UpToDate Talk

This episode features Dr. Robert Wood discussing the results of a trial of oral immunotherapy with a manufactured peanut protein product for peanut desensitization, and its potential role in clinical practice. Dr. Nancy Sokol hosts. Dr. Wood is Professor of Pediatrics and Director of Pediatric Allergy and Immunology at the Johns Hopkins University School of Medicine and Professor of International Health at the Johns Hopkins Bloomberg School of Public Health. He is Editor-in-Chief of the Allergy and Immunology specialty at UpToDate. Reference: Bird JA, Spergel JM, Jones SM, et al. Efficacy and Safety of AR101 in Oral Immunotherapy for Peanut Allergy: Results of ARC001, a Randomized, Double-Blind, Placebo-Controlled Phase 2 Clinical Trial. J Allergy Clin Immunol Pract 2018; 6:476. Contributor Disclosure: Grant/Research/Clinical Trial Support: DBV Technologies; Aimmune; Astellas; HAL-Allergy [Food allergy].

Dr. Leonard Ganz discusses pharmacologic rate control of atrial fibrillation (AF) and findings of a recent study published in the Journal of the American College of Cardiology regarding the use of digoxin and mortality in patients with AF. Dr. Nancy Sokol hosts. Dr. Ganz is a clinical cardiologist and Director of Cardiac Electrophysiology at the Heritage Valley Health System, in Western Pennsylvania, and Section Editor of the cardiac arrhythmias section in UpToDate. Reference: Lopes RD, Rordorf R, De Ferrari GM, et al. Digoxin and Mortality in Patients With Atrial Fibrillation. J Am Coll Cardiol 2018; 71:1063. Contributor Disclosure: Speaker’s Bureau: Amgen [Heart failure (Ivabradine)]; Pfizer, BMS [Anticoagulation (Apixaban)]; St. Jude Medical, Biotronik [Cardiac rhythm (Pacemaker/ICD)]; Lundbeck [Orthostatic hypotension (Northera)]. Consultant/Advisory Boards: Unequal Technologies [Commotio cordis (Protective equipment)]. Equity Ownership/Stock Options: Unequal Technologies [Commotio cordis (Protective equipment/apparel)].

Dr. Christopher Kabrhel discusses the PERC rule for evaluating patients with suspected pulmonary embolism and a trial exploring the effects of implementing the PERC rule in emergency departments in France, published in JAMA in February 2018. Dr. Nancy Sokol hosts. Dr. Kabrhel is Associate Professor at Harvard Medical School, an Emergency Medicine physician at Massachusetts General Hospital, and author of several topics on pulmonary embolism for UpToDate. Reference: Freund Y, Cachanado M, Aubry A, et al. Effect of the Pulmonary Embolism Rule-Out Criteria on Subsequent Thromboembolic Events Among Low-Risk Emergency Department Patients: The PROPER Randomized Clinical Trial. JAMA 2018; 319:559. Contributor Disclosure: Grant/Research Support: Siemens [Venous thromboembolism (D-dimer test)]; Janssen [Venous thromboembolism (Rivaroxaban)]; Diagnostica Stago [Venous thromboembolism (D-dimer test)]. Consultant/Advisory Board: Siemens [Venous thromboembolism (D-dimer test)]; Janssen [Venous thromboembolism (Rivaroxaban)].

This episode features Dr. Carol Weitzman discussing a recent study showing a higher incidence of fetal alcohol spectrum disorders in children than previously thought, as well as methods to raise awareness and improve detection. Dr. April Eichler hosts. Dr. Weitzman is Professor of Pediatrics and Director of the Developmental-Behavioral Pediatrics Program at the Yale School of Medicine. She is an author in the Pediatrics specialty at UpToDate. Reference: May PA, Chambers CD, Kalberg WO, et al. Prevalence of Fetal Alcohol Spectrum Disorders in 4 US Communities. JAMA 2018; 319:474. Contributor disclosure: HeartFlow (Investor).

This episode features Dr. Jose Biller discussing two recent studies showing that intra-arterial mechanical thrombectomy improves neurologic outcomes when performed up to 24 hours after symptom onset for selected patients with ischemic stroke. Dr. April Eichler hosts. Dr. Biller is a Professor of Neurology and Neurological Surgery and Chairman of the Department of Neurology at the Loyola University Chicago Stritch School of Medicine. He is Section Editor in the Neurology specialty at UpToDate. References: Nogueira RG, Jadhav AP, Haussen DC, et al. Thrombectomy 6 to 24 Hours after Stroke with a Mismatch between Deficit and Infarct. N Engl J Med 2018; 378:11. Albers GW, Marks MP, Kemp S, et al. Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging. N Engl J Med 2018; 378:708. Contributor disclosure: Nothing to disclose.

