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Superficial vein thrombosis (SuVT) is characterized by thrombus formation in the superficial veins, typically in the lower or upper extremities. In this podcast, the coauthor of a JAMA review on SuVT, Behnood Bikdeli, MD, MS, discusses pathophysiology, risk factors, diagnosis, and treatment of SuVT with JAMA Deputy Editor Mary McDermott, MD. Related Content: Superficial Vein Thrombosis
Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-450 Overview: Use of e-cigarettes has increased significantly over the last several years and their popularity continues to grow, notably among adolescents and young adults. Recent evidence indicates that the majority of teens and young adults who vape consider quitting; however, nicotine addiction has historically been difficult to treat in this population. Join us as we discuss the prevalence of vaping, associated harms, and new evidence on the effectiveness of varenicline on cessation. Episode resource links: CDC https://www.cdc.gov/tobacco/e-cigarettes/youth.html Evins, A. E., Cather, C., Reeder, H. T., Evohr, B., Potter, K., Pachas, G. N., Gray, K. M., Levy, S., Rigotti, N. A., Iroegbulem, V., Dufour, J., Casottana, K., Costello, M. A., Gilman, J. M., & Schuster, R. M. (2025). Varenicline for Youth Nicotine Vaping Cessation: A Randomized Clinical Trial. JAMA, e253810. Advance online publication. https://doi.org/10.1001/jama.2025.3810 Lindson N, Butler AR, McRobbie H, et al. Electronic cigarettes for smoking cessation. Cochrane Database Syst Rev. 2024;1(1):CD010216. Published 2024 Jan 8. doi:10.1002/14651858.CD010216.pub8 Park-Lee E, Ren C, Sawdey MD, et al. Notes from the Field: E-Cigarette Use Among Middle and High School Students — National Youth Tobacco Survey, United States, 2021. MMWR Morb Mortal Wkly Rep 2021;70:1387–1389. DOI: http://dx.doi.org/10.15585/mmwr.mm7039a4external icon; Tuisku A, Rahkola M, Nieminen P, Toljamo T. Electronic Cigarettes vs Varenicline for Smoking Cessation in Adults: A Randomized Clinical Trial. JAMA Intern Med. 2024;184(8):915–921. doi:10.1001/jamainternmed.2024.1822 Zhang, L., Gentzke, A., Trivers, K. F., & VanFrank, B. (2022). Tobacco Cessation Behaviors Among U.S. Middle and High School Students, 2020. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 70(1), 147–154. https://doi.org/10.1016/j.jadohealth.2021.07.011 Guest: Susan Feeney, DNP, FNP-BC, NP-C Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com
Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-450 Overview: Use of e-cigarettes has increased significantly over the last several years and their popularity continues to grow, notably among adolescents and young adults. Recent evidence indicates that the majority of teens and young adults who vape consider quitting; however, nicotine addiction has historically been difficult to treat in this population. Join us as we discuss the prevalence of vaping, associated harms, and new evidence on the effectiveness of varenicline on cessation. Episode resource links: CDC https://www.cdc.gov/tobacco/e-cigarettes/youth.html Evins, A. E., Cather, C., Reeder, H. T., Evohr, B., Potter, K., Pachas, G. N., Gray, K. M., Levy, S., Rigotti, N. A., Iroegbulem, V., Dufour, J., Casottana, K., Costello, M. A., Gilman, J. M., & Schuster, R. M. (2025). Varenicline for Youth Nicotine Vaping Cessation: A Randomized Clinical Trial. JAMA, e253810. Advance online publication. https://doi.org/10.1001/jama.2025.3810 Lindson N, Butler AR, McRobbie H, et al. Electronic cigarettes for smoking cessation. Cochrane Database Syst Rev. 2024;1(1):CD010216. Published 2024 Jan 8. doi:10.1002/14651858.CD010216.pub8 Park-Lee E, Ren C, Sawdey MD, et al. Notes from the Field: E-Cigarette Use Among Middle and High School Students — National Youth Tobacco Survey, United States, 2021. MMWR Morb Mortal Wkly Rep 2021;70:1387–1389. DOI: http://dx.doi.org/10.15585/mmwr.mm7039a4external icon; Tuisku A, Rahkola M, Nieminen P, Toljamo T. Electronic Cigarettes vs Varenicline for Smoking Cessation in Adults: A Randomized Clinical Trial. JAMA Intern Med. 2024;184(8):915–921. doi:10.1001/jamainternmed.2024.1822 Zhang, L., Gentzke, A., Trivers, K. F., & VanFrank, B. (2022). Tobacco Cessation Behaviors Among U.S. Middle and High School Students, 2020. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 70(1), 147–154. https://doi.org/10.1016/j.jadohealth.2021.07.011 Guest: Susan Feeney, DNP, FNP-BC, NP-C Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com
Send us a message with this link, we would love to hear from you. Standard message rates may apply.The DASH diet offers a powerful, evidence-based approach to lowering blood pressure through nutritional changes rather than medication.• Stands for Dietary Approaches to Stop Hypertension• Focuses on fruits, vegetables, whole grains, lean proteins, and low-fat dairy• Limits sodium, saturated fat, added sugars, and processed meats• Can lower systolic blood pressure by 5-6 points and diastolic by 3 points• Recommends 4-5 servings each of fruits and vegetables daily• Suggests 6-8 servings of whole grains per day• Advises limiting sodium to 1,500mg daily for those with hypertension• Provides numerous meal ideas including oatmeal with berries, turkey sandwiches, and grilled salmon• Encourages using herbs and spices instead of salt for flavoring• Benefits extend beyond blood pressure to include improved cholesterol and weight managementFor more information about hypertension management, check out our previous episodes: episode 4 (explaining hypertension), episode 5 (lifestyle changes), episode 14 (common medications), and episode 33 (measuring blood pressure at home).References1. Diets. Yannakoulia M, Scarmeas N. The New England Journal of Medicine. 2024;390(22):2098-2106. doi:10.1056/NEJMra2211889.2. Treatment of Hypertension: A Review. Carey RM, Moran AE, Whelton PK. JAMA. 2022;328(18):1849-1861. doi:10.1001/jama.2022.19590.3. DASH Dietary Pattern and Cardiometabolic Outcomes: An Umbrella Review of Systematic Reviews and Meta-Analyses. Chiavaroli L, Viguiliouk E, Nishi SK, et al. Nutrients. 2019;11(2):E338. doi:10.3390/nu11020338.4. Primary Prevention of ASCVD and T2DM in Patients at Metabolic Risk: An Endocrine Society* Clinical Practice Guideline. Rosenzweig JL, Bakris GL, Berglund LF, et al. The Journal of Clinical Endocrinology and Metabolism. 2019;104(9):3939-3985. doi:10.1210/jc.2019-01338.5. Recommended Dietary Pattern to Achieve Adherence to the American Heart Association/American College of Cardiology (AHA/ACC) Guidelines: A Scientific Statement From the American Heart Association. Van Horn L, Carson JA, Appel LJ, et al. Circulation. 2016;134(22):e505-e529. doi:10.1161/CIR.0000000000000462.6. Dietary Approaches to Stop Hypertension (DASH) for the Primary and Secondary Prevention of Cardiovascular Diseases. Bensaaud A, Seery S, Gibson I, et al. The Cochrane Database of Systematic Reviews. 2025;5:CD013729. doi:10.1002/14651858.CD013729.pub2.7. Popular Dietary Patterns: Alignment With American Heart Association 2021 Dietary Guidance: A Scientific Statement From the American Heart Association. Gardner CD, Vadiveloo MK, Petersen KS, et al. Circulation. 2023;147(22):1715-1730. doi:10.1161/CIR.0000000000001146.8. Dietary Approaches to Prevent and Treat Hypertension: A Scientific Statement From the American Heart Association. Appel LJ, Brands MW, Daniels SR, et al. Hypertension (Dallas, Tex. : 1979). 2006;47(2):296-308. doi:10.1161/01.HYP.0000202568.01167.B6.9. Dietary Approaches to Stop Hypertension (DASH): Potential Mechanisms of Action Against Risk Factors of the Metabolic Syndrome. Akhlaghi M. Nutrition Research Reviews. 2020;33(1):1-18. doi:10.1017/S0954422419000155.10. The Effects of the Dietary Approaches to Stop Hypertension (DASH) Diet on Metabolic Risk Factors in Patients With Chronic Disease: Support the showSubscribe to Our Newsletter! Production and Content: Edward Delesky, MD & Nicole Aruffo, RNArtwork: Olivia Pawlowski
Editor's Summary by Kirsten Bibbins-Domingo, PhD, MD, MAS, Editor in Chief, and Preeti Malani, MD, MSJ, Deputy Editor of JAMA, the Journal of the American Medical Association, for articles published from September 6-12, 2025.
