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 DuPont and Annie Feagins discuss how to diagnose and treat diarrhea. Related article: Persistent Diarrhea

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

Interview with Dorry Segev, MD, PhD, author of HIV and Transplantation: New Reasons for HOPE

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 how to diagnose and treat it, as told by Dr Alan Steere, Dr Lyndon Hu, and Dr Paul Auerwerter.

Related article: Review of Lyme Disease, Human Granulocytic Anaplasmosis, and Babesiosis

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

Interview with Dhruv S. Kazi, MD, MSc, MS, author of Cost-effectiveness of PCSK9 Inhibitor Therapy in Patients With Heterozygous Familial Hypercholesterolemia or Atherosclerotic Cardiovascular Disease

Introducing a new series of JAMA articles on professionalism, discussed from the perspective of how clinicians should address challenging clinical situations and adverse events in their medical practice. In the first episode of the accompanying podcast, JAMA Professionalism: Best Practice, we interview Wendy Levinson, MD, and Jensen Yeung, MD, authors of Disclosure of Medical Error, which appeared in the August 16, 2016 issue of JAMA, as well as Thomas H. Gallagher, MD.

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 Medical School discuss the role of brand name drugs and generics and how they influence the cost of pharmaceuticals.

Also see The Cost of US Pharmaceutical Price Reductions: A Financial Simulation Model of R&D Decisions by Thomas A. Abbott and John A. Vernon.

Interview with Francisco A.R. García, MD, MPH, author of Screening for Latent Tuberculosis Infection in Adults: US Preventive Services Task Force Recommendation Statement

Interview with Joel G. Ray, MD, MSc, FRCPC, author of Association Between MRI Exposure During Pregnancy and Fetal and Childhood Outcomes

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

Interview with Vivian S. Lee, MD, PhD, MBA;, author of Implementation of a Value-Driven Outcomes Program to Identify High Variability in Clinical Costs and Outcomes: Association With Reduced Cost and Improved Quality, and Michael E. Porter, PhD, author of From Volume to Value in Health Care: The Work Begins

Interview with John M. Jakicic, PhD, author of Effect of Wearable Technology Combined With a Lifestyle Intervention on Long-term Weight Loss: The IDEA Randomized Clinical Trial

What to do when the wrong procedure is performed? In this first installment of JAMA Performance Improvement: Do No Harm we explore the options for dealing with this very difficult problem with Tami Minnier, RN, MSN, Paul Phrampus, MD, Linda Waddell, RN, MSN, and David Baker, MD, MPH, FACP. Air traffic audio courtesy of LiveATC.net, used with permission.

Interview with Jeffrey L Saver, M.D., author of Time to Treatment With Endovascular Thrombectomy and Outcomes From Ischemic Stroke: A Meta-analysis

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 University of British Columbia, discusses shock management from the context of his Rational Clinical examination article in the September 27, 2016 issue of JAMA, entitled “Will This Hemodynamically Unstable Patient Respond to a Bolus of Intravenous Fluids?”

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.

Article discussed in this episode:

Treatments for Hyperemesis Gravidarum and Nausea and Vomiting in Pregnancy

Interview with Pieter A. Cohen, MD, author of The Supplement Paradox: Negligible Benefits, Robust Consumption

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.

In this episode of JAMA Professionalism: Best Practice, Edward H. Livingston, MD looks at the case of a physician requesting prescription medication from a colleague to examine professional boundaries between physicians and options for managing those boundaries. Shiphra Ginsburg, MD and Wendy Levinson, MD, authors of the related article, join Dr Livingston to discuss the best options for handling this challenging situation. Arthur S. Hengerer, MD, chair of the Federation of State Medical Boards discusses the legal and licensure ramifications of physicians prescribing for other clinicians and Kate E. Engelhardt, MD, and D. Brock Hewitt, MD, MPH, practicing physicians, relate their experience with other clinicians asking them to prescribe medications.

Interview with Ann E. Kurth, PhD, RN, MSN, MPH, Task Force member and co-author of Primary Care Interventions to Support Breastfeeding: US Preventive Services Task Force Recommendation Statement

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 critics, Karl Y. Bilimoria, MD, MS, and with Kate Goodrich, MD, the Director of the Center for Clinical Standards and Quality at Medicare.

Article discussed in this episode:

The New CMS Hospital Quality Star Ratings: The Stars Are Not Aligned

Interview with Douglas K. Owens, MD, MS, USPSTF Task Force member and coauthor of Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement

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 Roger L. Zemek, MD, author of Association Between Early Participation in Physical Activity Following Acute Concussion and Persistent Postconcussive Symptoms in Children and Adolescents

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

Interview with Alex H. Krist, MD, MPH, Task Force member and co-author of Screening for Obstructive Sleep Apnea in Adults: US Preventive Services Task Force Recommendation Statement

Interview with Julie Rani Nangia, BA, MD, author of Effect of a Scalp Cooling Device on Alopecia in Women Undergoing Chemotherapy for Breast Cancer: The SCALP Randomized Clinical Trial, and Hope S. Rugo, MD, author of Association Between Use of a Scalp Cooling Device and Alopecia After Chemotherapy for Breast Cancer

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

Interview with Maureen G. Phipps, MD, MPH, Task Force member and co-author of Screening for Gynecologic Conditions With Pelvic Examination: US Preventive Services Task Force Recommendation Statement

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 Freddie C. Hamdy, MD, FRCSEd(Urol), and Jenny L Donovan, PhD, FMedSci, authors of Patient-Reported Outcomes Following Treatment for Localized Prostate Cancer: Helping Decision Making for Patients and Their Physicians

Interview with Alex H Krist, MD, MPH, Task Force member and co-author of Screening for Celiac Disease: US Preventive Services Task Force Recommendation Statement

This Medical News podcast features an interview with Barry Marshall, MD, who codiscovered the stomach bug H pylori in 1982.

This podcast discusses the latest research into the workings of the lung microbiome and how it will affect future diagnosis and treatment of respiratory diseases. Related article: The Lung Microbiome: Key to Respiratory Ills?

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 Charles Landefeld, MD, author of Screening for Thyroid Cancer: US Preventive Services Task Force Recommendation Statement

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 David C. Grossman, MD, MPH, author of Screening for Obesity in Children and Adolescents: US Preventive Services Task Force Recommendation Statement

Interview with Susan J. Curry, PhD, author of Behavioral Counseling to Promote a Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Cardiovascular Risk Factors: US Preventive Services Task Force Recommendation Statement

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

Interview with Alex R Kemper, MD, MPH, MS, Task Force member and co-author of Vision Screening in Children Aged 6 Months to 5 Years: US Preventive Services Task Force Recommendation Statement

Interview with JoAnn E. Manson, MD, DrPH, author of Menopausal Hormone Therapy and Long-Term All-Cause and Cause-Specific Mortality: The Women’s Health Initiative Randomized Trials

Interview with Maureen Phipps, MD, Task Force member and co-author of Hormone Therapy for the Primary Prevention of Chronic Conditions in Postmenopausal Women: US Preventive Services Task Force Recommendation Statement

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 Alex R Kemper, MD, MPH, MS, Task Force member and co-author of Screening for Adolescent Idiopathic Scoliosis: US Preventive Services Task Force Recommendation Statement