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Dr. Jessica Ailani talks with Dr. Kathleen Digre about the recognition of symptoms, diagnostic imaging, treatment goals, and the importance of weight loss in managing IIH. Read the related article in JAMA. Read the related article in Neurology®. Disclosures can be found at Neurology.org.
Sasha K. Shillcutt, MD, MS, FASE is a tenured and endowed Professor and the Vice Chair of Strategy in the Department of Anesthesiology at the University of Nebraska Medical Center. She is a double-boarded cardiac anesthesiologist and is also CEO & Founder of Brave Enough, a community of thousands of women in healthcare where she teaches women how to advance through courses, coaching, and events. She leads conferences and retreats for professional women and is a certified coach for women leaders. Sasha is a well-published researcher in anesthesiology and gender equity, best-selling author, and international speaker. She speaks frequently to executives and leaders on the topics of professional resilience and wellbeing. Her TEDx talk titled Resilience: The Art of Failing Forward has been viewed by thousands of people. Her writing has been published in both the New England Journal of Medicine and JAMA. Her first book, Between Grit and Grace: How to be Feminine and Formidable, has sold thousands of copies and her second book, Brave Boundaries, is an international best seller. Her podcast, The Brave Enough Show, has over 315K downloads & she has coached hundreds of women leaders to thrive. Some of the topics we discussed were:Taking care of everybody else without leaving room for yourselfPrioritizing your well-being by setting aside time just for youHow to set up boundariesWhat boundaries really areSetting up boundaries in your personal life (like with your partner, children, parents, siblings, friends, etc.)Communicating your boundaries with othersSetting up boundaries at workAnd more!Learn more about me or schedule a FREE coaching call:https://www.joyfulsuccessliving.com/Join the Voices of Women Physicians Facebook Group:https://www.facebook.com/groups/190596326343825/ Connect with Dr. Shilcutt: WEBSITEINSTAGRAMFACEBOOKTWITTERLINKEDIN
REFERENCES 1. Miller RV. Tylenol autism lawsuit. Lawsuit Information Center. September 21, 2025. Accessed September 25, 2025. https://www.lawsuit-information-center.com/tylenol-autism-lawsuit.html 2. Gerstein AS, Niederhelman EF. Harvard's public health dean was paid $150,000 to testify Tylenol causes autism. The Harvard Crimson. September 24, 2025. Accessed September 25, 2025. https://www.thecrimson.com/article/2025/9/24/autism-dean-public-health/ 3. Poll: Most Americans encounter health misinformation, and most aren't sure whether it's true or false. News Release. KFF. August 22, 2023. Accessed September 26, 2025. https://www.kff.org/covid-19/poll-most-americans-encounter-health-misinformation-and-most-arent-sure-whether-its-true-or-false/ 4. Prada D, Ritz B, Bauer AZ, et al. Evaluation of the evidence on acetaminophen use and neurodevelopmental disorders using the Navigation Guide methodology. Environ Health. 2025 Aug 14;24(1):56. doi: 10.1186/s12940-025-01208-0. 5. Ahlqvist VH, Sjöqvist H, Dalman C, et al. Acetaminophen use during pregnancy and children's risk of autism, ADHD, and intellectual disability. JAMA. 2024;331(14):1205–1214. doi:10.1001/jama.2024.3172 6. Alemany S, Avella-García C, Liew Z, et al. Prenatal and postnatal exposure to acetaminophen in relation to autism spectrum and attention-deficit and hyperactivity symptoms in childhood: meta-analysis in six European population-based cohorts. Eur J Epidemiol. 2021 Oct;36(10):993-1004. doi: 10.1007/s10654-021-00754-4. 7. Ji Y, Azuine RE, Zhang Y, et al. Association of cord plasma biomarkers of in utero acetaminophen exposure with risk of attention-deficit/hyperactivity disorder and autism spectrum disorder in childhood. JAMA Psychiatry. 2020;77(2):180–189. doi:10.1001/jamapsychiatry.2019.3259
Editor's Summary by Linda Brubaker, MD, and Christopher C. Muth, MD, Deputy Editors of JAMA, the Journal of the American Medical Association, for articles published from September 27-October 3, 2025.
Un episodio que nunca quise grabar. Hoy destapamos un tema que une dos de los secretos más perturbadores del siglo XX: Marcial Maciel, el fundador de los Legionarios de Cristo, y el enigma del Tercer Secreto de Fátima.¿Sabía Maciel lo que nadie más debía conocer? ¿Por qué se relaciona su nombre con profecías ocultas, corrupción y poder en el Vaticano?Prepárate para descubrir documentos, testimonios y teorías que pocos se atreven siquiera a mencionar.