Send us a textThis week we're tackling a food we all know and love: flour. But is it really as harmless as it seems? Join me as I break down the surprising science of refined flour, cravings, and hormones—plus how a few small shifts can help you take back control of your weight loss journey.We'll talk about why flour is classified as an ultra-processed food, how it hijacks hunger signals, and why it can make weight loss feel harder than it should. Don't worry, I'll make it simple, light, and easy to understand—because this is about living your best life, not stressing over bread.Quote of the Week:“Your body is your home—feed it with care.” – Unknown Citations:Monteiro et al., 2019 – Ultra-processed foods: What they are and how to identify them. Public Health Nutrition.Hall et al., 2019 – Ultra-processed diets cause excess calorie intake and weight gain. Cell Metabolism.Ludwig, 2002 – The glycemic index: Physiological mechanisms relating to obesity, diabetes, and cardiovascular disease. JAMA.Friedman, 2014 – Leptin and the regulation of body weight. American Journal of Clinical Nutrition.Volkow et al., 2013 – The addictive dimensionality of obesity. Biological Psychiatry.Slavin, 2013 – Fiber and prebiotics: Mechanisms and health benefits. Nutrients.Hu, 2011 – Globalization of diabetes: The role of diet, lifestyle, and genes. Diabetes Care.ADA, 2020 – Standards of medical care in diabetes—2020. Diabetes Care.Let's go, let's get it done. Get more information at: http://projectweightloss.org
Sources of Aqeedah in Islam | ZAD Academy Audio | Blogpost by Zayd HajiBy Zayd Haji – Student at Zad AcademyAssalamu Alaikum wa Rahmatullahi wa Barakatuh,I am Zayd Haji, a student at Zad Academy. In this blog, I will summarize a key lesson on the sources of Aqeedah (Islamic creed). Aqeedah is the foundation of our faith, and it must be taken from authentic sources: the Qur'an, the Sunnah of the Prophet ﷺ, and the consensus of the righteous predecessors.The Qur'an is the first and most important source of Aqeedah. Allah warns against opposing the Messenger ﷺ and abandoning the path of the believers:“And whoever opposes the Messenger after guidance has become clear to him and follows other than the way of the believers – We will turn him to what he has chosen and drive him into Hell, and evil it is as a destination.”(Qur'an, Surah An-Nisa 4:115)
Husband-and-wife team William Firth Wells and Mildred Weeks Wells conducted research that had the potential to make a big difference in the safety of indoor air. But it didn’t really have a significant impact on public health. Research: Associated Press. “Super-Oyster Is On its Way to Dinner Table Bigger and Better Bivalve Sports Pedigree.” 3/13/1927. https://www.loc.gov/resource/sn84020064/1927-03-13/ed-1/?sp=14 “Brought Back to Texas.” The Houston Semi-Weekly Post. 12/26/1889. https://www.newspapers.com/image/1196039760/ Decatur Daily Review. “Scientists Fight Flu Germs with Violet Ray.” 7/30/1936. https://www.newspapers.com/image/94335504/ Evening Star. “Scientific Trap-shooter.” 6/26/1937. https://www.loc.gov/resource/sn83045462/1937-06-26/ed-1/?sp=7&q=William+Firth+Wells&r=0.668,0.557,0.438,0.158,0 Fair, Gordon M. and William Weeks Wells. “Method and Apparatus for Preventing Infection.” U.S. Patent 2,198,867. https://ppubs.uspto.gov/api/pdf/downloadPdf/2198867 Hall, Dominic. “New Center for the History of Medicine Artifact - Wells Air Centrifuge.” Harvard Countway Library. https://countway.harvard.edu/news/new-center-history-medicine-artifact-wells-air-centrifuge “Incubator Is Now Oyster Nurse.” Washington Times. 10/1/1925. https://www.loc.gov/resource/sn84026749/1925-10-01/ed-1/?sp=12 Lewis, Carol Sutton. “Mildred Weeks Wells’s Work on Airborne Transmission Could Have Saved Many Lives—If the Scientific Establishment Listened.” Lost Women of Science Podcast. Scientific American. 5/22/2025. https://www.scientificamerican.com/article/a-public-health-researcher-and-her-engineer-husband-found-how-diseases-can/ Library and Archives Team. “William Firth Wells and Mildred Weeks Wells.” Washington College. https://www.washcoll.edu/people_departments/offices/miller-library/archives-special-collections/archives-blog/Wells%20papers.php Molenti, Megan. “The 60-Year-Old Scientific Screwup That Helped Covid Kill.” Wired. 5/13/2021. https://www.wired.com/story/the-teeny-tiny-scientific-screwup-that-helped-covid-kill/ Perkins JE, Bahlke AM, Silverman HF. Effect of Ultra-violet Irradiation of Classrooms on Spread of Measles in Large Rural Central Schools Preliminary Report. Am J Public Health Nations Health. 1947 May;37(5):529-37. PMID: 18016521; PMCID: PMC1623610. Randall, Katherine and Ewing, E. Thomas and Marr, Linsey and Jimenez, Jose and Bourouiba, Lydia, How Did We Get Here: What Are Droplets and Aerosols and How Far Do They Go? A Historical Perspective on the Transmission of Respiratory Infectious Diseases (April 15, 2021). Available at SSRN: https://ssrn.com/abstract=3829873 Riley, Richard L. “What Nobody Needs to Know About Airborne Infection.” American Journal of Respiratory and Critical Care Medicine. Volume 163, Issue 1. https://www.atsjournals.org/doi/10.1164/ajrccm.163.1.hh11-00 Simon, Clea. “Did a socially awkward scientist set back airborne disease control?” The Harvard Gazette. 3/7/2025. https://news.harvard.edu/gazette/story/2025/03/did-a-socially-awkward-scientist-set-back-airborne-disease-control/ “Texas State News.” McKinney Weekly Democrat-Gazette. 4/17/1890. https://www.newspapers.com/image/65385350/ WELLS MW, HOLLA WA. VENTILATION IN THE FLOW OF MEASLES AND CHICKENPOX THROUGH A COMMUNITY: Progress Report, Jan. 1, 1946 to June 15, 1949, Airborne Infection Study, Westchester County Department of Health. JAMA. 1950;142(17):1337–1344. doi:10.1001/jama.1950.02910350007004 WELLS MW. VENTILATION IN THE SPREAD OF CHICKENPOX AND MEASLES WITHIN SCHOOL ROOMS. JAMA. 1945;129(3):197–200. doi:10.1001/jama.1945.02860370019006 WELLS WF, WELLS MW. AIR-BORNE INFECTION. JAMA. 1936;107(21):1698–1703. doi:10.1001/jama.1936.02770470016004 WELLS WF, WELLS MW. AIR-BORNE INFECTION: SANITARY CONTROL. JAMA. 1936;107(22):1805–1809. doi:10.1001/jama.1936.02770480037010 Wells, W F, and M W Wells. “Measurement of Sanitary Ventilation.” American journal of public health and the nation's health vol. 28,3 (1938): 343-50. doi:10.2105/ajph.28.3.343 Wells, William Firth and Gordon Maskew Fair. Viability of B. coli Exposed to Ultra-Violet Radiation in Air.Science82,280-281(1935).DOI:10.1126/science.82.2125.280.b Wells, William Firth and Mildred Weeks Wells. Measurement of Sanitary Ventilation American Journal of Public Health and the Nations Health 28, 343_350, https://doi.org/10.2105/AJPH.28.3.343 Zimmer, Carl. “Air-Borne: The Hidden History of the Life We Breathe.” Dutton. 2025. See omnystudio.com/listener for privacy information.
Interview with David C. Whiteman, MBBS, PhD, author of A Risk Prediction Tool for Invasive Melanoma. Hosted by Adewole S. Adamson, MD. Related Content: A Risk Prediction Tool for Invasive Melanoma
In this follow-up episode, Dr. Ed Livingston—renowned surgeon, educator, researcher, and former deputy editor at JAMA—returns to discuss the latest developments in his ongoing legal battle. He reflects on what has transpired in the three months since his last appearance, offering insights into the discovery process and the legal details shaping the case as it heads toward a July 2026 trial date. Check out Chadi's website for all Healthcare Unfiltered episodes and other content. www.chadinabhan.com/ Watch all Healthcare Unfiltered episodes on YouTube. www.youtube.com/channel/UCjiJPTpIJdIiukcq0UaMFsA
不只是憂鬱：認識飲食障礙症（eating disorders） 剛回到台大醫院當主治醫師時，有位住院醫師學弟在交代某位患者時和我說：「這個病人看起來像是不典型憂鬱症，要再多注意。」後來見到這位患者時，我的確觀察到憂鬱的症狀，但從她的身型、BMI與飲食情況，我更進一步發現個案其實有厭食症。 厭食症是死亡率最高的精神疾病之一，每年每一千人中就有 5.1 人死亡，死亡率約為同齡一般人群的 5.9倍； 而在所有與厭食症相關的死亡中，約有25%是自殺。 厭食症屬於「飲食障礙症」（eating disorders）的一種，本集Podcast將藉由這數篇文獻回顧並分析如何區分「厭食症」（anorexia nervosa）、「暴食症」（bulimia nervosa）與「嗜食症」（binge eating disorder），以及分享在臨床上應如何判斷患者的狀態與應用哪些會談技巧，讓我們對這同時影響著生理與心理的疾患有更具體的認識。
In episode 64 we discuss an article about addictive screen use and suicide. Xiao Y, Meng Y, Brown TT, Keyes KM, Mann JJ. Addictive Screen Use Trajectories and Suicidal Behaviors, Suicidal Ideation, and Mental Health in US Youths. JAMA. 2025;334(3):219–228. We also discuss the impact of the first 100 days of the Trump administration on addiction treatment, and the DEA scheduling of 7-OH (hydroxymitrigynine). Journal of Addiction Medicine: The First 100 Days: The Trump Administration and Changes to Addiction Policy FDA: FDA Takes Steps to Restrict 7-OH Opioid Products Threatening American Consumers --- This podcast offers category 1 and MATE-ACT CME credits through MI CARES and Michigan State University. To get credit for this episode and others, go to this link to make your account, take a brief quiz, and claim your credit. To learn more about opportunities in addiction medicine, visit MI CARES. CME: https://micaresed.org/courses/podcast-addiction-medicine-journal-club/ --- Original theme music: composed and performed by Benjamin Kennedy Audio editing: Michael Bonanno Executive producer: Dr. Patrick Beeman A podcast from Ars Longa Media --- This is Addiction Medicine Journal Club with Dr. Sonya Del Tredici and Dr. John Keenan. We practice addiction medicine and primary care, and we believe that addiction is a disease that can be treated. This podcast reviews current articles to help you stay up to date with research that you can use in your addiction medicine practice. --- The best part of any journal club is the conversation. Send us your comments on social media or join our Facebook group. Email: addictionmedicinejournalclub@gmail.com Facebook: @AddictionMedJC Facebook Group: Addiction Medicine Journal Club Instagram: @AddictionMedJC Threads: @AddictionMedJC YouTube: addictionmedicinejournalclub Twitter/X: @AddictionMedJC --- Addiction Medicine Journal Club is intended for educational purposes only and should not be considered medical advice. The views expressed here are our own and do not necessarily reflect those of our employers or the authors of the articles we review. All patient information has been modified to protect their identities. Learn more about your ad choices. Visit megaphone.fm/adchoices