Dr. John Pemberton discusses a cohort study of patients with acute diverticulitis followed for 4 years for recurrence rates and need for surgery following the initial episode, published in Diseases of the Colon & Rectum in March 2018. Dr. Nancy Sokol hosts. Dr. Pemberton is Professor of Surgery at the Mayo Clinic and Mayo Medical School, and authors several topics on diverticular disease for UpToDate. Reference: El-Sayed C, Radley S, Mytton J, et al. Risk of Recurrent Disease and Surgery Following an Admission for Acute Diverticulitis. Dis Colon Rectum 2018; 61:382. Contributor Disclosure: Nothing to disclose

Dr. Brian Olshansky discusses a paper in the February 2018 New England Journal of Medicine regarding a trial of catheter ablation for atrial fibrillation with heart failure. Dr. Nancy Sokol hosts. Dr. Olshansky is Professor Emeritus of Internal Medicine at the University of Iowa, Adjunct Professor of Medicine at Des Moines University, and Section Editor for UpToDate cardiology topics. Reference: Marrouche NF, Brachmann J, Andresen D, et al. Catheter Ablation for Atrial Fibrillation with Heart Failure. N Engl J Med 2018; 378:417. Contributor Disclosure: Speaker’s Bureau: Lundbeck [Orthostatic hypotension (Droxidopa)]; CryoLife [Heart Valve Replacement (On-X Aortic Valves)]. Consultant/Advisory Boards: Lundbeck [Orthostatic hypotension (Droxidopa)]; CryoLife [Heart Valve Replacement (On-X Aortic Valves)]. Other Financial Interest: Amarin [Hypertriglyceridemia (EPA; Chair, Data and Safety Monitoring Board)]; Boerhringer Ingelheim [Atrial fibrillation (GLORIA AF trial)].

This episode features Dr. Kenneth Schmader discussing new guidelines from the Advisory Committee on Immunization Practices regarding the herpes zoster vaccines. Dr. Sadhna Vora hosts. Dr. Schmader is a Professor of Medicine and Chief of the Division of Geriatrics at Duke University. He is Section Editor in Primary Care and Editor-in-Chief of the Geriatrics specialty at UpToDate. Reference: Dooling KL, Guo A, Patel M, et al. Recommendations of the Advisory Committee on Immunization Practices for Use of Herpes Zoster Vaccines. MMWR Morb Mortal Wkly Rep 2018; 67:103. Contributor Disclosure: Grant/Research/Clinical Trial Support: Merck [Herpes zoster (Zoster vaccine)]; GlaxoSmithKline [Herpes zoster (Zoster vaccine)].

This episode features Dr. Joseph Wolfsdorf discussing advances in devices to manage children and adolescents with type 1 diabetes. Dr. Sadhna Vora hosts. Dr. Wolfsdorf is a Professor of Pediatrics at Harvard Medical School and Director of the Diabetes Program at Boston Children's Hospital. He is also Section Editor in Pediatric Endocrinology at UpToDate. Reference: Abraham MB, Nicholas JA, Smith GJ, et al. Reduction in Hypoglycemia with the Predictive Low-Glucose Management System: A Long-term Randomized Controlled Trial in Adolescents With Type 1 Diabetes. Diabetes Care 2018; 41:303. Contributor Disclosure: Nothing to disclose.

This episode features Dr. Sheldon Kaplan discussing the use of a third dose of the MMR vaccine for the prevention of mumps in an outbreak setting. Dr. Jennifer Mitty hosts. Dr. Kaplan is Professor of Pediatrics and head of the Pediatric Infectious Disease section at Baylor College of Medicine, and he is Chief of the Infectious Disease service and head of the Department of Pediatric Medicine at Texas Children's Hospital in Houston. References: Marin M, Marlow M, Moore KL, et al. Recommendation of the Advisory Committee on Immunization Practices for Use of a Third Dose of Mumps Virus-Containing Vaccine in Persons at Increased Risk for Mumps During an Outbreak. MMWR Morb Mortal Wkly Rep 2018; 67:33. Cardemil CV, Dahl RM, James L, et al. Effectiveness of a Third Dose of MMR Vaccine for Mumps Outbreak Control. N Engl J Med 2017; 377:947. Contributor Disclosure: Grant/Research/Clinical Trial Support: Pfizer [Streptococcus pneumonia (PCV13, linezolid)]; Merck [Staphylococcus aureus (Tedizolid)]; Allergen [Osteomyelitis (Ceftaroline)]. Consultant/Advisory Boards: Pfizer [Staphylococcus aureus (vaccine development); linezolid]. Other Financial Interest: Pfizer [Speaker on PCV13, linezolid]; Medscapre [Video discussion on bacterial meningitis]; Elsevier [Co-editor (Feigin and Cherry Textbook of Pediatric Infectious Diseases)].