Epidemiologist Brian Lee, PhD, discusses his study on acetaminophen use during pregnancy and children's risk of autism and other neurodevelopmental disorders in this interview with JAMA Deputy Editor Linda Brubaker, MD. Related Content: Acetaminophen Use in Pregnancy—Study Author Explains the Data
Epidemiologist Brian Lee, PhD, discusses his study on acetaminophen use during pregnancy and children's risk of autism and other neurodevelopmental disorders in this interview with JAMA Deputy Editor Linda Brubaker, MD. Related Content: Acetaminophen Use in Pregnancy—Study Author Explains the Data
Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers goals of care conversations.Our guest for this episode is Dr. Tavis Apramian, a clinician-investigator in the Department of Family & Community Medicine (DFCM) at the University of Toronto and scientist in the Office of Education Scholarship. He works as a palliative care physician at St. Michael's Hospital and at Kensington Hospice. His largely qualitative program of research is focused on advance care planning; workplace-based learning and assessment; palliative care in family medicine; medical assistance in dying; and inequity in end-of-life care. His primary focus is on telling rich stories of learner and patient experiences to spark conversation about socioculturally complex educational and clinical problems in serious illness.The learning objectives for this episode are as follows:Describe a palliative approach to care and its relevance across different contextsDemonstrate a structured and compassionate approach to goals of care conversationsApply effective communication strategies to build therapeutic alliance, navigate difficult conversations, and involve multiple actors in the palliative contextRecognize and manage challenges in goals of care conversationsGuest: Dr. Tavis ApramianHosts: Dr. Daamoon Ghahari (PGY2) and Dr. Angad Singh (PGY2)Audio editing: Dr. Angad Singh (PGY2)Timestamps:(1:07) - Journey to palliative care(5:07) - What is palliative care(14:47) - Understanding patient values(33:47) - Structuring goals of care conversations(44:16) - Communication strategies(57:05) - Navigating family meetings(77:25) - Reflections on MAiD for sole mental illnessResources:Roth, H. (2024). Hearing the unspoken. Canadian Family Physician, 70(10), 642-642. https://pmc.ncbi.nlm.nih.gov/articles/PMC11477260/pdf/0700642.pdfReferences:Bernacki, R. E., & Block, S. D. (2014). Communication about serious illness care goals: a review and synthesis of best practices. JAMA internal medicine, 174(12), 1994-2003.Gross, J., & Koffman, J. (2024). Examining how goals of care communication are conducted between doctors and patients with severe acute illness in hospital settings: A realist systematic review. PLoS One, 19(3), e0299933.Scheunemann, L. P., Ernecoff, N. C., Buddadhumaruk, P., Carson, S. S., Hough, C. L., Curtis, J. R., ... & White, D. B. (2019). Clinician-family communication about patients' values and preferences in intensive care units. JAMA internal medicine, 179(5), 676-684.You, J. J., Downar, J., Fowler, R. A., Lamontagne, F., Ma, I. W., Jayaraman, D., ... & Canadian Researchers at the End of Life Network (CARENET). (2015). Barriers to goals of care discussions with seriously ill hospitalized patients and their families: a multicenter survey of clinicians. JAMA Internal Medicine, 175(4), 549-556.For more PsychEd, follow us on Instagram (@psyched.podcast), Facebook (PsychEd Podcast), X (@psychedpodcast), and Bluesky (@psychedpodcast.bsky.social). You can email us at psychedpodcast@gmail.com and visit our website at psychedpodcast.org.
“It's 5pm and your Consultant (attending) has headed off home. A patient arrives in the resuscitation room blood spurting from a stab wound in the armpit. Join Roisin – a junior Major Trauma fellow, Prash – a surgical trainee, Max – a senior trauma surgery fellow, and Chris – a Consultant trauma surgeon, as we talk through decision making from point of injury to aftercare in this challenging trauma surgical case”. • Hosts: Bulleted list of host names, including title, institution, & social media handles if indicated 1. Mr Prashanth Ramaraj. General Surgery trainee, Edinburgh rotation. @LonTraumaSchool 2. Dr Roisin Kelly. Major Trauma Junior Clinical Fellow, Royal London Hospital. 3. Mr Max Marsden. Resuscitative Major Trauma Fellow, Royal London Hospital. @maxmarsden83 4. Mr Christopher Aylwin. Consultant Trauma & Vascular Surgeon and Co-Programme Director MSc Trauma Sciences at Queen Mary University of London. @cjaylwin • Learning objectives: Bulleted list of learning objectives. A) To become familiar with prehospital methods of haemorrhage control in penetrating junctional injuries. B) To recognise the benefits of prehospital blood product resuscitation in some trauma patients. C) To follow the nuanced decision making in decision for CT scan in a patient with a penetrating junctional injury. D) To describe the possible approaches to the axillary artery in the context of resuscitative trauma surgery. E) To become familiar with decision making around intraoperative systemic anticoagulation in the trauma patient. F) To become familiar with decision making on type of repair and graft material in vascular trauma. G) To recognise the team approach in holistic trauma care through the continuum of trauma care. • References: Bulleted list of references with PubMed links. 1. Perkins Z. et al., 2012. Epidemiology and Outcome of Vascular Trauma at a British Major Trauma Centre. EJVES. https://www.ejves.com/article/S1078-5884(12)00337-1/fulltext 2. Ramaraj P., et al. 2025. The anatomical distribution of penetrating junctional injuries and their resource implications: A retrospective cohort study. Injury. https://www.injuryjournal.com/article/S0020-1383(24)00771-X/ 3. Smith, S., et al. 2019. The effectiveness of junctional tourniquets: A systematic review and meta-analysis. J Trauma Acute Care Surg. https://journals.lww.com/jtrauma/abstract/2019/03000/the_effectiveness_of_junctional_tourniquets__a.20.aspx 4. Rijnhout TWH, et al. 2019. Is prehospital blood transfusion effective and safe in haemorrhagic trauma patients? A systematic review and meta-analysis. Injury. https://www.injuryjournal.com/article/S0020-1383(19)30133-0/ 5. Davenport R, et al. 2023. Prehospital blood transfusion: Can we agree on a standardised approach? Injury. https://www.injuryjournal.com/article/S0020-1383(22)00915-9. 