Episode 202: BPA OverviewWritten by Cameron Carlisle, MSIV, Ross University School of Medicine. Comments by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice._____________________Arr: Welcome to another episode of Rio Bravo qWeek. My name is Hector Arreaza, I'm an associate program director and faculty in the Rio Bravo Family Medicine Residency Program. Today my co-host is Cameron Carlisle, who is a 4th-year medical student finishing his last rotation of med school. Welcome, Cameron, please introduce yourself.Arreaza: What are we talking about today, Cameron?Cam: Dr. Arreaza, did you know you're probably carrying around a chemical in your body that mimics estrogen? In fact, a 2004 CDC study found over 92% of Americans had detectable levels of Bisphenol A (BPA) in their urine. Today's topic is BPA.BPA is everywhere: receipts, water bottles, canned foods, baby bottles, and even our dental fillings. It's one of the most ubiquitous endocrine-disrupting chemicals (EDCs), which interferes with the body's hormone systems. That's why today's episode is about making the invisible visible. Our goals for today's podcast:Break down what BPA isShow how it affects the human bodyExplain how you and your patients can limit exposureEmpower both clinicians and the public with real, practical informationArreaza: Thanks for clarifying BPA today. It seems like we always have to learn about a new carcinogen or toxic substance that we are exposed to. I remember when I was a child, Yellow #5 became very concerning for the general public but it is still being used in our foods. So, it's good you are talking about this. What Is BPA?Cam: Bisphenol A (BPA) is an industrial chemical used since the 1950s, primarily in polycarbonate plastics and epoxy resins. It makes plastic clear, and is often found in:Water bottlesCanned food liningsBaby bottles (pre-2012)Takeout containersCash register receiptsDental sealantsArreaza: So, I've seen the “BPA-free” labels many times, and today I'm glad you are going to shed some light about it.Cam: What's alarming is that BPA leaches out of these products, especially when exposed to heat, acidity, or repeated use. A Harvard study found that people who drank from plastic bottles for just one week had a 69% increase in urinary BPA levels (Carwile & Michels, 2009).Arreaza: That's a lot of people 69%. Section 3: What happens when BPA gets into our body? How BPA Works in the BodyCam: BPA is classified as an endocrine disruptor, meaning it can bind to estrogen receptors and mimic or block natural hormone functions.It affects:Reproductive systems (both male and female)NeurodevelopmentThyroid signalingPancreatic β-cell functionMetabolism and fat storageEven low-dose exposure can disrupt cellular function. BPA acts as a xenoestrogen (foreign estrogen) and has been shown to alter DNA methylation, leading to epigenetic changes that persist across generations (Manikkam et al., 2013).Arreaza: So, BPA can cause epigenetic changes that can be inherited. BPA can persist for generations in your offspring.BPA's Health Impacts – What the Research SaysHere's where it gets serious. Let's go system-by-system:1. Reproductive HealthFemales: Linked to PCOS, infertility, and early puberty (Peretz et al., 2014).Males: Reduced sperm count and motility; altered testosterone levels.2. Pregnancy and Birth OutcomesIncreased risk of preterm birth, gestational diabetes, and low birth weight (Snijder et al., 2013).Studies show BPA crosses the placenta, directly affecting the fetus.3. Neurological DevelopmentAssociated with ADHD, anxiety, and impaired executive function in children exposed in utero (Mustieles et al., 2015).4. Metabolism and DiabetesBPA exposure is linked to insulin resistance, obesity, and type 2 diabetes, even at low doses (Lang et al., 2008).5. CancerAnimal and human data link BPA to increased risk of breast and prostate cancer via estrogenic mechanisms.6. MortalityA 2020 JAMA study found individuals with higher BPA levels had a 49% increased risk of all-cause mortality compared to those with lower levels (Gao et al., 2020).Arreaza: You are scaring me. I wonder what my BPA level is in my blood. Actually, BPA can be detected in urine. This is the most common approach for population-level biomonitoring, because BPA and its metabolites are mostly excreted in urine. Studies have found that BPA is present in most people, even up to 85–99% in large cohorts. Cam: That's literally everyone. Sources of BPA ExposureLet's talk about things we use every day:Thermal receipts (like from Target or Starbucks): BPA can transfer onto your skin and be absorbed, especially if your hands are wet or lotioned.Canned soups: One study showed that eating canned soup daily for five days led to a 1000% increased urinary BPA levels (Carwile et al., 2011).Plastic water bottles left in the car on hot days or plastic food trays for microwaving = chemical leaching.Baby bottles and pacifiers (pre-2012): primary concern for newborns.Arreaza: So, Cameron, you were exposed to BPA as a baby.Cam: Here's the jaw-dropper: We ingest up to 5 grams of plastic per week, roughly the weight of a credit card (WWF, 2019; University of Newcastle). This includes microplastics like BPA, which enter through food, water, and air.Arreaza: So, it translates into 40 lbs of plastic in a lifetime, by age 70. What can we do as family physicians?Family Medicine and Preventive CareAs family physicians, we are at the frontlines of prevention. Our role includes:Anticipatory guidance: during prenatal visits, well-child visits, and chronic disease managementScreening opportunities: ask about storage habits, microwave use, and receipt handlingEnvironmental health counseling: AAFP recommends addressing endocrine disrupting chemicals (EDCs) when relevant to a patient's concerns.It's not just about treating diabetes or obesity. It's about recognizing that environmental exposure may be a root cause.Arreaza: Prevention is my favorite topic!Cam: One helpful clinical practice:Arreaza: What else can we do to reduce BPA exposure?Practical Steps to Reduce BPAHere's what patients and doctors alike can do today:Switch to BPA-free products, but be careful, as replacements like BPS or BPF may also be harmful (Rochester & Bolden, 2015).Avoid microwaving or dishwashing plastic containers.Use digital receipts.Filter tap water using carbon filters, which can reduce microparticle ingestion.Choose fresh produce over canned goods when possible.Also, wash your hands after handling receipts, especially before eating or touching your face.Arreaza: What is our government doing to protect us?Public Health and Policy UpdatesRegulations are slowly catching up:The FDA banned BPA in baby bottles and sippy cups in 2012.The European Union has stricter limits, and France banned BPA in all food packaging in 2015.California's Proposition 65 requires BPA warning labels.Arreaza: Proposition 65, passed by direct voter initiative in 1986, “WARNING: This product contains chemicals known to the State of California to cause cancer and birth defects or other reproductive harm.”Arreaza: The FDA is planning to phase out petroleum-based food dyes (certified color additives) from the American food supply – marking a significant milestone in the efforts to protect the public. Cam: Many products still contain BPA analogs (BPS, BPF), which are not yet well-regulated.This is where clinician advocacy matters, where we can guide public opinion and support legislative change.Arreaza: So, millions of pounds of toxic substances are produced by many industries in the US. As physicians, we have to stay informed and update our patients.Cameron: How can we wrap up this episode?Conclusion and TakeawaysBPA is a hormone disruptor hiding in plain sight.People are exposed to BPA every day, but small lifestyle changes can dramatically reduce it.Family medicine has a role in education, prevention, and advocacy.Let's all be part of the solution for our health and future generations. Stanley (tumblers) are not sponsoring this episode, and we did not receive any money from them. Arreaza: That's it for today's episode of Rio Bravo qWeek. If you enjoyed this episode, share it with a colleague or medical student who may need to know about BPA. I'm Dr. Arreaza, signing off.Cameron: Hopefully, in the future I will talk to you about more endocrine disrupting chemicals. Thanks for listening._____________________Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:Carwile, J. L., & Michels, K. B. (2009). Urinary bisphenol A and obesity: NHANES 2003–2006. Environmental Research, 111(6), 825–830.Carwile, J. L., et al. (2011). Canned soup consumption and urinary bisphenol A: A randomized crossover trial. JAMA, 306(20), 2218–2220.Centers for Disease Control and Prevention (CDC). (2004). Fourth National Report on Human Exposure to Environmental Chemicals.Gao, X., et al. (2020). Urinary bisphenol A and mortality risk. JAMA Network Open, 3(8), e2011620.Lang, I. A., et al. (2008). Association of urinary bisphenol A with medical disorders and laboratory abnormalities in adults. JAMA, 300(11), 1303–1310.Manikkam, M., et al. (2013). Epigenetic transgenerational inheritance of disease. PLOS ONE, 8(1), e55387.Mustieles, V., et al. (2015). Bisphenol A and neurodevelopmental outcomes in children. Environmental Health Perspectives, 123(7), 689–695.Peretz, J., et al. (2014). Bisphenol A and reproductive health. Environmental Health Perspectives, 122(8), 775–786.Rochester, J. R., & Bolden, A. L. (2015). Bisphenol S and F: A systematic review. Environmental Health Perspectives, 123(7), 643–650.Snijder, C. A., et al. (2013). Fetal growth and prenatal exposure to bisphenol A. Environmental Health Perspectives, 121(3), 393–398.World Wildlife Fund (WWF). (2019). No Plastic in Nature: Assessing Plastic Ingestion from Nature to People.University of Newcastle (Australia). (2019). Human Consumption of Microplastics.Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/.
Editor's Summary by Linda Brubaker, MD, and Preeti Malani, MD, MSJ, Deputy Editors of JAMA, the Journal of the American Medical Association, for articles published from August 30-September 5, 2025. Related Content: European Society of Cardiology Congress (ESC)
A demência atinge milhões e pode chegar a 135 milhões em 2050. O US POINTER trial avaliou se mudanças no estilo de vida ajudam a prevenir o declínio cognitivo em idosos. Danielle Calil apresenta os principais resultados do estudo, divulgado no AAIC 2025 e publicado no JAMA. Ouça agora no podcast Afya!