This episode features Dr. Andrew Saxon discussing treatments for opioid use disorder. Dr. Jennifer Mitty hosts. Dr. Saxon is a Professor in the Department of Psychiatry and Behavioral Sciences at the University of Washington in Seattle, and he is Chair of the American Psychiatric Association's Council on Addiction Psychiatry. References: Lee JD, Nunes EV Jr, Novo P, et al. Comparative effectiveness of extended-release naltrexone versus buprenorphine-naloxone for opioid relapse prevention (X:BOT): a multicentre, open-label, randomised controlled trial. Lancet 2018; 391:309. Tanum L, Solli KK, Latif ZE, et al. Effectiveness of Injectable Extended-Release Naltrexone vs Daily Buprenorphine-Naloxone for Opioid Dependence: A Randomized Clinical Noninferiority Trial. JAMA Psychiatry 2017; 74:1197. Contributor Disclosure: Grant/Research/Clinical Trial Support: Medicasafe [Medication dispensing]. Consultant/Advisory Boards: Neurocrine Biosciences [Tardive dyskinesia (Valbenazine)].

Today’s episode of UpToDate Talk features Dr. Jerry Swanson discussing novel monoclonal antibody therapies to prevent migraines, and Dr. Ciarán Kelly discussing oral fecal microbiota transplantation for the treatment of C. difficile infection. The second segment begins at 14:58. Dr. Nancy Sokol hosts.

Today’s UpToDate Talk episode features discussions related to three papers published in the New England Journal of Medicine. Dr. Jess Mandel discusses anticoagulation options for cancer-associated venous thromboembolism, and Dr. George Mallory discusses two studies of tezacaftor-ivacaftor in patients with cystic fibrosis. Segment two begins at 11:32. Dr. Helen Hollingsworth hosts.

Today’s episode of UpToDate Talk features Dr. Gregory Simon discussing the management of suicide risk in children and adolescents, and Dr. Khalil Ghanem discussing the increasing prevalence of syphilis in the United States. The second segment begins at 18:10. Dr. Nancy Sokol hosts.

In this episode of UpToDate Talk, Dr. Stanley Schrier joins us to discuss an article from Lancet Haematology on a new paradigm for the dosing of oral iron, and Dr. Dan Hayes discusses his meta-analysis from the New England Journal of Medicine on the risk of late recurrence after adjuvant endocrine therapy for breast cancer. Dr. Jennifer Tirnauer hosts. Figure on hepcidin in UpToDate: https://www.uptodate.com/contents/image?imageKey=HEME%2F105245

This edition of UpToDate Talk features Dr. Nicholas Talley, who joins us to discuss the evaluation and management of dyspepsia in adults, and Dr. William White, who discusses the new ACC/AHA guidelines for the evaluation and management of high blood pressure in adults. Dr. April Eichler hosts.

This episode of UpToDate Talk begins with Dr. Scott Kasner, who outlines three recent NEJM studies investigating the effects of PFO device closure on recurrent stroke risk. The second segment features Dr. James O’Dell, discussing the cost effectiveness of triple therapy in the treatment of rheumatoid arthritis. Dr. Helen Hollingsworth hosts.

This episode features Dr. Benjamin Raby discussing a recent paper on correcting a pathogenic gene mutation in human embryos, and Dr. Martin Hirsch discussing testing for diagnosing influenza. Dr. Nancy Sokol hosts.

This episode features Dr. Kenneth Mayer, discussing use of pre-exposure HIV prophylaxis for high-risk adolescents, and Dr. Samuel Lévy, discussing use of an implantable cardioverter defibrillator for the primary prevention of sudden death in patients with nonischemic cardiomyopathy. Dr. Nancy Sokol hosts.