6. Borgman MA., et al. 2007. The Ratio of Blood Products Transfused Affects Mortality in Patients Receiving Massive Transfusions at a Combat Support Hospital. J Trauma Acute Care Surg. https://journals.lww.com/jtrauma/fulltext/2007/10000/the_ratio_of_blood_products_transfused_affects.13.aspx 7. Holcomb JB., et al. 2013. The Prospective, Observational, Multicenter, Major Trauma Transfusion (PROMMTT) Study. Comparative Effectiveness of a Time-Varying Treatment With Competing Risks. JAMA Surgery. https://jamanetwork.com/journals/jamasurgery/fullarticle/1379768 8. Holcomb JB, et al. 2015. Transfusion of Plasma, Platelets, and Red Blood Cells in a 1:1:1 vs a 1:1:2 Ratio and Mortality in Patients With Severe Trauma. The PROPPR Randomized Clinical Trial. JAMA. https://jamanetwork.com/journals/jama/fullarticle/2107789 9. Davenport R., et al. 2023. Early and Empirical High-Dose Cryoprecipitate for Hemorrhage After Traumatic Injury. The CRYOSTAT-2 Randomized Clinical Trial. JAMA. https://jamanetwork.com/journals/jama/fullarticle/2810756 10. Baksaas-Aasen K., et al. 2020. Viscoelastic haemostatic assay augmented protocols for major trauma haemorrhage (ITACTIC): a randomized, controlled trial. ICM. https://link.springer.com/article/10.1007/s00134-020-06266-1 11. Wahlgren CM., et al. 2025. European Society for Vascular Surgery (ESVS) 2025 Clinical Practice Guidelines on the Management of Vascular Trauma. EJVES. https://esvs.org/wp-content/uploads/2025/01/2025-Vascular-Trauma-Guidelines.pdf 12. Khan S., et al. 2020. A meta-analysis on anticoagulation after vascular trauma. Eur J Traum Emerg Surg. https://link.springer.com/article/10.1007/s00068-020-01321-4 13. Stonko DP., et al. 2022. Postoperative antiplatelet and/or anticoagulation use does not impact complication or reintervention rates after vein repair of arterial injury: A PROOVIT study. Vascular. https://journals.sagepub.com/doi/10.1177/17085381221082371?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed 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://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US
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-452 Overview: The healthcare landscape is undergoing a sea change, significantly impacting established, evidence-based recommendations. Media coverage suggests that the HHS Secretary plans to release a report linking acetaminophen use during pregnancy with an increased risk of autism spectrum disorder (ASD) in offspring as well as linking maternal folate deficiency with ASD—associations that have not been supported by evidence. If promoted by public health agencies, such discrepancies pose a dilemma for clinicians who have relied on and trusted that guidance reflects evidence and is grounded in scientific methods. Join us to review the evidence on acetaminophen and ASD risk and learn strategies to ensure your practice is based on valid findings. Episode resource links: Ahlqvist VH, Sjöqvist H, Dalman C, et al. Acetaminophen Use During Pregnancy and Children's Risk of Autism, ADHD, and Intellectual Disability. JAMA. 2024;331(14):1205–1214. doi:10.1001/jama.2024.3172 Damkier, P., Gram, E. B., Ceulemans, M., Panchaud, A., Cleary, B., Chambers, C., Weber-Schoendorfer, C., Kennedy, D., Hodson, K., Grant, K. S., Diav-Citrin, O., Običan, S. G., Shechtman, S., & Alwan, S. (2025). Acetaminophen in Pregnancy and Attention-Deficit and Hyperactivity Disorder and Autism Spectrum Disorder. Obstetrics and gynecology, 145(2), 168–176. https://doi.org/10.1097/AOG.0000000000005802 Ji Y, Azuine RE, Zhang Y, et al. Association of Cord Plasma Biomarkers of In Utero Acetaminophen Exposure With Risk of Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorder in Childhood. JAMA Psychiatry. 2020;77(2):180–189. doi:10.1001/jamapsychiatry.2019.3259 Hirota T, King BH. Autism Spectrum Disorder: A Review. JAMA. 2023;329(2):157–168. doi:10.1001/jama.2022.23661 Liu, X., Zou, M., Sun, C., Wu, L., & Chen, W. X. (2022). Prenatal Folic Acid Supplements and Offspring's Autism Spectrum Disorder: A Meta-analysis and Meta-regression. Journal of autism and developmental disorders, 52(2), 522–539. https://doi.org/10.1007/s10803-021-04951-8 DSM-5-TR: Neurocognitive Disorders Supplement; October 2022. https://psychiatryonline.org/pb-assets/dsm/update/DSM-5-TR_Neurocognitive-Disorders-Supplement_2022_APA_Publishing.pdf https://www.npr.org/sections/shots-health-news/2025/09/06/nx-s1-5532143/hhs-responds-to-report-about-autism-and-acetaminophen Guest: Susan Feeney, DNP, FNP-BC, NP-C Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com
La sepsis, una respuesta inflamatoria severa causada por una infección, es una de las principales causas de mortalidad intrahospitalaria en todo el mundo. A pesar de décadas de investigación y avances en protocolos de tratamiento, identificar esta condición rápidamente y actuar de manera efectiva sigue siendo un desafío considerable. La tecnología, especialmente en forma de sistemas electrónicos de salud (EHR), está mostrando ser una herramienta prometedora para cerrar esta brecha crítica en la atención médica. En este artículo, exploraremos el impacto de los sistemas de detección electrónica de sepsis, sus beneficios, limitaciones y cómo pueden transformar el futuro de los cuidados críticos. Además, discutiremos cómo los profesionales de la salud, especialmente los enfermeros en cuidados intensivos, pueden liderar el cambio en la implementación de estas tecnologías. El Contexto de la Sepsis La sepsis es una emergencia médica que ocurre cuando el cuerpo responde de manera descontrolada a una infección, lo que lleva a disfunción orgánica e incluso la muerte si no se trata de manera oportuna. Según datos globales, la sepsis es responsable de millones de muertes cada año y representa una causa importante de hospitalización y readmisión. Los protocolos actuales