V najnovšej epizóde Cashflow sme privítali investičného experta Slovenskej sporiteľne Jakuba Kábrta. Diskutovali sme o aktuálnej podnikateľskej klíme na Slovensku, o tom, aké je to dnes u nás podnikať, s akými prekážkami sa podnikatelia stretávajú, ale aj o tom, prečo má stále zmysel začať vlastný biznis či investovať práve na Slovensku.Rozobrali sme aj osobnejšiu tému: Aké boli Jakubove pocity, keď sa dozvedel, že Separ sa stane porotcom v šou Jama levova. Prezradil, aký má na umelca názor, prečo ho v show vníma ako „chodiacu encyklopédiu“ a čím ho dokáže inšpirovať. To všetko a ešte viac sa dozviete v novej epizóde Cashflow.Ak ťa zaujíma svet podnikania a investícií, od 3.9. sleduj každú stredu o 22:15 show Jama levova. Reláciu plnú zaujímavých nápadov a príbehov šikovných Slovákov a Sloveniek uvidíš iba na Markíze.V spolupráci s
For weight loss, complete avoidance of ultra-processed foods outperforms mere “healthy diet” comprising minimally-processed items; Research fraud undermines anti-dementia drug pipeline; Comprehensive lifestyle modification program scores against cognitive decline; Women's brains especially vulnerable to Omega-3 deficiencies; Bible says “Lame shall walk again” and 21st century science may soon bring about this miracle; Breakthroughs in rheumatoid arthritis treatment.
Punky reggae party avec Kiddus I, Camille Bazbaz et Jérôme « Tchiky » Perez #SessionLive ! (Rediffusion) The Salmon est le projet d'un trio légendaire de « soul men » réuni pour célébrer une longue amitié, la liberté musicale et la créativité. Inspirés par les sons originaux du reggae, de la country, du blues et de la soul, ils remontent la rivière tels des saumons, à contre-courant des clichés et des normes. Leur balade nous ravit et nous transporte vers des paysages lointains, apaisants qui nous reconnectent à l'essentiel : l'amour de la musique. Le groupe est composé de trois amis aux carrières bien remplies : Kiddus I, la légende du reggae à la voix envoûtante, « Last Crooner on Earth », héros du film Rockers sorti en 1977 et un des membres du projet Inna De Yard ; Bazbaz, pianiste auteur-compositeur-interprète français avec neuf disques à son actif ; et Tchiky, guitariste hors pair qui accompagne De La Soul depuis une dizaine d'années. Après un premier EP sorti en 2020 composé des titres « Enough is Enough » et « The Long Road », et une pandémie plus tard, The Salmon renaît finalement en janvier 2022 du haut des collines de Kingston, où le trio enfin réuni fera vibrer la Jamaïque aux côtés de musiciens chevronnés français comme jamaïcains tels que Delroy Wormbass, Viryane Say, Sly Dunbar, Christianne Prince, Pam Hall, Fabrice Colombani, Fonso, Yann Cléry, David Hadjadj, Flabba Holt et Style Scott. Leur premier album est un pur bijou franco-jamaïcain imprégné de la terre natale du reggae, et reflète la volonté du trio de revenir aux racines de leurs inspirations. Music is love… or is nothing ! ► Titres interprétés au grand studio - Wiggling Live RFI - The Salmon (Ska Version), extrait de l'album - Flowers Live RFI ► Line Up : Kiddus I (chant), Camille Bazbaz (claviers) et Jérôme « Tchiky » Perez (guitare) Son : Mathias Taylor, Benoît Letirant, Camille Roch ► Album The Salmon (22D Music 2025) Bandcamp - Facebook ► Playlist - The Specials – Gangsters 1979 - Bob Marley – Punky Reggae Party 1977 - Junior Murvin – Police and Thieves 1976 - Femi Kuti – Journey Through Life (Journey Through Life Bongo Joe 2025) - Sami Galbi – Casaflex (1er album YLH Bye Bye Bongo Joe 2025) Réalisation : Hadrien Touraud
Punky reggae party avec Kiddus I, Camille Bazbaz et Jérôme « Tchiky » Perez #SessionLive ! (Rediffusion) The Salmon est le projet d'un trio légendaire de « soul men » réuni pour célébrer une longue amitié, la liberté musicale et la créativité. Inspirés par les sons originaux du reggae, de la country, du blues et de la soul, ils remontent la rivière tels des saumons, à contre-courant des clichés et des normes. Leur balade nous ravit et nous transporte vers des paysages lointains, apaisants qui nous reconnectent à l'essentiel : l'amour de la musique. Le groupe est composé de trois amis aux carrières bien remplies : Kiddus I, la légende du reggae à la voix envoûtante, « Last Crooner on Earth », héros du film Rockers sorti en 1977 et un des membres du projet Inna De Yard ; Bazbaz, pianiste auteur-compositeur-interprète français avec neuf disques à son actif ; et Tchiky, guitariste hors pair qui accompagne De La Soul depuis une dizaine d'années. Après un premier EP sorti en 2020 composé des titres « Enough is Enough » et « The Long Road », et une pandémie plus tard, The Salmon renaît finalement en janvier 2022 du haut des collines de Kingston, où le trio enfin réuni fera vibrer la Jamaïque aux côtés de musiciens chevronnés français comme jamaïcains tels que Delroy Wormbass, Viryane Say, Sly Dunbar, Christianne Prince, Pam Hall, Fabrice Colombani, Fonso, Yann Cléry, David Hadjadj, Flabba Holt et Style Scott. Leur premier album est un pur bijou franco-jamaïcain imprégné de la terre natale du reggae, et reflète la volonté du trio de revenir aux racines de leurs inspirations. Music is love… or is nothing ! ► Titres interprétés au grand studio - Wiggling Live RFI - The Salmon (Ska Version), extrait de l'album - Flowers Live RFI ► Line Up : Kiddus I (chant), Camille Bazbaz (claviers) et Jérôme « Tchiky » Perez (guitare) Son : Mathias Taylor, Benoît Letirant, Camille Roch ► Album The Salmon (22D Music 2025) Bandcamp - Facebook ► Playlist - The Specials – Gangsters 1979 - Bob Marley – Punky Reggae Party 1977 - Junior Murvin – Police and Thieves 1976 - Femi Kuti – Journey Through Life (Journey Through Life Bongo Joe 2025) - Sami Galbi – Casaflex (1er album YLH Bye Bye Bongo Joe 2025) Réalisation : Hadrien Touraud
Delaying diagnosis of parkinsonism can mean delaying care. In a study recently published in JAMA Neurology, David Vaillancourt, PhD, and colleagues tested the ability of an AI model to differentiate between Parkinson disease and other neurodegenerative disorders when paired with MRI. He joins JAMA and JAMA+ AI Associate Editor Yulin Hswen, ScD, MPH to discuss. Related Content: A Large Proportion of Parkinson Disease Diagnoses Are Wrong—Here's How AI Could Help Automated Imaging Differentiation for Parkinsonism
Interview with Alexander Chern, MD, author of Over-the-Counter Hearing Aid–Enabled Earbuds—Merging Hearing Health and Technology. Hosted by Paul C. Bryson, MD, MBA. Related Content: Over-the-Counter Hearing Aid–Enabled Earbuds—Merging Hearing Health and Technology
LISTENER DISCRETION IS ADVISED. References: Buxton. Sustained Monomorphic VT: Clinical Manifestations, Diagnosis, and Evaluation. Up-to-Date. Farré J, Rubio JM, Sternick EB. Confounding factors leading to misdiagnosing ventricular tachycardia as supraventricular in the emergency room. Indian Pacing Electrophysiol J. 2023;23(1):1-13. doi:10.1016/j.ipej.2022.11.002 Kashou AH, Evenson CM, Noseworthy PA, et al. Differentiating wide complex tachycardias: A historical perspective. Indian Heart J. 2021;73(1):7-13. doi:10.1016/j.ihj.2020.09.006 Salim Rezaie, "SVT With Aberrancy Versus VT", REBEL EM blog, November 22, 2013. Available at: https://rebelem.com/svt-aberrancy-versus-vt/. Steinman RT, Herrera C, Schuger CD, Lehmann MH. Wide QRS tachycardia in the conscious adult. Ventricular tachycardia is the most frequent cause. JAMA. 1989 Feb 17;261(7):1013-6. PMID: 2915409. Vereckei A. Current algorithms for the diagnosis of wide QRS complex tachycardias. Curr Cardiol Rev. 2014 Aug;10(3):262-76. doi: 10.2174/1573403x10666140514103309. PMID: 24827795; PMCID: PMC4040878.
Editor's Summary by Kirsten Bibbins-Domingo, PhD, MD, MAS, Editor in Chief, and Preeti Malani, MD, MSJ, Deputy Editor of JAMA, the Journal of the American Medical Association, for articles published from August 23-29, 2025.
With all the attention focused on Alzheimer's biomarkers and amyloid antibodies, it's easy to forget that comprehensive dementia care is more than blood draws and infusions. On today's podcast, we buck this trend and dive into the complexities and challenges of comprehensive dementia care with the authors of two pivotal articles recently published in JAMA. We've invited David Reuben and Greg Sachs to talk about their two respective trials, published in JAMA — D-CARE and IN-PEACE — aimed at improving the evidence for care models supporting individuals diagnosed with dementia. D-CARE tested the comparative effectiveness of health system-based dementia care, a community-based program, and usual care, while IN-PEACE assessed the addition of palliative care to dementia care programs for individuals with moderate to severe dementia. Despite their pragmatic trial designs and high expectations, both studies' primary outcomes were negative, although there were some intriguing positive secondary outcomes. We discuss how some critical questions about the integration of these findings into practice, and how they fit in with previous research that did show benefits (see this past podcast on using health navigators to improve dementia care). If you want to learn more about comprehensive dementia care, check out these past podcasts: Our previous podcast on comprehensive dementia care with Lee Jennings and Chris Callahan Our podcast on the GUIDE Model with Malaz Boustani and Diane Ty Our podcast on Transforming the Culture of Dementia Care with Anne Basting, Ab Desai, Susan McFadden, and Judy Long Lastly, here is the link to Greg Sachs' NEJM article that describes his maternal grandmother decline from Alzheimer's disease.