This episode features Dr. Karin Nielsen discussing maternal Zika virus and potential factors associated with birth outcomes, and Dr. Jess Mandel discussing screening for occult cancer in patients with unprovoked venous thromboembolism. Dr. Jennifer Mitty hosts.

In this episode, Dr. David Nathan discusses choice of basal insulin for management of type 1 and type 2 diabetes, and Dr. Douglas Nordli, Jr., discusses evaluation of children with febrile seizures. Dr. Nancy Sokol hosts.

This episode features Dr. Kristina Callis Duffin discussing the efficacy and safety of guselkumab and tildrakizumab in patients with moderate to severe plaque psoriasis, and Dr. Amy Shapiro discussing emicizumab prophylaxis in hemophilia A with inhibitors and targeting of antithrombin in hemophilia A or B using RNA interference therapy. Dr. Jennifer Tirnauer hosts.

This podcast features Dr. Steven Weinberger, discussing new guidelines on the management of solitary pulmonary nodules, and Dr. Michael Corwin, discussing interventions to promote safe sleep practices for infants and decrease the incidence of sudden infant death syndrome (SIDS). Dr. Nancy Sokol hosts.

This episode features Dr. Michael Atkins discussing the management of positive sentinel lymph nodes in patients with cutaneous melanoma, and Dr. Peter Roy-Byrne discussing an investigational transcranial therapy for individuals with depression. Dr. April Eichler hosts.

In this episode, Dr. Ivor Hill discusses the psychological impact of celiac autoimmunity in children, and Dr. Daniel Hayes discusses adjuvant therapy with capecitabine for selected women with breast cancer.

Edaravone for amyotrophic lateral sclerosis; Neonatal mortality in US planned home births by UpToDate

In this episode, Dr. Lauren Jansson discusses buprenorphine for neonatal abstinence syndrome, and Dr. Peter Creticos discusses a sublingual immunotherapy tablet for house dust mite allergies. Dr. Sadhna Vora hosts.

This episode features Dr. Brent Egan discussing the target blood pressure in older adults, and Dr. Mark Aronson discussing the use of dexamethasone for acute pharyngitis pain in adults. Dr. Nancy Sokol hosts.

Dr. Joseph Wolfsdorf discusses complications related to type 1 and type 2 diabetes in pediatric patients, and Dr. Michael DeBaun discusses a report of gene therapy for sickle cell disease. Dr. Nancy Sokol hosts.

This episode features Dr. Richard Larson discussing the long-term outcomes of imatinib treatment for chronic myeloid leukemia, and Dr. Francisco Gonzalez-Scarano discussing the use of ocrelizumab for treatment of primary progressive multiple sclerosis. Dr. Jennifer Mitty hosts.

In this episode, Dr. Stephen Brecker discusses transcatheter aortic valve implantation for severe aortic stenosis in patients with intermediate surgical risk, and Dr. David McCulloch discusses outcomes of bariatric surgery for patients with diabetes mellitus.

This episode features Dr. Christopher Fanta, discussing the role of spirometry in the diagnosis of asthma; and Dr. James O’Dell, discussing baricitinib, a promising oral agent for the treatment of rheumatoid arthritis. Dr. Helen Hollingsworth hosts.

This episode features Dr. Hope Rugo, discussing the use of a scalp-cooling device to prevent hair loss after chemotherapy in breast cancer patients; and Dr. David Golden, discussing the joint practice parameter on immunotherapy for stinging insect hypersensitivity. Dr. Nancy Sokol hosts.

This podcast features Dr. Martin Hirsch, discussing persistence of Zika virus in body fluids; and Dr. Mark Crowther, discussing underdosing of direct oral anticoagulants (DOACs). Dr. Jennifer Tirnauer hosts.

This podcast features Dr. Sheldon Kaplan, discussing the duration of antibiotic treatment in young children with acute otitis media; and Dr. Anna Lok, discussing the use of tenofovir alafenamide for the treatment of chronic hepatitis B virus infection. Dr. Jennifer Mitty hosts.

This episode features Dr. David Nathan, discussing clinical outcomes of metformin use in populations with chronic kidney disease, congestive heart failure, or chronic liver disease; and Dr. Chyke Doubeni, discussing the effectiveness of screening for colorectal cancer using flexible sigmoidoscopy in men and women at different age groups. Dr. Nancy Sokol hosts.

In this episode, Dr. Charles Pozner discusses criteria for determining futility for resuscitation for out-of-hospital cardiac arrest and potential implications for organ donation; and Dr. Robert Brown discusses management of hepatitis C infection in patients undergoing liver transplantation. Dr. Nancy Sokol hosts.