para el manejo de la sepsis, como el cumplimiento de las guías de "bundles" de tratamiento (por ejemplo, administración temprana de antibióticos, pruebas de lactato y reposición de líquidos), han demostrado mejorar significativamente los resultados en los pacientes. Sin embargo, la adherencia a estas guías sigue siendo inconsistente en muchos entornos hospitalarios debido a factores como el reconocimiento tardío de la condición o la falta de diagnóstico oportuno. La Promesa de la Detección Electrónica Uno de los avances tecnológicos más esperanzadores en la atención médica moderna es el uso de registros electrónicos de salud (EHR) para monitorear continuamente el estado del paciente en tiempo real. La idea es simple: al analizar los datos del paciente de manera continua, estos sistemas pueden alertar automáticamente al equipo médico cuando detectan signos tempranos de deterioro clínico, como ocurre en la sepsis. Resultados Prometedores Un estudio reciente publicado en JAMA (diciembre 2024) evaluó el impacto de un sistema de detección electrónica de sepsis basado en el score qSOFA en cinco hospitales de Arabia Saudita. Este ensayo aleatorizado incluyó a más de 60,000 pacientes y mostró resultados impresionantes: Reducción de la mortalidad a 90 días: Los pacientes monitoreados electrónicamente tuvieron un 15% menos de riesgo de morir en el hospital en comparación con aquellos sin monitoreo (RR ajustado: 0.85). Mejoras en la intervención temprana: La detección electrónica aumentó significativamente la probabilidad de que los pacientes recibieran pruebas clave como lactato sérico y líquidos intravenosos en las primeras 12 horas. Estos hallazgos destacan cómo los sistemas de detección pueden mejorar la respuesta clínica y salvar vidas. Cómo Funcionan las Alertas Electrónicas Los sistemas de detección de sepsis utilizan datos existentes en los registros electrónicos de los pacientes, como: Cambios en los signos vitales (frecuencia cardíaca, presión arterial, temperatura). Pruebas de laboratorio (niveles de lactato, marcadores inflamatorios). Notas clínicas relacionadas con infecciones. Cuando el sistema detecta patrones que cumplen con criterios preestablecidos (como un puntaje alto en el qSOFA), genera una alerta para el equipo médico. Estas alertas se diseñan para ser inmediatas y accionables, ayudando a priorizar la atención en pacientes en riesgo. Beneficios de los Sistemas de Detección Electrónica Identificación Temprana y Precisa: La sepsis es una condición dinámica que puede evolucionar rápidamente. La capacidad de detectar signos tempranos antes de que se presenten complicaciones graves es crucial para mejorar los resultados. Estandarización de la Atención: Las alertas electrónicas aseguran que cada paciente reciba atención basada en las mejores prácticas, independientemente del nivel de experiencia del personal o la carga de trabajo en el momento. Reducción de Errores: Las herramientas electrónicas minimizan los errores humanos asociados con el monitoreo manual y la toma de decisiones en entornos de alta presión. Optimización del Tiempo del Equipo: Al priorizar a los pacientes de mayor riesgo, estas herramientas permiten al personal clínico concentrarse en intervenciones críticas. Desafíos en la Implementación Aunque los sistemas de detección electrónica tienen un potencial significativo, también enfrentan barreras que deben abordarse: Fatiga de Alertas: Un exceso de alertas puede saturar al equipo médico, reduciendo la efectividad de las notificaciones críticas. Precisión y Sesgo: Algunos sistemas han sido criticados por generar falsos positivos o no funcionar bien en poblaciones subrepresentadas. Sobrerreacción y Tratamiento Excesivo: Las alertas pueden llevar a intervenciones innecesarias, como el uso de antibióticos en pacientes que no los necesitan. Adopción Tecnológica: La capacitación y la aceptación por parte del personal son esenciales para el éxito de cualquier sistema nuevo. El Rol de los Profesionales de la Enfermería Los enfermeros en cuidados críticos son esenciales para maximizar el impacto de los sistemas de detección electrónica. Al estar en la primera línea de atención, desempeñan un papel clave en interpretar las alertas y coordinar las respuestas clínicas. Liderazgo en Tecnología Clínica En nuestro curso Critical Care Nursing, enfatizamos cómo los enfermeros pueden liderar la integración de herramientas tecnológicas: Capacitación en el uso de EHR y alertas electrónicas. Monitoreo continuo de pacientes críticos y priorización de intervenciones. Colaboración interdisciplinaria para garantizar respuestas rápidas y precisas. Mirando Hacia el Futuro La detección electrónica de sepsis es un ejemplo claro de cómo la tecnología puede mejorar la calidad y consistencia de la atención médica. Sin embargo, la clave del éxito radica en encontrar un equilibrio entre tecnología y juicio clínico. Para los hospitales y los profesionales de la salud, esto significa: Elegir sistemas diseñados para minimizar la fatiga de alertas. Capacitar al personal para usar estas herramientas de manera efectiva. Incorporar la retroalimentación del equipo clínico para ajustar los sistemas según las necesidades locales. La sepsis sigue siendo un desafío complejo, pero con herramientas innovadoras como la detección electrónica, estamos un paso más cerca de salvar más vidas y optimizar los recursos hospitalarios. Conclusión La detección electrónica de sepsis es más que una herramienta tecnológica; es un catalizador para transformar cómo se brindan los cuidados críticos. Su impacto no solo se mide en tasas de mortalidad reducidas, sino también en la confianza que los equipos médicos pueden depositar en sistemas que complementan su juicio clínico. A medida que avancemos, el papel de los enfermeros en la implementación y uso eficaz de estas herramientas será fundamental para garantizar que cada paciente reciba la atención que necesita. La combinación de tecnología innovadora y atención humana sigue siendo nuestra mejor esperanza para enfrentar los desafíos del futuro en la medicina crítica. "La tecnología salva vidas, pero es el juicio clínico el que las transforma."