Send us a Text Message (please include your email so we can respond!)Episode 72! We continue talking about the articles from the CCR25 conference with UK-ROX or "Conservative Oxygen Therapy in Mechanically Ventilated Critically Ill Adult Patients" published in JAMA 2025 by Martin et al and TARGET-Protein or "Sodium bicarbonate therapy for patients with severe metabolic acidaemia in the intensive care unit" by Jaber et al in Lancet 2018.UK-ROX: https://pubmed.ncbi.nlm.nih.gov/40501321/UK-ROX (JAMA): https://jamanetwork.com/journals/jama/article-abstract/2835384TARGET-Protein: https://pubmed.ncbi.nlm.nih.gov/40495743/TARGET-Protein (JAMA): https://jamanetwork.com/journals/jama/article-abstract/2835302If you enjoy the show be sure to like and subscribe, leave that 5 star review! Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!
In this World Shared Practice Forum Podcast, Dr. Padmanabhan Ramnarayan discusses the findings of the clinical trial comparing high-flow nasal cannula (HFNC) therapy to continuous positive airway pressure (CPAP) therapy in pediatric critical care. The trial, which was published in JAMA, explores the effectiveness of HFNC as a non-inferior alternative to CPAP for respiratory support in acutely ill children. Dr. Ramnarayan reviews the trial's design, key outcomes, and implications for clinical practice, providing valuable insights for healthcare professionals involved in pediatric respiratory care. LEARNING OBJECTIVES - Understand the design and methodology of the clinical trial comparing HFNC and CPAP in pediatric critical care - Identify the primary and secondary outcomes of the trial and their significance - Discuss the implications of the trial findings for clinical practice and future research in pediatric respiratory care AUTHORS Padmanabhan "Ram" Ramnarayan, MBBS, MD, FRCPCH, FFICM Professor of Paediatric Critical Care Imperial College London Jeffrey Burns, MD, MPH Emeritus Chief Division of Critical Care Medicine Department of Anesthesiology, Critical Care and Pain Medicine Boston Children's Hospital Professor of Anesthesia Harvard Medical School DATE Initial publication date: August 26, 2025. ARTICLES REFERENCED Ramnarayan P, Richards-Belle A, Drikite L, et al. Effect of High-Flow Nasal Cannula Therapy vs Continuous Positive Airway Pressure Therapy on Liberation From Respiratory Support in Acutely Ill Children Admitted to Pediatric Critical Care Units: A Randomized Clinical Trial. JAMA. 2022;328(2):162-172. doi:10.1001/jama.2022.9615 RENOVATE Investigators and the BRICNet Authors, Maia IS, Kawano-Dourado L, et al. High-Flow Nasal Oxygen vs Noninvasive Ventilation in Patients With Acute Respiratory Failure: The RENOVATE Randomized Clinical Trial. JAMA. 2025;333(10):875-890. doi:10.1001/jama.2024.26244 Pelletier JH, Maholtz DE, Hanson CM, et al. Respiratory Support Practices for Bronchiolitis in the Pediatric Intensive Care Unit. JAMA Netw Open. 2024;7(5):e2410746. Published 2024 May 1. doi:10.1001/jamanetworkopen.2024.10746 TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/as/whctgh753rgnhc7rxn7w3mn/20250712_WSP_Ramnarayan_Transcript Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu CITATION Ramnarayan P, O'Hara JE, Burns JP. High-Flow Nasal Cannula vs CPAP in Acutely Ill Children. 08/2025. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/high-flow-nasal-cannula-vs-cpap-in-acutely-ill-children-by-p-ramnarayan-openpediatrics
Good morning from Pharma and Biotech daily: the podcast that gives you only what's important to hear in Pharma and Biotech world.AbbVie has acquired Gilgamesh Pharmaceuticals for $1.2 billion, focusing on neurology and depression treatments. This move follows AbbVie's previous failure with Emraclidine in schizophrenia treatment. The biotech industry's IPO stalemate appears to be ending, with Lb Pharma planning an IPO to fund a phase III-ready schizophrenia asset. The FDA has pulled Valneva's chikungunya shot from the market due to safety concerns, and several obesity drugs have failed to make it to market. Meanwhile, Arnatar is working on advancing RNA therapies beyond silencing.In other news, the disappointment of oral obesity therapies is discussed, with Novo emerging as a leader in the field. Trials for Eli Lilly's Orforglipron and Viking Therapeutics' VK2735 were underwhelming, leading to increased interest in weight loss pills in low- and middle-income countries. Capricor Therapeutics plans to fight FDA rejection of its DMD cardiomyopathy treatment, while a study in JAMA contradicts claims of corruption in vaccine advisory committees. Updates on cancer, cell and gene therapy are also provided.Stay tuned for more updates and feel free to suggest topics for future coverage.
Quick summaries of articles 51-60. Enjoy! 51. Fun Activities and Recovery Acuff, S. F., et al. A brief measure of non-drug reinforcement: Association with treatment outcomes during initial substance use recovery. Drug and Alcohol Dependence, 256, 111092. 52. Buprenorphine-precipitated Fentanyl Withdrawal Thakrar AP, et al. Buprenorphine-Precipitated Withdrawal Among Hospitalized Patients Using Fentanyl. JAMA Netw Open. 2024 Sep 3;7(9):e2435895. 53. Methadone Vs. Buprenorphine Nosyk B, Et al. Buprenorphine/Naloxone vs Methadone for the Treatment of Opioid Use Disorder. JAMA. 2024 Oct 17. 54. High Daily Doses of Buprenorphine Axeen S, et al. Association of Daily Doses of Buprenorphine With Urgent Health Care Utilization. JAMA Netw Open. 2024 Sep 3;7(9):e2435478. 55. How Buprenorphine Works in Pregnancy Caritis, Steve N. MD; et al. A Pharmacologic Evaluation of Buprenorphine in Pregnancy and the Postpartum Period. Journal of Addiction Medicine ():10.1097/ADM.0000000000001380, September 2, 2024. 56. How Many Quite Attempts Does It Take? Fontes RM, et al. Beyond the first try: How many quit attempts are necessary to achieve substance use cessation? Drug Alcohol Depend. 2024 Dec 8;267:112525. 57. What is Recovery? Zemore SE, et al. Understanding the Shared Meaning of Recovery From Substance Use Disorders: New Findings From the What is Recovery? Study. Subst Abuse. 2023 Sep 15;17:11782218231199372. 58. Semaglutide for Alcohol Use Disorder (The RCT) Hendershot CS, et al. Once-Weekly Semaglutide in Adults With Alcohol Use Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2025 Feb 12:e244789. 59. Low-Dose Buprenorphine Initiation (Micro-induction) Suen LW, et al. Outpatient Low-Dose Initiation of Buprenorphine for People Using Fentanyl. JAMA Netw Open. 2025 Jan 2;8(1):e2456253. 60. Lisdexamfetamine for methamphetamine use disorder Ezard N, et al LiMA Investigator Group. Lisdexamfetamine in the treatment of methamphetamine dependence: A randomised, placebo-controlled trial. Addiction. 2024 Dec 19. --- This podcast offers category 1 and MATE-ACT CME credits through MI CARES and Michigan State University. To get credit for this episode and others, go to this link to make your account, take a brief quiz, and claim your credit. To learn more about opportunities in addiction medicine, visit MI CARES. CME: https://micaresed.org/courses/podcast-addiction-medicine-journal-club/ --- Original theme music: composed and performed by Benjamin Kennedy Audio editing: Michael Bonanno Executive producer: Dr. Patrick Beeman A podcast from Ars Longa Media --- This is Addiction Medicine Journal Club with Dr. Sonya Del Tredici and Dr. John Keenan. We practice addiction medicine and primary care, and we believe that addiction is a disease that can be treated. This podcast reviews current articles to help you stay up to date with research that you can use in your addiction medicine practice. The best part of any journal club is the conversation. Send us your comments on social media or join our Facebook group. --- Email: addictionmedicinejournalclub@gmail.com Facebook: @AddictionMedJC Facebook Group: Addiction Medicine Journal Club Instagram: @AddictionMedJC Threads: @AddictionMedJC YouTube: addictionmedicinejournalclub Twitter/X: @AddictionMedJC --- Addiction Medicine Journal Club is intended for educational purposes only and should not be considered medical advice. The views expressed here are our own and do not necessarily reflect those of our employers or the authors of the articles we review. All patient information has been modified to protect their identities. Learn more about your ad choices. Visit megaphone.fm/adchoices
Pred dvanástimi rokmi predával na jarmokoch na opačnej strane zemegule píšťalky. Dnes jeho topánky, ktoré simulujú chôdzu naboso, nosia ľudia od Tokia po Toronto. Juraj Fehervari je podnikateľ a filantrop, známy aj ako investor z televíznej šou Jama levova. Vypočujte si podcast Impact Talks, v ktorom prinášame inšpiratívne príbehy o pomáhaní a búrame tabu spojené so slovom filantropia. Keď Juraj Fehervari prišiel v Sydney o prácu v reštaurácii, získal licenciu na predaj špeciálnych píšťaliek pre Nový Južný Wales a obiehal s nimi jarmoky. Úspech prišiel paradoxne po návrate domov, vďaka barefootovej obuvi, ktorá sa predáva v 70 krajinách. Juraj založil Be Lenka Foundation, podporuje ekologické iniciatívy aj vzdelávanie mladých, pomáha nemocniciam aj staniciam na záchranu zvierat. Prednášky či workshopy na komerčných akciách si necháva zaplatiť a peniaze posiela na účet Be Lenka Foundation. „Vypýtať si na Slovensku alebo v Čechách honorár nie je úplne sexi téma. Nepotrebujem na tom zarábať, ľuďom hovorím – pozrite sa, kam to posielate.“ V podcaste sa dozviete: ako pomáha spojenie barefoot obuvi s Guinnessovým rekordom, čo Juraj urobil pre nemocnicu po synovej liečbe, koľko krokov chôdze naboso prinesie duševnú pohodu, čo pre neho znamená karma-free biznis, a budete počuť aj špeciálnu píšťalku z Austrálie. Kto je Juraj Fehervari Zakladateľ a CEO značiek Be Lenka a Barebarics získal v roku 2022 titul EY Podnikateľ roka. Diváci ho poznajú ako jedného z investorov v televíznej šou Jama levova. Svoje skúsenosti zdieľa prostredníctvom konzultácií a mentoringu so zameraním na biznis. Be Lenka Foundation organizuje osvetové kampane, podporuje startupy a vzdelávanie. Impact Talks V podcaste Impact Talks vám predstavujeme osobnosti z biznisu, kultúry a športu, ktoré búrajú zaužívané predstavy o filantropii. Srdciarov, ktorí pomáhajú intuitívne, aj tých, ktorí sa snažia o čo najväčší spoločenský dopad. Lebo filantropia je pestrá a zďaleka nie je iba o rozdávaní peňazí. Impact Talks vám prináša Nadácia Pontis, ktorá sa dlhodobo venuje rozvíjaniu filantropie, sociálnych inovácií a zodpovedného podnikania. Podcast vzniká v spolupráci s portálom Aktuality.sk a moderuje ho Martin Staňo.
