal recessive disease. It is caused by any one of many discrete genetic abnormalities that affect chloride transport. Identification of specific genetic abnormalities enables clinicians to identify drugs that…
Mendelian Randomization: How the Natural Assortment of Genes Can Mimic Randomized Clinical Trials
Nov 21, 2017 • 29 min
The best evidence for proving cause-and-effect comes from randomized clinical trials. However, they are expensive and difficult to perform. The natural assortment of gene variants at birth can mimic randomization in some circumstances and yield…
Bacteriophage Treatment for Serious Infections Is Back!
Nov 14, 2017 • 37 min
Bacteriophages are viruses that infect and kill bacteria. When they were first discovered in the early part of the 20th century, there was great enthusiasm for their potential use to treat all sorts of bacterial infections. They were supplanted by…
Incontinence in Women: How We Talk About It and What Can Be Done
Oct 24, 2017 • 33 min
Urinary incontinence in women is common but not often discussed. Linda Brubaker, MD, and Emily S. Lukacz, MD, review the evaluation and management of incontinence in women, including how to broach the topic with patients and when to use treatments…
Managing Transgender Patients: Endocrine Society Guideline Update 2017
Oct 17, 2017 • 25 min
An increasing number of transgender patients are being seen in all care settings. Their medical needs are not too different from those for any primary care patient. New guidelines issued by the Endocrine Society in September 2017 are summarized in…
Replacing Tissue Biopsies With a Blood Test: The Technique of Liquid Biopsy
Oct 3, 2017 • 26 min
Powerful new genetic technologies enable clinicians to detect and sequence tiny amounts of free DNA circulating in blood. DNA gets into blood when cells fall apart. Abnormal DNA from diseased cells can be detected, enabling clinicians to detect cancer…
Delirium: Prevention, Diagnosis, and Treatment
Sep 26, 2017 • 23 min
Delirium goes unrecognized in approximately 60% of cases. When it is recognized, it can be difficult to treat. Recognizing and treating, as well as preventing, delirium is important because delirium is associated with poor health outcomes and…
Breast Cancer Surgery: Less Is More
Sep 12, 2017 • 34 min
Every successive major clinical trial of less invasive breast cancer surgery seems to show that less is more—less because less surgery seems to not influence outcomes and more because with less surgery, there are fewer complications, resulting in a…
How Couples With Genetic Disease Can Have Healthy Offspring
Sep 5, 2017 • 15 min
Clinicians can now sample DNA from in vitro blastocysts to identify embryos with genetic abnormalities and avoid implanting them. This genetic screening allows couples who carry dangerous genetic diseases to avoid having children with those diseases….
Are they safe? Drugs and devices receiving accelerated approval by the FDA
Aug 15, 2017 • 27 min
Some drugs and devices receive accelerated approval from the FDA in order to provide potentially important treatments for patients when effective therapies may not be available. These drugs or devices are supposed to have postmarketing studies to…
How Studying Familial Hypercholesterolemia Resulted in the Discovery of Statins as an Effective Treatment for High Cholesterol
Jul 25, 2017 • 20 min
Scott Grundy, MD, PhD, is a professor of medicine at UT Southwestern in Dallas and is one of a small group of investigators who saved statins from being dumped as a potential drug class. Dr Grundy tells the story of how studying patients with familial…
How to Diagnose and Manage Adult Asthma
Jul 18, 2017 • 33 min
Asthma often develops in childhood but also affects a significant number of adults. It can present in various ways and with varying degrees of severity. William J. Calhoun, MD, of the University of Texas Medical Branch, Galveston, discusses the…
Dual Antiplatelet Therapy: Balancing Ischemic and Bleeding Risk
Jul 11, 2017 • 28 min
Following placement of cardiac stents, patients receive dual antiplatelet therapy (DAPT) to prevent stent thrombosis. Prevention of thrombosis is offset by a risk of bleeding. The optimal balance between thrombosis prevention and bleeding risk is not…
Penicillin Allergy – It’s Less Common Than You Think
Jul 3, 2017 • 20 min
Allergy to penicillin is one of the most commonly reported allergies by patients. In reality, true penicillin allergy is uncommon. Dr. Elizabeth Phillips from Vanderbilt University discusses her experience with testing for penicillin allergy in…
Diagnosing Congenital and Intellectual Abnormalities With Chromosomal Microarray Analysis
Jun 27, 2017 • 18 min
Chromosomal microarray technology (CMA) facilitates the genetic diagnosis of intellectual disabilities, autism spectrum disorder, and congenital abnormalities in children. Previously, G-band karyotyping was the test performed for this purpose but it…
