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 since bad eating habits are the underlying cause for a great deal of disease in the US and that these guidelines influence the operations of programs such as school lunch assistance, meals on wheels etc. Because these guidelines influence policy, they have been criticized by various investigators and special interest groups. Karen DeSalvo, MD, Acting Assistant Secretary for Health at HHS and author of Dietary Guidelines for Americans responds to some of these criticisms and explains how the guideline was created and what it is intended to do. Implementation of the guidelines dietary advice may be challenging and Deborah Clegg, RD, PhD, Professor of Internal Medicine at UCLA discusses how the various recommendations can be followed.

Interview with David C. Grossman, MD, MPH, author of Screening for Autism Spectrum Disorder in Young Children: US Preventive Services Task Force Recommendation Statement

Interview with Clifford Deutschman, MD, MS, Mervyn Singer, MD and Derek Angus, MD, MPH, authors of The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)

Interview with Michael P. Pignone, MD, MPH, author of Screening for Impaired Visual Acuity in Older Adults: US Preventive Services Task Force Recommendation Statement

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)

Christine Curry, MD, PhD, assistant professor of obstetrics and gynecology at the University of Miami, discusses the challenges of keeping pregnant patients and her colleagues well-informed of the facts as Zika virus fears circulate.

Howard Bauchner, MD, Editor in Chief of JAMA, interviews Simon Chapman, MD, author of Association Between Gun Law Reforms and Intentional Firearm Deaths in Australia, 1979-2013

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

Interview with Ezekiel J. Emanuel, MD, PhD, author of Attitudes and Practices of Euthanasia and Physician-Assisted Suicide in the United States, Canada, and Europe

Richard N. Rosenthal, MD discusses a randomized clinical trial demonstrating the efficacy of an implantable buprenorphine-releasing device for treating opioid use disorder.

Interview with Axel Linke, MD, author of Effect of a Cerebral Protection Device on Brain Lesions Following Transcatheter Aortic Valve Implantation in Patients With Severe Aortic Stenosis: The CLEAN-TAVI Randomized Clinical Trial

Interview with David Grossman, MD, author of Screening for Lipid Disorders in Children and Adolescents: US Preventive Services Task Force Recommendation Statement

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, and Humayun J. Chaudhry, DO, MS, MACP, FACOI.

Articles and resources discussed in this episode: 

• Opioid Use and Addiction Microsite,
• Clinical Management of Opioid Use Disorder (JAMA Clinical Guidelines Synopsis),
• The Vancouver Opioid Use Disorder Guideline,
• Model Policy on DATA 2000 And Treatment of Opioid Addiction in the Medical Office

This Medical News podcast features a Q&A with CDC Director Tom Frieden, MD, commemorating the agency’s historic 70th anniversary. The interview was recorded on August 8th, 2016.

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 how students and residents might respond to these events. We interview Geoffrey Young, MD, from the Association of American Medical Colleges and Thomas J. Nasca, MD, from the Accreditation Council for Graduate Medical Education, who discuss how they expect medical schools to respond to abusive behaviors and what resources are available to students and residents who have been abused to report those experiences without fearing retribution.

Article discussed in this episode:

Medical Student Mistreatment

Interview with Christopher JL. Murray, MD, DPhil, author of US County-Level Trends in Mortality Rates for Major Causes of Death, 1980-2014

Interview with Alex R. Kemper, MD, MPH, MS, Task Force member and co-author of Folic Acid Supplementation for the Prevention of Neural Tube Defects: US Preventive Services Task Force Recommendation Statement

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.

Interview with Gail Hayward, MA (Oxon) D.Phil MRCP MRCGP, author of Effect of Oral Dexamethasone Without Immediate Antibiotics vs Placebo on Acute Sore Throat in Adults: A Randomized Clinical Trial

Interview with Stuart M. Butler, PhD, MA, BSc, author of State Flexibility for Medicaid: How Much?

Interview with Jeffrey Alan. Golden, MD, author of Deep Learning Algorithms for Detection of Lymph Node Metastases From Breast Cancer: Helping Artificial Intelligence Be Seen

Interview with Christopher JL. Murray, MD, DPhil, author of The State of US Health, 1990-2016: Burden of Diseases, Injuries, and Risk Factors Among US States

Interview with Elizabeth O'Connor, PHD, author of Interventions to Prevent Perinatal Depression: Evidence Report and Systematic Review for the US Preventive Services Task Force

Interview with Neil Skolnik, M.D., author of Reexamining Recommendations for Treatment of Hypercholesterolemia in Older Adults

Interview with Nancy L. Keating, MD, MPH, author of New Federal Requirements to Inform Patients About Breast Density: Will They Help Patients?

Interview with David M. Cutler, PhD, author of Life and Death in Norway and the United States

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

Interview with Alan Leshner, PhD, author of Medication-Based Treatment to Address Opioid Use Disorder

Interview with Paul A. Volberding, MD, and Hyman Scott, MD MPH, authors of HIV Screening and Preexposure Prophylaxis Guidelines: Following the Evidence

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

Interview with Karina W. Davidson, PhD, MASc, author of Screening for Social Determinants of Health: The Known and Unknown

Interview with Yngvild Olsen, M.D., M.P.H., author of Lessons Learned From the Opioid Epidemic

Interview with Anna D. Sinaiko, Ph. D., author of What Is the Value of Market-Wide Health Care Price Transparency?

Interview with Benjamin Daniel Sommers, MD, PhD, author of Medicaid Expansion and Health: Assessing the Evidence After Five Years

Interview with Francisco G. Cigarroa, MD, author of The Advancing American Kidney Health Executive Order: An Opportunity to Enhance Organ Donation

Interview with Deborah Dowell, M.D., M.P.H., author of Patient-Centered Reduction or Discontinuation of Long-term Opioid Analgesics: The HHS Guide for Clinicians

Interview with Pascale Carayon, PhD, author of Improving the System to Support Clinician Well-being and Provide Better Patient Care

Interview with Claire J. Creutzfeldt, MD, author of Treatment Decisions for a Future Self: Ethical Obligations to Guide Truly Informed Choices

Interview with Maya M. Hammoud, MD, MBA, author of Improving the Residency Application and Selection Process: An Optional Early Result Acceptance Program

Interview with Jack Resneck, MD, author of Refocusing Medication Prior Authorization on Its Intended Purpose

Interview with Victor M. Montori, MD, MSC, author of When Guidelines Recommend Shared Decision-making

Interview with Sandro Galea, MD, author of The Role of Physicians in Addressing Social Determinants of Health

Infectious epidemics have always driven change and triggered discrimination in human societies. Frank Snowden, DPhil, Professor Emeritus of History and History of Medicine at Yale University and author of Epidemics and Society: From the Black Death to the Present (Yale University Press, 2019), puts the COVID-19 pandemic in historical context.

Interview with Chien-Wen W Tseng, MD, MPH, USPSTF member and coauthor of Screening for Bacterial Vaginosis in Pregnant Persons to Prevent Preterm Delivery: US Preventive Services Task Force Recommendation Statement

Interview with Jeffrey A. Linder, MD, author of Delayed Antibiotic Prescriptions in Ambulatory Care: Reconsidering a Problematic Practice

Marc Lipsitch, DPhil, an infectious diseases epidemiologist developing biological and modeling approaches to pathogen transmission and outbreaks, discusses evolution of the COVID-19 pandemic in summer and fall 2020. Originally recorded April 22, 2020.

Interview with Robert D. Truog, MD, MA, author of Understanding Brain Death