Drs. Whitney Hartlage (@whithartlage11) and Sam Windham join Dr. Ryan Moenster to discuss updates in the diagnosis and management of community-acquire pneumonia. Hear from our guests on the role of rapid diagnostic tests such as multiplex PCR and urinary antigen tests in the inpatient and outpatient setting, considerations for initiating steroids and withholding macrolides, and when to use short antibiotic durations. Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/. Visit our website! https://breakpoints-sidp.org/ References: Metlay JP, Waterer GW, Long AC, Anzueto A, Brozek J, Crothers K, Cooley LA, Dean NC, Fine MJ, Flanders SA, Griffin MR, Metersky ML, Musher DM, Restrepo MI, Whitney CG. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019 Oct 1;200(7):e45-e67. doi: 10.1164/rccm.201908-1581ST. PMID: 31573350; PMCID: PMC6812437. Chaudhuri D, Nei AM, Rochwerg B, Balk RA, Asehnoune K, Cadena R, Carcillo JA, Correa R, Drover K, Esper AM, Gershengorn HB, Hammond NE, Jayaprakash N, Menon K, Nazer L, Pitre T, Qasim ZA, Russell JA, Santos AP, Sarwal A, Spencer-Segal J, Tilouche N, Annane D, Pastores SM. 2024 Focused Update: Guidelines on Use of Corticosteroids in Sepsis, Acute Respiratory Distress Syndrome, and Community-Acquired Pneumonia. Crit Care Med. 2024 May 1;52(5):e219-e233. doi: 10.1097/CCM.0000000000006172. Epub 2024 Jan 19. PMID: 38240492. Odeyemi Y, Tekin A, Schanz C, Schreier D, Cole K, Gajic O, Barreto E. Comparative effectiveness of azithromycin versus doxycycline in hospitalized patients with community acquired pneumonia treated with beta-lactams: A multicenter matched cohort study. Clin Infect Dis. 2025 May 16:ciaf252. doi: 10.1093/cid/ciaf252. Epub ahead of print. PMID: 40378193. Butler AM, Nickel KB, Olsen MA, Sahrmann JM, Colvin R, Neuner E, O'Neil CA, Fraser VJ, Durkin MJ. Comparative safety of different antibiotic regimens for the treatment of outpatient community-acquired pneumonia among otherwise healthy adults. Clin Infect Dis. 2024 Oct 23:ciae519. doi: 10.1093/cid/ciae519. Epub ahead of print. PMID: 39442057; PMCID: PMC12355227. Furukawa Y, Luo Y, Funada S, Onishi A, Ostinelli E, Hamza T, Furukawa TA, Kataoka Y. Optimal duration of antibiotic treatment for community-acquired pneumonia in adults: a systematic review and duration-effect meta-analysis. BMJ Open. 2023 Mar 22;13(3):e061023. doi: 10.1136/bmjopen-2022-061023. PMID: 36948555; PMCID: PMC10040075 Schober T, Wong K, DeLisle G, et al. Clinical outcomes of rapid respiratory virus testing in emergency departments. JAMA Intern Med. 2024;184(5):528-536. Clark T, Lindsley K, Wigmosta T, et al. Rapid multiplex PCR for respiratory viruses reduces time to result and improves clinical care: results of a systematic review and meta-analysis. J Infect. 2023;86(5):462-475. May L, Robbins EM, Canchola JA, Chugh K, Tran NK. A study to assess the impact of the cobas point-of-care RT-PCR assay (SARS-CoV-2 and Influenza A/B) on patient clinical management in the emergency department of the University of California at David Medical Center. J Clin Virol. 2023:168:105597. Cartuliares MB, Rosenvinge FS, Mogensen CB, Skovsted TA, Andersen SL, Østergaard C, et al. Evaluation of point-of-care multiplex polymerase chain reaction in guiding antibiotic treatment of patients acutely admitted with suspected community-acquired pneumonia in Denmark: a multicentre randomised controlled trial. PLoS Med. 2023;20:e1004314. doi: 10.1371/ journal.pmed.1004314. Vaughn VM, Dickson RP, Horowitz JK, Flanders SA. Community-acquired pneumonia: a review. JAMA. 2024;332(15):1282-1295. Davis MR, McCreary EK, Trzebucki AM. Things we do for no reason – ordering Streptococcus pneumoniae urinary antigen in patients with community-acquired pneumonia. Open Forum Infect Dis. 2024;11(3):ofae089. Centers for Disease Control and Prevention. Laboratory Testing for Legionella. Updated June 9, 2025. Accessed July 13, 2025. https://www.cdc.gov/legionella/php/laboratories/index.html. Jain S, Self WH, Wunderink RG. Community-acquired pneumonia requiring hospitalization among U.S. adults. N Engl J Med. 2015;373(5):415-427. Kamat IS, Ramachandram V, Eswaran H, Guffey D, Musher DM. Procalcitonin to distinguish viral from bacterial pneumonia: a systematic review and meta-analysis. Clin Infect Dis. 2020;70(3):538-542. Christ-Crain M, Jaccard-Stolz D, Bingisser R, Gencay MM, Huber PR, Tamm M, et al. Effect of procalcitonin-guided treatment on antibiotic use and outcome in lower respiratory tract infections: cluster-randomised, single blinded intervention trial. Lancet. 2004;363:600–7. doi: 10.1016/S0140- 6736(04)15591-8. Schuetz P, Christ-Crain M, Thomann R, Falconnier C, Wolbers M, Widmer I, et al. Effect of procalcitonin-based guidelines vs standard guidelines on antibiotic use in lower respiratory tract infections: the ProHOSP randomized controlled trial. JAMA. 2009;302:1059–66. Schuetz P, Muller B, Christ-Crain M, Stolz D, Tamm M, Bouadma L, et al. Procalci- € tonin to initiate or discontinue antibiotics in acute respiratory tract infections. Cochrane Datab System Rev. 2017;10(10):CD007498. doi: 10.1002/14651858. cd007498.pub2. Huang DT, Yealy DM, Filbin MR, Brown AM, Chang C-CH, Doi Y, et al. Procalcitonin-guided use of antibiotics for lower Respiratory tract infection. New Engl J Med. 2018;379:236–49. doi: 10.1056/NEJMoa1802670. Dequin PF, Meziani F, Quenot JP, et al. Hydrocortisone in severe community-acquired pneumonia. N Engl J Med. 2023;389(19):1623-1634. doi:10.1056/NEJMoa2215145. Gupta AB, Flanders SA, Petty LA, et al. Inappropriate diagnosis of pneumonia among hospitalized adults. JAMA Intern Med. 2024;184(5):548-556. Jones BE, Chapman AB, Ying J, et al. Diagnostic Discordance, Uncertainty, and Treatment Ambiguity in Community-Acquired Pneumonia: A National Cohort Study of 115 U.S. Veterans Affairs Hospitals. Ann Intern Med. 2024;177(9):1179-1189. doi:10.7326/M23-2505. Hartlage W, Imlay H, Spivak ES. The role of empiric atypical antibiotic coverage in non-severe community-acquired pneumonia. Antimicrob Steward Healthc Epidemiol. 2024;4(1):e214. doi:10.1017/ash.2024.453. Dinh A, Barbier F, Bedos JP, et al. Update of guidelines for management of community acquired pneumonia in adults by the French Infectious Disease Society (SPILF) and the French-Speaking Society of Respiratory Diseases (SPLF). Endorsed by the French Infectious Disease Society (SPILF) and the French-Speaking Society of Respiratory Diseases (SPLF); endorsed by the French Intensive Care Society (SRLF), the French Microbiology Society (SFM), the French Radiology Society (SFR), and the French Emergency Society (SFMU). Respir Med and Res. 2025. El Moussaoui R, de Borgie CAJM, van den Broek P, et al. Effectiveness of discontinuing antibiotic treatment after three days versus eight days in mild to moderate-severe community acquired pneumonia: randomised, double blind study. BMJ. 2006;332(7554):1355. doi:10.1136/bmj.332.7554.1355. Dinh A, Ropers J, Duran C, et al. Discontinuing β-lactam treatment after 3 days for patients with community-acquired pneumonia: a randomized, non-inferiority trial. Lancet. 2021;397(10280):1195-1203.