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-452 Overview: The healthcare landscape is evolving rapidly, and clinicians are navigating conflicting guidance on established, evidence-based recommendations. Recent news suggest acetaminophen use during pregnancy causes autism spectrum disorder (ASD), which is not the consensus of medical experts based on available data. When guidance from various sources conflicts with established research, clinicians face challenges in providing evidence-based care. Join us to review the current evidence on acetaminophen and ASD risk. Episode resource links: Ahlqvist VH, Sjöqvist H, Dalman C, et al. Acetaminophen Use During Pregnancy and Children's Risk of Autism, ADHD, and Intellectual Disability. JAMA. 2024;331(14):1205–1214. doi:10.1001/jama.2024.3172 Damkier, P., Gram, E. B., Ceulemans, M., Panchaud, A., Cleary, B., Chambers, C., Weber-Schoendorfer, C., Kennedy, D., Hodson, K., Grant, K. S., Diav-Citrin, O., Običan, S. G., Shechtman, S., & Alwan, S. (2025). Acetaminophen in Pregnancy and Attention-Deficit and Hyperactivity Disorder and Autism Spectrum Disorder. Obstetrics and gynecology, 145(2), 168–176. https://doi.org/10.1097/AOG.0000000000005802 Ji Y, Azuine RE, Zhang Y, et al. Association of Cord Plasma Biomarkers of In Utero Acetaminophen Exposure With Risk of Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorder in Childhood. JAMA Psychiatry. 2020;77(2):180–189. doi:10.1001/jamapsychiatry.2019.3259 Hirota T, King BH. Autism Spectrum Disorder: A Review. JAMA. 2023;329(2):157–168. doi:10.1001/jama.2022.23661 Liu, X., Zou, M., Sun, C., Wu, L., & Chen, W. X. (2022). Prenatal Folic Acid Supplements and Offspring's Autism Spectrum Disorder: A Meta-analysis and Meta-regression. Journal of autism and developmental disorders, 52(2), 522–539. https://doi.org/10.1007/s10803-021-04951-8 DSM-5-TR: Neurocognitive Disorders Supplement; October 2022. https://psychiatryonline.org/pb-assets/dsm/update/DSM-5-TR_Neurocognitive-Disorders-Supplement_2022_APA_Publishing.pdf https://www.npr.org/sections/shots-health-news/2025/09/06/nx-s1-5532143/hhs-responds-to-report-about-autism-and-acetaminophen 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.Screen time impacts our mental health in significant ways, with research suggesting particular risks for teens who spend more than three hours daily on social media.• Higher social media usage linked to increased rates of depression, anxiety, and stress• Teens more vulnerable to negative mental health effects than adults• Using social media to escape negative feelings raises mental health risks• Limiting social media to 30 minutes per day can lower depression and anxiety• Open conversations about online experiences help teens develop healthy digital habits• Unrealistic images and constant comparisons on social media harm self-worth• Adults experience similar but less pronounced negative effects from excessive screen time• Maintaining real-life relationships outside digital spaces provides important balance• Screen time isn't benign—moderation is key to protecting mental wellbeingCheck us out on Instagram, find us on Threads, or send us an email at yourcheckuppod@gmail.com.References1. Associations Between Time Spent Using Social Media and Internalizing and Externalizing Problems Among US Youth. Riehm KE, Feder KA, Tormohlen KN, et al. JAMA Psychiatry. 2019;76(12):1266-1273. doi:10.1001/jamapsychiatry.2019.2325.2. Impact of Social Media Use on Mental Health Within Adolescent and Student Populations During COVID-19 Pandemic: Review. Draženović M, Vukušić Rukavina T, Machala Poplašen L. International Journal of Environmental Research and Public Health. 2023;20(4):3392. doi:10.3390/ijerph20043392.3. Annual Research Review: Adolescent Mental Health in the Digital Age: Facts, Fears, and Future Directions. Odgers CL, Jensen MR. Journal of Child Psychology and Psychiatry, and Allied Disciplines. 2020;61(3):336-348. doi:10.1111/jcpp.13190.4. Addictive Screen Use Trajectories and Suicidal Behaviors, Suicidal Ideation, and Mental Health in US Youths. Xiao Y, Meng Y, Brown TT, Keyes KM, Mann JJ. JAMA. 2025;:2835481. doi:10.1001/jama.2025.7829.5. Exploring the Relationship Between Social Media Use and Symptoms of Depression and Anxiety Among Children and Adolescents: A Systematic Narrative Review. Saleem N, Young P, Yousuf S. Cyberpsychology, Behavior and Social Networking. 2024;27(11):771-797. doi:10.1089/cyber.2023.0456.6. Adolescents' Interactive Electronic Device Use, Sleep and Mental Health: A Systematic Review of Prospective Studies. Dibben GO, Martin A, Shore CB, et al. Journal of Sleep Research. 2023;32(5):e13899. doi:10.1111/jsr.13899.7. Relationship Between Depression and the Use of Mobile Technologies and Social Media Among Adolescents: Umbrella Review. Arias-de la Torre J, Puigdomenech E, García X, et al. Journal of Medical Internet Research. 2020;22(8):e16388. doi:10.2196/16388.Support the showSubscribe to Our Newsletter! Production and Content: Edward Delesky, MD & Nicole Aruffo, RNArtwork: Olivia Pawlowski
Have you ever thought, “I don't even know what would be restorative right now”? You're not alone. In fact, nearly 60% of women report spending no time on self-care most days, leaving them depleted and unsure how to fill their own tank. In this episode 155 of Medium Lady Talks, I share a practical way to bridge the gap between knowing you're exhausted and actually choosing something restorative. Building on Dr. Saundra Dalton-Smith's 7 Types of Rest, I introduce my simplified BEMS framework, four buckets you can reach for when you're too tired to think clearly: Body (hydrate, stretch, nap, walk) Emotions (cry, laugh, connect with someone safe) Mind (phone break, music, doodle, brain dump) Senses (dim the lights, light a candle, step outside) You'll hear why decision fatigue makes it so hard to choose rest, what the latest research tells us about the decline in maternal mental health, and how invisible labor and overstimulation drain us daily. (For reference, here's the JAMA study I mention: Trends and Disparities in Maternal Self-Reported Mental and Physical Health, 2016–2023). If you've been feeling flat, frazzled, or unsure how to restore yourself, this episode will give you a gentle place to start — one tiny action at a time. ✨ Bonus: Patreon subscribers can download the printable Restorative Cheat Sheet that turns this framework into an easy everyday tool - will be Published on Tuesday Sept 30