This episode features Dr. Barbara Goff, discussing a population-based study on adverse pregnancy outcomes associated with treatment for cervical intraepithelial neoplasia (CIN) (starts at 00:43); and Dr. David Fleischer, discussing data on early dietary egg introduction for the prevention of egg allergy in infants (starts at 15:32).

This episode features Dr. Peter Bonis, Chief Medical Officer, and Dr. Denise Basow, President and CEO of Clinical Effectiveness for Wolters Kluwer Health, discussing current challenges in the U.S. healthcare space, including undesirable variability in care, suboptimal patient outcomes and rising costs, and the digital solutions necessary to address these problems. We hope this will be a valuable insight into how a coordinated, harmonized, multitargeted digital solution might meet these challenges and improve healthcare delivery and outcomes for patients, clinicians, and payers.

This episode features Dr. Jess Mandel, discussing the prevalence of pulmonary embolism in patients hospitalized for syncope (starts at 00:54); and Dr. Robert Barbieri, discussing the potential role for a new topical drug, prasterone (DHEA), in the treatment of genitourinary syndrome of menopause (starts at 11:44). Nancy Sokol hosts.

In this episode, Dr. William Elliott discusses management of hypertensive urgency (starts at 00:50); and Dr. John Eidt discusses a comparison of long-term outcomes following endovascular and open surgical repair of an asymptomatic abdominal aneurysm (starts at 17:09). Dr. Nancy Sokol hosts.

This episode features Dr. Joann Elmore, discussing the UpToDate What’s New topic on the overdiagnosis of breast cancer with mammography. Dr. Sandy Falk hosts.

This episode features Dr. Scott Manaker, discussing the UpToDate What’s New topic on the lack of benefit of glucocorticoids in severe sepsis (starts at 01:07); and Dr. Joel Palefsky, discussing the UpToDate Practice Changing UpDate regarding updated guidelines for HPV vaccination in young adolescents (starts at 14:56). Dr. Sandy Falk hosts.

This episode features Dr. Sonja Rasmussen, discussing infant protection against influenza illness through maternal immunization (starts at 00:44); and Dr. Karl Fields, discussing outcomes for patients with degenerative meniscal tears, comparing meniscectomy with physical therapy (starts at 13:38). Dr. Nancy Sokol hosts.

This episode features Dr. Gordon Guyatt, discussing general principles of evidence-based medicine (EBM) and how EBM is incorporated into UpToDate topics, using an example from a topic in UpToDate on aspirin for primary prevention.

This episode features Dr. Jerome Richie, discussing options for treatment of localized low-risk prostate cancer (starts at 00:42); and Dr. Donald Cutlip, discussing comparison of current generation drug-eluting and bare metal intracoronary stents (starts at 14:30).

This episode features Dr. Brett Cucchiara discussing aspirin for secondary prevention after transient ischemic attack or stroke (starts at 01:28); and Dr. Paul Sax discussing the prevention of HIV1 transmission with antiretroviral therapy (starts at 16:50). Dr. Helen Hollingsworth hosts.

This episode features Dr. Martin Hirsch discussing choice of influenza vaccines for the 2016-17 season in the northern hemisphere (starts at 00:35); and Dr. Alon Avidan discussing the diagnosis and management of augmentation, a condition seen in patients with restless legs syndrome who have been treated with dopamine agonists (starts at 13:37). Dr. Nancy Sokol hosts.

This episode features Dr. Adrian Di Bisceglie discussing a Practice Changing UpDate related to sofosbuvir-velpatasvir for treatment of chronic HCV infection (starts at 00:51); and Dr. Vinod Bhutani discussing neonatal phototherapy and risk of childhood cancer (starts at 14:50). Dr. Nancy Sokol hosts.

This episode features Dr. Harold Burstein discussing a Practice Changing Update related to the duration of adjuvant hormone therapy for non-metastatic, post-menopausal breast cancer (starts at 01:01); and Dr. Joel Yager discussing a recent systematic review of treatment for binge eating disorder (starts at 15:04). Dr. Nancy Sokol hosts.

In this episode, Dr. Jan Shifren discusses flibanserin for treatment of sexual dysfunction in women (starts at 01:13); Dr. Stephen Freedman discusses use of diluted apple juice for hydration in children with mild gastroenteritis (starts at 11:31); and Dr. Kathleen Motil discusses the association between obesity in adolescence and cardiovascular mortality in adulthood (starts at 20:53).