Editor's Summary by Kirsten Bibbins-Domingo, PhD, MD, MAS, Editor in Chief, and Preeti Malani, MD, MSJ, Deputy Editor of JAMA, the Journal of the American Medical Association, for articles published from August 16-22 2025.
A new JAMA study found that 84% of abortion prescriptions from Aid Access went to patients in states with bans, enabled by “shield laws” protecting telehealth providers across state lines. Provision rates were highest in underserved Southern and Midwestern counties, highlighting telemedicine's role in maintaining access. A Scientific Reports study showed that large language models for clinical use can be manipulated into giving unsafe answers through subtle “adversarial hallucination attacks,” with success rates over 95%. Finally, JAMA Ophthalmology reported GLP-1 agonists may slightly increase risk of sudden vision loss, though benefits still outweigh risks.
Ênio Macedo e Joanne Alves convidam Eduarda Guedes e Mariana Tourinho, R2 CM do HCMFMUSP, para discutir sobre 7 armadilhas na Doença arterial periférica (DAP), antiga DAOP.1. Não reconhecer manifestações clínicas iniciais 2. Valorizar somente o exame físico e não realizar o ITB 3. Solicitar exame de imagem no diagnóstico4. Focar apenas no tratamento farmacológico5. Não usar os tratamentos farmacológicos disponíveis6. Não reconhecer o momento de indicar revascularização7. Não reconhecer isquemia de membro agudaReferências: 1. https://www.tadeclinicagem.com.br/guia/324/doenca-arterial-obstrutiva-periferica-diretriz-ahaacc-2024/2. Gornik, Heather L et al. “2024 ACC/AHA/AACVPR/APMA/ABC/SCAI/SVM/SVN/SVS/SIR/VESS Guideline for the Management of Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.” Circulation vol. 149,24 (2024): e1313-e1410. doi:10.1161/CIR.00000000000012513. Khan, Nadia A et al. “Does the clinical examination predict lower extremity peripheral arterial disease?.” JAMA vol. 295,5 (2006): 536-46. doi:10.1001/jama.295.5.5364. Londero, Louise S et al. “Pulse palpation is an effective method for population-based screening to exclude peripheral arterial disease.” Journal of vascular surgery vol. 63,5 (2016): 1305-10. doi:10.1016/j.jvs.2015.11.044
Send us a textWhy are U.S. health care costs so high—and what does that mean for you and your family? In this episode, I dive into the real reasons behind America's staggering health care bills.We start with a story that hits close to home—a $189,000 outpatient cancer surgery bill followed by $12,000-a-month immunotherapy—and I unpack how even with Medicare coverage, the pricing dynamics can feel shocking. Using my experience as a physician and health policy researcher, I explain why these massive charges happen and where the system is breaking down.At the national level, we now spend over $5 trillion a year on health care—roughly 18% of our GDP—and this number is growing far faster than inflation. This growth threatens the solvency of key programs like Medicare, which is projected to run out of funds by 2033 (Health Affairs). Employers are also feeling the pinch, with average family coverage costs now topping $25,500 annually (WSJ). Individuals, especially those using ACA exchanges, face rising premiums—some increasing by 20–30% next year (Axios)—and deductibles between $3,000 and $5,000 are now typical.Despite all this spending, our health outcomes are among the worst in the developed world. The U.S. ranks 33rd in infant mortality and 32nd in life expectancy out of 38 OECD countries, even though we spend about $12,000 per person annually—nearly three times the OECD average (America's Health Rankings).So, what drives these costs? It boils down to three factors: high prices, high utilization, and high administrative overhead. Prices for common procedures are far above international norms—a CT scan in the U.S. costs around $900 compared to $279 in the Netherlands and just $97 in Canada (Health Imaging). U.S. physicians, nurses, and hospital executives also earn significantly more, contributing to overall spending (Medscape; JAMA).On the utilization front, studies estimate that around 25% of all care may be unnecessary, driven by defensive medicine, patient expectations, and incentive structures that reward more procedures—not necessarily better outcomes (PGPF; Choosing Wisely).Even administrative overhead plays a massive role: nearly 25% of U.S. health care spending goes to bureaucracy—four times what's typical in simpler, single-payer systems (Health System Tracker; Health Affairs%20of%20US%20GDP)).If you're wondering why your doctor spends just 17 minutes with you or why your premiums feel like a second mortgage, this episode offers the context—and data—to help you understand what's really going on.Takeaways: Start asking about cash prices—especially if you're still in your deductible phase. Preventive steps like regular exercise may offer the highest return on investment when compared to costly downstream care. And above all, consider your plan carefully during open enrollment.For deeper insights, links to all the studies mentioned, and access to my newslet
In this episode, Dr. Doug Lucas reviews a recent article on osteoporosis published in JAMA, discussing its implications for bone health. *Check out 4Well's Saw Palmetto For Men here:* https://tinyurl.com/4WellSawPalmetto *Interested in checking out 4Well's products?* https://tinyurl.com/DRDOUG4WELL. Use promo code DRDOUG4WELL to save 10%!*STUDIES*https://jamanetwork.com/journals/jama/article-abstract/2835762
In this special episode on Obstructive Sleep Apnea our host, Dr. Neil Skolnik will discuss treatment of OSA. In Part 1 we discussed and overview of OSA, in Part 2 we discussed making the diagnosis will, and Part 4 will look at cases. This special episode is supported by an independent educational grant from Lilly. Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health Dr. Sanjay Patel, M.D, Professor of Medicine, Epidemiology, & Clinical and Translational Science, and Director of the Center for Sleep and Cardiovascular Outcomes Research; Medical Director of the Comprehensive Sleep Disorders Program, University of Pittsburgh Medical Center Selected references: Diagnosis and Management of Obstructive Sleep Apnea - A Review. JAMA. 2020;323(14):1389-1400 Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity. N Engl J Med 2024;391:1193-1205
There's a lot of fear and misinformation around HRT, and one of the biggest myths is that HT is a highly significant cause of breast cancer. That is not the case. This is a remnant concept from 2002, with MANY caveats. Calls for the removal of the black box warning on hormone replacement therapy (HRT) stems primarily from the outdated and limited nature of the data from the Women's Health Initiative (WHI) study published in 2002. The WHI, while groundbreaking at the time, focused predominantly on a specific formulation of conjugated equine estrogens (CEE) and medroxyprogesterone acetate (MPA) in older, postmenopausal women, leading to concerns about its generalizability to the broader population of women considering HRT. This is why on July 17, 2025, the FDA met with a panel of experts, in open forum, to hear the petition of removing the black box warning on hormone replacement therapy. Listen in for details. 1. Writing Group for the Women's Health Initiative Investigators. Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal Women: Principal Results From the Women's Health Initiative Randomized Controlled Trial. JAMA.2002;288(3):321–333. doi:10.1001/jama.288.3.3212. Manson JE, Crandall CJ, Rossouw JE, Chlebowski RT, Anderson GL, Stefanick ML, Aragaki AK, Cauley JA, Wells GL, LaCroix AZ, Thomson CA, Neuhouser ML, Van Horn L, Kooperberg C, Howard BV, Tinker LF, Wactawski-Wende J, Shumaker SA, Prentice RL. The Women's Health Initiative Randomized Trials and Clinical Practice: A Review. JAMA. 2024 May 28;331(20):1748-1760. doi: 10.1001/jama.2024.6542. PMID: 38691368.3. NAMS: The 2022 hormone therapy position statement of The North American Menopause Society (Menopause)
Editor's Summary by Kirsten Bibbins-Domingo, PhD, MD, MAS, Editor in Chief, and Preeti Malani, MD, MSJ, Deputy Editor of JAMA, the Journal of the American Medical Association, for articles published from August 9-15, 2025.
In this episode, Dr. Sergio Zanotti discusses ECPR–Extracorporeal Cardiopulmonary Resuscitation. ECPR is still be considered a niche therapy, but its relevance and availability are increasing. He is joined by Dr. Adam Green, a practicing intensivist at Cooper University Health Care and an Associate Professor of Medicine at Cooper Medical School of Rowan University (CMSRU). Dr. Green is the director of research for the division of Critical Care and has authored over 50 peer-reviewed publications. He has been part of the ECMO team at Cooper since its inception. Additional resources: Extracorporeal cardiopulmonary resuscitation for refractory cardiac arrest. The Lancet Respiratory Medicine 2025: https://www.sciencedirect.com/science/article/pii/S2213260025001225 Effect of Intra-arrest Transport, Extracorporeal Cardiopulmonary Resuscitation, and Immediate Invasive Assessment and Treatment on Functional Neurologic Outcome in Refractory Out-of-Hospital Cardiac Arrest. JAMA 2022: https://jamanetwork.com/journals/jama/fullarticle/2789313 Association between increasing institutional experience with ECPR and outcomes in patients with out-of-hospital cardiac arrest: A nationwide multicenter observational study in Japan (the JAAM–OHCA registry) RESUSCITATION 2025: https://www.resuscitationjournal.com/article/S0300-9572(24)00862-1/fulltext Early Extracorporeal CPR for Refractory Out-of-Hospital Cardiac Arrest. N Eng J of Med 2023: https://www.nejm.org/doi/full/10.1056/NEJMoa2204511 Books mentioned in this episode: The Perfect Predator: A Scientist's Race to Save Her Husband from a Deadly Superbug. By S. Strathdee and T Patterson: https://amzn.to/3Hxjmez
Some conversations change lives. Others change the way we think about how we have them.In this episode, I share the lesson I took from Dr. Rahul Jandial, world-renowned brain surgeon, neuroscientist, and author, about the quiet power of the pause.Rahul has delivered some of the hardest news anyone can hear. And what he's learned is that it's not just the words that matter, it's what happens after them. In those seconds of silence, people begin to process, to find their footing, to summon the courage for what comes next.It's a habit we can all use. At work when we're giving feedback. At home in tough conversations. In moments with friends when they trust us enough to share what's really going on.In this episode, we explore:How silence builds trust faster than reassuranceThe neuroscience behind giving people space to thinkWhy the pause can change the way we lead, comfort, and connectHow to practice it in your everyday lifeIf you've ever wanted to show up better in the conversations that matter most, this one's for you.Here is more information on the studies referenced: Physician–Patient Communication: The Relationship With Malpractice Claims (Wendy Levinson et al., JAMA 1997)How to Stop Saying “Um,” “Ah,” and “You Know” Harvard Business ReviewListen to the full episode with Dr. Rahul Jandial: https://pod.fo/e/251425
A recent paper published in JAMA shows that Idaho has lost approximately 35 percent of doctors specializing in obstetrics and gynecology, leaving many counties without any maternal or reproductive health care providers at all. That comes after the state passed one of the most restrictive abortion bans in the country after the U.S. Supreme Court overturned Roe v. Wade in 2022. Amber Nelson, executive director of the Idaho Coalition for Safe Healthcare, says 85% of these practicing specialists work in just seven of the state’s urban counties. Dr. Amelia Huntsberger was a practicing OBGYN in Idaho for many years before the ban. But after the ban, the emotional strain of navigating patient care amid the possibility of prosecution, led to the painful decision to uproot her family and move out of state. Huntsberger now practices in Eugene, but she says her family still deals with the grief that transition brought. We talk with her and Nelson about the larger trends and what they mean in the lives of women seeking reproductive and material care.
Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-445 Overview: Managing knee osteoarthritis (OA) in patients with obesity can be challenging, especially when standard treatments fall short. In this episode, we discuss emerging evidence on the use of metformin to reduce knee pain in patients without diabetes and explore how this option could expand your approach to OA management. Episode resource links: Pan F, Wang Y, Lim YZ, et al. Metformin for Knee Osteoarthritis in Patients With Overweight or Obesity: A Randomized Clinical Trial. JAMA. 2025;333(20):1804-1812. Guest: Alan M. Ehrlich, MD, FAAFP Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com
Send us a textIn this episode of Causes or Cures, Dr. Eeks chats with Dr. Jerry Avorn, a Professor of Medicine at Harvard Medical School, drug safety watchdog, and author of Rethinking Medications: Truth, Power, and the Drugs You Take. If you've ever felt uneasy about the rising cost of prescription drugs, the process or speed by which new meds are approved, or why the side effects list is longer than your grocery receipt, this episode is for you.Dr. Avorn pulls no punches. We talk about:How our current system rewards speed over evidence, and why “accelerated approval” may sound good but can lead to disaster.The rise of drugs approved with weak or surrogate endpoints, yet priced like gold (yep, you still pay full price for half-baked science).Shocking case studies, like the Vioxx heart attack debacle and the controversial Alzheimer's drug Aduhelm.The FDA's evolution from watchdog to lapdog (in some cases).Conflicts of interest.Public funding, private profits: how taxpayer money fuels breakthroughs that we can't afford. (WTF!)And, yes, we talk about the “Do Your Own Research” crowd.Dr. Avorn's mission? Help patients and doctors actually understand what they're taking or prescribing, and what forces are shaping those decisions.Why listen?Because behind every pill is a story, and it's not always the one you're told in the ad with the beach scene and happy jazz flute.Links:Grab the book: Rethinking Medications: Truth, Power, and the Drugs You Take (Simon & Schuster, 2025)Jerry Avorn, MD, is a professor of medicine at Harvard Medical School and a senior internist in the Mass General Brigham health-care system. He built a leading research center at Harvard to study medication use, outcomes, costs, and policies and developed the educational approach of “academic detailing” to provide evidence-based information about medications to prescribers. One of the nation's most highly cited researchers, Dr. Avorn is the author of Powerful Medicines: The Benefits, Risks, and Costs of Prescription Drugs, and he has written or cowritten over six hundred papers in the medical literature as well as commentaries in the New York Times, The Washington Post, JAMA, and The New England Journal of Medicine.You can contact Dr. Eeks at bloomingwellness.com.Follow Eeks on Instagram here.Or Facebook here.Or X.On Youtube.Or TikTok.SUBSCRIBE to her monthly newsletter here! (Now featuring interviews with top experts on health you care about!)Support the show
As the Trump administration works to reimagine public health, a new study paints a stark picture of the challenges facing the nation’s kids. American children’s health has significantly worsened across several key indicators since 2007, according to a recent study published in JAMA. Ali Rogin speaks with Dr. Christopher Forrest, a pediatrician and one of the study’s lead authors, for more. PBS News is supported by - https://www.pbs.org/newshour/about/funders
Today, we're diving into a condition that's as fascinating as it is complex: Achalasia—where the esophagus stops playing nice, and swallowing becomes a daily challenge. We're breaking down the latest evidence, comparing POEM, pneumatic dilation, and Heller myotomy, and digging into what actually matters when deciding how to treat each achalasia subtype. Join show hosts Drs. Jake Greenberg, Dana Portenier, Zach Weitzner, and Joey Lew as they discuss the past, present, and future of Achalasia management. Whether you're a medical student or a seasoned attending, this episode will arm you with the tools to think critically about diagnosis, tailor your treatment strategy, and stay ahead of the curve on the future of achalasia care. Hosts: · Jacob Greenberg, MD, EdM, MIS Division Chief and Vice Chair for Education, Duke University · Dana Portenier, MD, MIS Fellowship Director, Duke University · Zachary Weitzner, MD, Minimally Invasive and Bariatric Surgery Fellow, Duke University, @ZachWeitznerMD · Joey Lew, MD, MFA, Surgical resident PGY-3, Duke University, @lew__actually Learning Goals: By the end of this episode, listeners will be able to: · Describe the pathophysiology and key diagnostic criteria for achalasia, including the role of manometry, EGD, and esophagram. · Differentiate between the three subtypes of achalasia based on the Chicago Classification and understand the clinical significance of each. · Compare treatment options for achalasia—pneumatic dilation, Lap Heller myotomy, and POEM—including indications, efficacy, and long-term outcomes. · Interpret landmark studies (e.g., European Achalasia Trial, JAMA POEM trial) and their impact on treatment decision-making. · Recognize patient-specific factors (age, comorbidities, achalasia subtype) that influence the choice of therapy. · Discuss evolving technologies and future directions in achalasia management, including endoluminal robotics, ARMS, and combined anti-reflux strategies. · Outline a basic treatment algorithm for newly diagnosed achalasia, incorporating diagnostic steps and tailored interventions. · Appreciate the multidisciplinary approach to achalasia care, including the roles of MIS surgeons, gastroenterologists, and emerging procedural skillsets. References: · Boeckxstaens G, Elsen S, Belmans A, Annese V, Bredenoord AJ, Busch OR, Costantini M, Fumagalli U, Smout AJPM, Tack J, Vanuytsel T, Zaninotto G, Salvador R; European Achalasia Trial Investigators. 10‑year follow-up results of the European Achalasia Trial: a multicentre randomised controlled trial comparing pneumatic dilation with laparoscopic Heller myotomy. Gut. 2024 Mar;73(4):582‑589. doi: 10.1136/gutjnl‑2023‑331374. PMID: 38050085 https://pubmed.ncbi.nlm.nih.gov/38050085/ · He J, Yin Y, Tang W, Jiang J, Gu L, Yi J, Yan L, Chen S, Wu Y, Liu X. Objective Outcomes of an Extended Anti‑reflux Mucosectomy in the Treatment of PPI‑Dependent Gastroesophageal Reflux Disease (with Video). J Gastrointest Surg. 2022 Aug;26(8):1566–1574. doi:10.1007/s11605‑022‑05396‑9. PMID: 35776296 https://pubmed.ncbi.nlm.nih.gov/35776296/ · Modayil RJ, Zhang X, Rothberg B, et al. Peroral endoscopic myotomy: 10-year outcomes from a large, single-center U.S. series with high follow-up completion and comprehensive analysis of long-term efficacy, safety, objective GERD, and endoscopic functional luminal assessment. Gastrointest Endosc. 2021;94(5):930-942. doi:10.1016/j.gie.2021.05.014. PMID: 33989646. https://pubmed.ncbi.nlm.nih.gov/33989646/ · Ponds FA, Fockens P, Lei A, Neuhaus H, Beyna T, Kandler J, Frieling T, Chiu PWY, Wu JCY, Wong VWY, Costamagna G, Familiari P, Kahrilas PJ, Pandolfino JE, Smout AJPM, Bredenoord AJ. Effect of peroral endoscopic myotomy vs pneumatic dilation on symptom severity and treatment outcomes among treatment-naive patients with achalasia: a randomized clinical trial. JAMA. 2019 Jul 9;322(2):134–144. doi:10.1001/jama.2019.8859. PMID: 31287522. https://pubmed.ncbi.nlm.nih.gov/31287522/ · Vaezi MF, Pandolfino JE, Yadlapati RH, Greer KB, Kavitt RT; ACG Clinical Guidelines Committee. ACG clinical guidelines: Diagnosis and management of achalasia. Am J Gastroenterol. 2020 Sep;115(9):1393–1411. doi:10.14309/ajg.0000000000000731. PMID: 32773454; PMCID: PMC9896940 https://pubmed.ncbi.nlm.nih.gov/32773454/ · West RL, Hirsch DP, Bartelsman JF, de Borst J, Ferwerda G, Tytgat GN, Boeckxstaens GE. Long term results of pneumatic dilation in achalasia followed for more than 5 years. Am J Gastroenterol. 2002;97(6):1346-1351. doi:10.1111/j.1572-0241.2002.05771.x. PMID:12094848. https://pubmed.ncbi.nlm.nih.gov/12094848/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen
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