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 September 20-26, 2025.
A JAMA study finds biking is associated with lower dementia incidence: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2835115 (23:00) Should we tell people they ought to bike to COSTCO? A Bluesky user responds to episode #2535 (2:49). Bike East Bay Advocacy Director Robert Prinz explains why federal bike infrastructure doesn't have to be “stupid,” in response to Charles Marohn's comments in episode #2537 (4:49). A West Hollywood resident defends the famous Fountain Ave bike lane pilot project from the perspective of both “entitled driver” AND “entitled cyclist” (7:13). Black Girls Do Bike founder Monica Garrison on the Kitty Knox Academy, a program to prepare “Sheroes” to become nationally certified League Cycling Instructors (LCIs) through the League of American Bicyclists https://www.blackgirlsdobike.org/lead (9:06). Dutch Cycling Embassy International Relations Manager Chris Bruntlett on how China is leapfrogging the Netherlands in bike infrastructure and bikeshare, the popularity of bike transportation versus bikelash fueled by a privileged minority, and Women Changing Cities https://bookshop.org/a/99134/9781915722409 (22:07). Pushing Pedals Sundays, a social ride that patronizes black owned businesses in Detroit, closes for winter and football season. Reo Ramsey, bike light and pedicab entrepreneur, tells us about the ride (48:50).
In this Greatest Hits episode, we're diving into the science behind why coaching works—and why it can completely transform high-pressure careers. I'm revisiting my conversation with Dr. Tyra Fainstad and Dr. Adrienne Mann about their groundbreaking research, published in the Journal of the American Medical Association (JAMA), and how structured coaching can change not just individual outcomes, but entire organizational cultures. Tune in to discover what their study revealed about coaching's real-world impact, why traditional systems often leave women disproportionately stressed, and how coaching can produce measurable improvements in both performance and well-being.Get full show notes, transcript, and more information here: schoolofnewfeministthought.com/426The Socratic Coaching Method Certification: thesocraticcoachingacademy.com/Follow along on Instagram: instagram.com/karaloewentheil/
Is that penicillin or amoxicillin allergy real? Probably not. In this episode, we explore how to assess risk, talk to parents, and refer for delabeling. You'll also learn what happens in the allergy clinic, why the label matters, and how to be a better antimicrobial steward. Learning Objectives Describe the mechanisms and clinical manifestations of immediate and delayed hypersensitivity reactions to penicillin, including diagnostic criteria and risk stratification tools such as the PEN-FAST score. Differentiate between low-, moderate-, and high-risk penicillin allergy histories in pediatric patients and identify appropriate candidates for direct oral challenge or allergy referral based on current evidence and guidelines. Formulate an evidence-based approach for evaluating and counseling families in the Emergency Department about reported penicillin allergies, including when to recommend outpatient referral for formal delabeling. Connect with Brad Sobolewski PEMBlog: PEMBlog.com Blue Sky: @bradsobo X (Twitter): @PEMTweets Instagram: Brad Sobolewski References Khan DA, Banerji A, Blumenthal KG, et al. Drug Allergy: A 2022 Practice Parameter Update. J Allergy Clin Immunol. 2022;150(6):1333-1393. doi:10.1016/j.jaci.2022.08.028 Moral L, Toral T, Muñoz C, et al. Direct Oral Challenge for Immediate and Non-Immediate Beta-Lactam Allergy in Children. Pediatr Allergy Immunol. 2024;35(3):e14096. doi:10.1111/pai.14096 Castells M, Khan DA, Phillips EJ. Penicillin Allergy. N Engl J Med. 2019;381(24):2338-2351. doi:10.1056/NEJMra1807761 Shenoy ES, Macy E, Rowe T, Blumenthal KG. Evaluation and Management of Penicillin Allergy: A Review.JAMA. 2019;321(2):188–199. doi:10.1001/jama.2018.19283 Transcript Note: This transcript was partially completed with the use of the Descript AI and the Chat GPT 5 AI Welcome to PEM Currents, the Pediatric Emergency Medicine podcast. As always, I'm your host, Brad Sobolewski, and today we are taking on a label that's misleading, persistent. Far too common penicillin allergy, it's often based on incomplete or inaccurate information, and it may end up limiting safe and effective treatment, especially for the kids that we see in the emergency department. I think you've all seen a patient where you're like. I don't think this kid's really allergic to amoxicillin, but what do you do about it? In this episode, we're gonna break down the evidence, walk through what actually happens during de labeling and dedicated allergy clinics. Highlight some validated tools like the pen FAST score, which I'd never heard of before. Preparing for this episode and discuss the current and future role of ED based penicillin allergy testing. Okay, so about 10% of patients carry a penicillin allergy label, but more than 90% are not truly allergic. And