High-Intensity Statin Therapy – The Controversy Continues
Jun 27, 2017 • 35 min
Multiple guidelines have been issued regarding how aggressively cholesterol should be managed. These guidelines do not agree with one another and the most significant area of disagreement is in recommendations for high intensity statin therapy. In…
Treating Depression in Older Patients
May 23, 2017 • 34 min
Depression is very common in old age. Because it is associated with many issues related to aging such as having diabetes, hypertension, and other diseases and also the general ability to do less than when a person was younger, it is often assumed that…
Genomic Sequencing for the Healthy Individual?: Think Smaller
May 9, 2017 • 17 min
Whole-genome sequencing is now easily done for very little cost. It is not known how to interpret the results of this testing. It is inadvisable for healthy individuals to undergo routine whole-genome sequencing but if someone has a reason to suspect…
Diabetes in 2017: Focus Less On HbA1c and More On Cardiovascular Risk Reduction
Apr 3, 2017 • 29 min
Much has changed recently in diabetes management. The treatment goal has shifted from rigorous glucose control with HbA1c as the primary target to cardiovascular risk reduction. Risk reduction can be achieved in a variety of ways and does not…
JAMA Performance Improvement: Retained Foreign Body From a Sheared Off Lumbar Drain
Mar 28, 2017 • 19 min
A resident is asked to remove a drain that was placed in the lumbar space during an operation. Having never seen this sort of drain before not having removed one, the resident proceeded to remove the catheter. Several days later, the patient…
Alzheimer Disease Overview and the Possibility That It’s Caused By Infections
Mar 20, 2017 • 27 min
Alzheimer disease causes progressive neurologic deterioration and is reasonably common in elderly patients. It is characterized by specific patterns of memory loss, which progressively worsens and for which there is no treatment. Recent drug trials…
Why the New Sepsis Guideline Changed
Mar 7, 2017 • 33 min
Recent guidelines for how to best manage septic shock have changed. Gone are recommendations for central venous oxygen saturation monitoring and goal-directed therapy. In is the concept that septic shock be treated as an emergency with rapid…
Updated Guidelines for Sepsis Management
Feb 28, 2017 • 15 min
In 2017 the Society for Critical Care Medicine updated its guidelines for sepsis management. These new guidelines differ significantly from ones in the past in that they no longer recommend protocolized resuscitation and emphasize early and…
JAMA Professionalism: What Should Students or Residents Do When Abused by Faculty
Feb 16, 2017 • 30 min
Approximately one-third of all medical school graduates report having been abused as students. Medical student and resident abuse has long been considered unacceptable behavior but still persists in the teaching environment. In this podcast we discuss…
Sarcopenia, Frailty and Risk Prediction in Geriatric Patients
Feb 9, 2017 • 18 min
As people age, loss of muscle mass is inevitable, resulting in sarcopenia. Muscle loss contributes to overall weakness, which causes frailty. Frailty, in turn, is the generalized susceptibility to disease and injury, all of which causes loss of…
Hypertension Management and Dealing With Polypharmacy in Elderly Patients—A Report From the 2016 European Union Geriatric Medical Society Meeting
Feb 2, 2017 • 28 min
Managing hypertension in elderly patients is complicated. Recent studies have shown that elderly patients may benefit from aggressive hypertension management, but other studies have shown that some are harmed by overly aggressive hypertension…
Managing Violent Patients in Health Care Settings
Jan 30, 2017 • 21 min
Workplace violence–related injuries occur disproportionately in health care settings. In this podcast, we discuss how individual clinicians should manage violent patients who might attack them. Article discussed in this episode: Ensuring Staff…
Systematic Approach to a New Onset Seizure
Dec 27, 2016 • 28 min
Between 8% and 10% of the population will have a seizure at one point in life. It’s important to distinguish seizures from other entities that can look like them and, once a diagnosis of a seizure is established, know how to treat them. In this…
Using Medicare Star Ratings to Select Hospitals
Nov 1, 2016 • 26 min
Medicare recently developed a star rating system to help consumers determine the quality of care delivered at various hospitals. This rating system was considered controversial by many. In this podcast we discuss the rating system with one of its…
Treatments for Hyperemesis and Nausea and Vomiting in Pregnancy
Oct 4, 2016 • 18 min
Nearly all women experience some element of nausea and vomiting during their pregnancies. In this podcast we review the entire spectrum of disease all the way up to hyperemesis gravidarum and how to provide care for women experiencing these problems….
