Interview with Lynn Babcock, MD, MS, author of Identifying Children and Adolescents at Risk for Persistent Postconcussion Symptoms

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 to simplify treatment regimens for older patients, it is necessary to consider the evidence supporting treatment of various conditions and when the evidence is not particularly strong, reduce or eliminate medications accordingly.  Diabetes management in the elderly is highlighted in this podcast with specific attention given to deintensifying diabetes treatment in the elderly.

Articles discussed in this episode:

• Polypharmacy in the Aging Patient: Glycemic Control in Older Adults With Type 2 Diabetes: A Review (Kasia J. Lipska, MD, MHS)
• Evaluation and Treatment of Older Patients With Hypercholesterolemia: A Clinical Review (Timo E. Strandberg, MD, PhD)
• Trends in Prescription Drug Use Among Adults in the United States From 1999-2012 (Elizabeth D. Kantor, PhD, MPH)

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 chronic pain must change. In this podcast, we summarize recent CDC guidelines for the proper use of opioids for treating chronic pain.

Articles discussed in this episode:

• CDC Guideline for Prescribing Opioids for Chronic Pain— United States, 2016,
• The CDC Guideline on Opioid Prescribing: Rising to the Challenge (Yngvild Olsen, MD, MPH),
• The DSM-V definition for opioid use disorder and 11 point checklist

Interview with Wendy C. King, PhD, author of Change in Pain and Physical Function Following Bariatric Surgery for Severe Obesity

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 and pepsin reflux into the esophagus and burn the mucosa layers.

Related articles:
Association of Acute Gastroesophageal Reflux Disease With Esophageal Histologic Changes
Turning the Pathogenesis of Acute Peptic Esophagitis Inside Out

Interview with Jeff D. Williamson, MD, MHS, author of Intensive vs Standard Blood Pressure Control and Cardiovascular Disease Outcomes in Adults Aged ≥75 Years: A Randomized Clinical Trial

Patrick Soon-Shiong, MD, physician-scientist and entrepreneur, talks about the National MoonShot Initiative, his MoonShot 2020 Program, as well as promising approaches in cancer immunotherapy. This podcast was originally recorded on June 3, 2016

This Medical News podcast discusses the Human Genome Project-write with Harvard geneticist, George Church, PhD.

Interview with Ann E. Kurth, PhD, RN, MSN, MPH, author of Serologic Screening for Genital Herpes Infection: US Preventive Services Task Force Recommendation Statement

Can testosterone gel improve memory, correct anemia, increase bone density or prevent the growth of coronary artery plaque in older men with low testosterone levels? Four new studies in JAMA and JAMA Internal Medicine found improvement in some of these measures.

Articles discussed in this episode:

• Testosterone Treatment and Coronary Artery Plaque Volume in Older Men With Low Testosterone

• Testosterone Treatment and Cognitive Function in Older Men With Low Testosterone and Age-Associated Memory Impairment

• Effect of Testosterone Treatment on Volumetric Bone Density and Strength in Older Men With Low Testosterone: A Controlled Clinical Trial

• Association of Testosterone Levels With Anemia in Older Men: A Controlled Clinical Trial

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 aggressive fluid resuscitation when patients present with septic shock. This is the first podcast in the Surviving Sepsis guideline series. The next episode discusses why the new sepsis guideline changed.

Article discussed in this episode: Management of Sepsis and Septic Shock

Speakers:

Laura Evans, MD, MSc, of Bellevue Hospital and NYU Medical Center

Andrew Rhodes, MBBS, MD, of St George’s University Hospitals NHS Trust and co-chair of the Surviving Sepsis guideline panel

Mitchell M. Levy, MD, of the Alpert Medical School of Brown University and Rhode Island Hospital

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 administration of antibiotics and large amounts of fluids. Our discussants Derek C. Angus, MD, MPH, and Michael D. Howell, MD, MPH, discuss why these recommendations have changed. This is the second podcast in the Surviving Sepsis guideline series. The first podcast reviewed what recommendations are in the guideline itself.

Article discussed in this episode: Management of Sepsis and Septic Shock

Speakers: JAMA Associate Editor Derek C. Angus, MD, MPH, University of Pittsburgh, and Michael D. Howell, MD, MPH, University of Chicago.

Whole-genome sequencing is now easily done for very little cost. It is not known how to interpret the results of this testing. Healthy individuals should not have this performed. If someone has a reason to suspect a particular disease with a known genetic association, then whole-genome or targeted sequencing is reasonable to pursue.

Interview with Sonoo Thadaney-Israni, MBA, and Abraham Verghese, MD, MACP, authors of Humanizing Artificial Intelligence

Interview with Benjamin Tolchin, MD, MS, author of Treatment of Patients With Psychogenic Nonepileptic Attacks

Interview with Andrew A. Nierenberg, MD, author of Evolving Issues in the Treatment of Depression

Interview with S. Claiborne Johnston, MD, PhD, author of Academic Medical Centers: Too Large for Their Own Health?

Interview with Robert M. Wachter, MD, author of Reimagining Specialty Consultation in the Digital Age: The Potential Role of Targeted Automatic Electronic Consultations

Interview with Carol M Mangione, MD MSPH, USPSTF member and coauthor of Risk Assessment, Genetic Counseling, and Genetic Testing for BRCA-Related Cancer: US Preventive Services Task Force Recommendation Statement

Audio at 5:55 was changed to reflect a revised risk increase statement.

Interview with Amol S. Navathe, MD, PhD, author of Addressing Bias in Artificial Intelligence in Health Care

Interview with Julia A. Segre, Ph.D., author of Manipulating the Human Microbiome to Manage Disease

Interview with I Glenn. Cohen, JD, author of Ethical and Legal Aspects of Ambient Intelligence in Hospitals

Noninvasive ventilation (NIV), working with dying patients’ families, use of experimental therapies, and more. JAMA Associate Editor Derek Angus, MD, MPH, Distinguished Professor and Chair of Critical Care Medicine at the University of Pittsburgh, provides a COVID-19 ICU management update.

Watch the recording of this livestream

Interview with Madison Kilbride, PhD, author of The Need to Improve the Clinical Utility of Direct-to-Consumer Genetic Tests: Either Too Narrow or Too Broad

Safianowicz, Katarzyna Marta, author

Hill, J., author

Allen, Simon James, author

Longo, Stefano, author

Bennett, Brett M., 1983-

Iqbal, Sadia, author

Cottingham, Alan, author

Tan, Jo-Anne Chiew Hwa, author

Beaumont, W. R. C., author

Shah, Ramisah Mohd, author

Nuthall, P. L. (Peter Leslie), author