this label can be really problematic in kids. It limits first line treatment choices like amoxicillin, otitis media, or penicillin for strep throat, and instead. Kids get prescribed second line agents that are less effective, broader spectrum, maybe more toxic or poorly tolerated and associated with a higher risk of antimicrobial resistance. So it's not just an EMR checkbox, it's a label with some real clinical consequences. And it's one, we have a role in removing. And so let's understand what allergy really means. And most patients with a reported penicillin allergy, especially kids, aren't true allergies in the immunologic sense. Common misinterpretations include a delayed rash, a maculopapular, or viral exum, or benign, delayed hypersensitivity, side effects, nausea, vomiting, and diarrhea. And unverified childhood reactions that are undocumented and nonspecific. Most of these are not true allergies. Only a very small subset of patients actually have IgE mediated hypersensitivity, such as urticaria, angioedema, wheezing, and anaphylaxis. These are super rare, and even then they may resolve over time without treatment. If a parent or sibling has a history of a penicillin allergy, remember that patient might actually not be allergic, and that is certainly not a reason to label a child as allergic just because one of their first degree relatives has an allergy. So right now, in 2025, as I'm recording this episode, there are clinics like the Pats Clinic or the Penicillin Allergy Testing Services at Cincinnati Children's and in a lot of our peer institutions that are at the forefront of modern de labeling. Their approach reflects the standard of care as outlined by the. Quad ai or the American Academy of Allergy, asthma and Immunology and supported by large trials like Palace. And you know, you have a great trial if you have a great acronym. So here's what happens step by step. So first you stratify the risk. How likely is this to be a true allergy? And that's where a tool like the pen fast comes. And so pen fast scores, a decision rule developed to help assess the likelihood of a true penicillin allergy based on the patient's history. The pen in pen fast is whether or not the patient has a self-reported history of penicillin allergy. They get two points if the reaction occurred in the past five years. Two points if the reaction is anaphylaxis or angioedema. One point if the reaction required treatment, and one point if the reaction was not due to testing. And so you can get a total score of. Up to six points. If you have a score of less than three. This is a low risk patient and they can be eligible for direct oral challenge. A score greater than three means they're higher risk and they may require skin testing. First validation studies show that the PEN FFA score of less than three had a negative predictive value of 96.3%. Meaning a very, very low chance of a true allergy. And this tool has been studied more extensively in adults, but pediatric specific adaptations are emerging, and they do inform current allergy clinic protocols. But I would not use this score in the emergency department just to give a kid a dose of amoxicillin. So. For low risk patients, a pen fast score of less than three or equivalent clinical judgment clinics proceed with direct oral challenge with no skin testing required. The protocol is they administer one dose of oral amoxicillin and they observe for 62 120 minutes monitoring for signs of reaction Urticaria. Respiratory symptoms or GI upset. This approach is safe and effective. There was a trial called Palace back in 2022, which validated this in over 300 children. In adolescents. There were no serious events that occurred. De labeling was successful in greater than 95% of patients. And skin tested added no benefit in low risk patients. So if the child tolerates this dose, then you can remove that allergy immediately from the chart. Parents and primary care doctors will receive a summary letter noting that the challenge was successful and that there's new guidance. Children and families are told they can safely receive all penicillins going forward. And providers are encouraged to document this clearly in the allergy section of the EMR. So you're wondering, can we actually do this in the emergency department? Technically, yes, you can do what you want, but practically we're not quite there yet. So we'd need clearer risk stratification tools like the Pen fast, a safe place for monitoring, post challenge, clinical pathways and documentation support. You know, a clear way to update EMR allergy labels across the board and involvement or allergy or infectious disease oversight. But it's pretty enticing, right? See a kid you diagnose otitis media. You think that their penicillin allergy is wrong, you just give 'em a dose of amox and watch 'em for an hour. That seems like a pretty cool thing that we might be able to do. So some centers, especially in Canada and Australia, do have some protocols for ED or inpatient based de labeling, but they rely on that structured implementation. So until then, our role in the pediatric emergency department is to identify low risk patients, avoid over document. Unconfirmed reactions and refer to allergy ideally to a clinic like the pets. So who should be referred and good candidates Include a child with a rash only, especially one that's remote over a year ago. Isolated GI symptoms. Parents unsure of the details at all. No history of anaphylaxis wheezing her hives, and no recent serious cutaneous reactions. I would avoid referring and presume that this allergy is true. If they've had recent anaphylaxis, they've had something like Stevens Johnson syndrome dress, or toxic epidermolysis necrosis. Fortunately, those are very, very rare with penicillins