Fluid Resuscitation for Patients in Septic Shock
Sep 27, 2016 • 30 min
When managing septic shock, passive leg raising is the best test to determine if a patient is likely to respond to a fluid bolus, better than CVP lines or even bedside ultrasound. Dr Najib Ayas, Associate professor of Critical Care Medicine at the…
The High Cost of Pharmaceuticals in the United States
Aug 26, 2016 • 32 min
Drug prices continue to rise in the US. Many solutions have been proposed but few have been implemented. Drs. Janet Woodcock from the FDA and Aaron Kesselheim, author of The High Cost of Prescription Drugs in the United States from the Harvard…
Opioid Use Disorder
Aug 11, 2016 • 34 min
Edward H. Livingston, MD, discusses the British Columbia Ministry of Health’s 2015 guidelines on clinical management of opioid use disorder in adults with Keith Ahamad, MD, Evan Wood, MD, PhD, ABIM, FRCPC, Tony L. Yaksh, PhD,…
Treating Opioid Use Disorder Using Buprenorphine Implants
Jul 19, 2016 • 18 min
Richard N. Rosenthal, MD discusses a randomized clinical trial demonstrating the efficacy of an implantable buprenorphine-releasing device for treating opioid use disorder.
Review of Lyme Disease
Jul 12, 2016 • 38 min
Lyme disease is very common in certain regions of the country and is caused by the spirochete Borrelia bergdorferi. Lyme disease is transmitted by tick bites and in this podcast we review the discovery of Lyme disease, its major clinical features, and…
Managing Persistent Diarrhea
Jun 28, 2016 • 37 min
Persistent diarrhea is a poorly recognized syndrome in all populations that requires proper assessment and diagnosis to ensure that affected individuals receive the treatment needed to experience improvement of clinical symptoms. Listen to Drs Herbert…
The Discovery of Lyme Disease with Dr Allen Steere
Jun 14, 2016 • 23 min
Dr Allen Steere discovered Lyme disease and discusses what he saw and did when confronted early in his career with a previously undescribed disease. Late stage disease, a form not commonly seen today, is discussed in detail since that is how the…
GERD and Esophagitis
May 17, 2016 • 29 min
Drs Stuart Spechler and Peter Kahrilis discuss GERD and esophagitis—how they occur and how they are treated. Dr Spechler also discusses a new hypothesis regarding how reflux esophagitis is caused that differs from the traditional teaching that acid…
Treating ADHD in Adolescents
May 10, 2016 • 25 min
Attention-Deficit/Hyperactivity Disorder, or ADHD is a very common problem affecting about 10% of all adolescents. Children with ADHD have short attention spans, are hyperactive, talk a great deal, can be disruptive in the classroom etc.-features that…
Diagnosing Infectious Mononucleosis
Apr 12, 2016 • 33 min
Mononucleosis is a common disease of young adults manifested by lethargy, fever, pharyngitis, lymphadenopathy and splenomegaly. In this podcast, we review the clinical features of the disease and how good each of them is at establishing a diagnosis of…
Opioid Prescribing: Rising to the Challenge
Mar 15, 2016 • 23 min
An opioid abuse epidemic now plagues US healthcare. It was caused, in part, by overzealous advocacy for controlling chronic pain resulting in overuse of narcotics. There are now 2 million Americans addicted to opioids. The approach for treating…
Treating Geriatric Polypharmacy by Deintensifying Unnecessary Diabetes Treatment
Mar 8, 2016 • 27 min
Polypharmacy is a rapidly worsening problem that hits elderly patients particularly hard. As patients grow older, they need more medications but at the same time become less capable of managing the complexity of drug treatments. In order…
2015 Breast Cancer Screening Recommendations for Women at Average Risk
Feb 23, 2016 • 22 min
The American Cancer Society breast cancer screening guidelines have been changed to recommend annual screening for women older than 45 and every other year screening for women older than 55. Older women should only pursue screening if they have a more…
Antibiotic Therapy for Community-Acquired Pneumonia in Adults
Feb 9, 2016 • 18 min
Community acquired pneumonia accounts for 600,000 hospital admissions a year. Many patients with this disease are quite ill and have a very high mortality. To save lives, the appropriate antibiotics should be given in a timely basis, but it is not…
New Dietary Guidelines
Feb 2, 2016 • 25 min
The 2015-2020 US Dietary Guidelines for Americans were recently released. They are intended to provide guidance for health policy officials and clinicians regarding healthy diets and establishing goals for improving nutrition. These are important…
Peripheral Neuropathy
Jan 19, 2016 • 26 min
Peripheral neuropathy is a highly prevalent and morbid condition affecting 2% to 7% of the population. Patients frequently experience pain and are at risk of falls, ulcerations, and amputations. It is most commonly occurs in patients with diabetes….