and there's a need for penicillin during the ED visit without allergy backup. So even though we don't have an ED based protocol yet. De labeling amoxicillin or penicillin allergy can start with good questions in the emergency department. So here's one way to talk to patients and families. You can say, thanks for letting me know about the amoxicillin allergy. Can I ask you a few questions to better understand what happened? This is gonna help us decide the safest and most effective treatment for your child today, and then possibly go through a process to remove a label for this allergy that might not be accurate. You wanna ask good, open-ended questions. What exactly happened when your child took penicillin or amoxicillin? You know, look for rash, hives, swelling, trouble breathing, or anaphylaxis. Many families just say, allergic, when the reaction was just GI upset, diarrhea or vomiting, which is not an allergy. How old was your child when this happened? Reactions that occurred before age of three are more likely to be falsely attributed. How soon after taking the medicine did the reaction start? Less than one hour is an immediate reaction, but one hour to days later is delayed. Usually mild and probably not a true allergy. Did they have a fever, cold or virus at that time? Viral rashes are often misattributed to antibiotics, and we shouldn't be treating viruses with antibiotics anyway, so get good at looking at ears and know what you're seeing. And have they taken similar antibiotics since then? Like. Different penicillins, Augmentin, or cephalexin. So if they said that they were allergic to amoxicillin, but then somehow tolerated Augmentin. They're not allergic. If a patient had rash only, but no hive swelling or difficulty breathing, no reaction within the first hour. It occurred more than five years ago or before the kid was three. And especially if they tolerated beta-lactam antibiotics. Since then, they're a great candidate for de labeling and I would refer that kid to the allergy clinic. Generally, they can get them in pretty darn quick. Alright, we're gonna wrap up this episode. Most kids labeled penicillin allergic or amoxicillin allergic, or not actually allergic to the medication. There are some scores like pen fasts that are validated tools to assess risk and support de labeling. Direct oral challenge for most patients is safe, efficient, and increasingly the standard of care. There are allergy clinics like the Pats at Cincinnati Children's that can dela children in a single visit with oral challenges alone, needing no skin testing, and emergency departments can play a key role in identifying and referring these patients and possibly de labeling ourselves in the future. Well, that's all for this episode on Penicillin Allergy. I hope you learn something new, especially how to assess whether an allergy label is real, how to ask the right questions and when to refer to an allergy testing clinic. If you have feedback, send it my way. Email, comment on the blog, a message on social media. I always appreciate hearing from you all, and if you like this episode, please leave a review on your favorite podcast app. Really helps more people find the show and that's great 'cause I like to teach people stuff. Thanks for listening for PEM Currents, the Pediatric Emergency Medicine podcast. This has been Brad Sobolewski. See you next time.
The Crew Is Back At The Table To Talk All Things Sports and Entertainment! The fellas react to the WrestlePalooza/AEW All Out weekend as the road to WWE's Crown Jewel begins which includes Stephanie Vaquer's reign as Women's World Champion beginning, AJ Lee's first match back in WWE, What's next for Hangman Page in AEW while also reacting to the 2025 PWI 500 list and more! Shop: https://greshapparel.creator-spring.com/ Website: https://www.greshunleashed.com Twitter: https://twitter.com/greshunleashed Facebook: https://facebook.com/GreshUnleashed Instagram: https://instagram.com/greshunleashed Reddit: https://www.reddit.com/r/Gresh/ Discord: https://discord.gg/QHCzpCj FOLLOW THE CREW: GRESH - https://solo.to/gresh | HI-LITE REAL - https://linktr.ee/hilitereal Want to start YOUR OWN Podcast? Click the links below to get started with Podbean Today! Unlimited Hosting Plan: https://www.podbean.com/greshunleashed Business Hosting Plan: https://www.podbean.com/pro/greshunleashed
Amy and T.J. did a deep dive on the recent and conflicting research on whether acetaminophen- the active ingredient in Tylenol - has a proven link to an increased risk of Autism. From some of the most respected scientific minds - we’re talking Harvard, Johns Hopkins and JAMA - there is no simple explanation, so why are Trump and RFK Jr claiming they have the answer? See omnystudio.com/listener for privacy information.
Amy and T.J. did a deep dive on the recent and conflicting research on whether acetaminophen- the active ingredient in Tylenol - has a proven link to an increased risk of Autism. From some of the most respected scientific minds - we’re talking Harvard, Johns Hopkins and JAMA - there is no simple explanation, so why are Trump and RFK Jr claiming they have the answer? See omnystudio.com/listener for privacy information.
Amy and T.J. did a deep dive on the recent and conflicting research on whether acetaminophen- the active ingredient in Tylenol - has a proven link to an increased risk of Autism. From some of the most respected scientific minds - we’re talking Harvard, Johns Hopkins and JAMA - there is no simple explanation, so why are Trump and RFK Jr claiming they have the answer? See omnystudio.com/listener for privacy information.
Content curated for dermatologists and skin deep HCPs – on Psoriasis, CLE, vasculitis, HS and dermatology drugs use, efficacy and side effects and more. Features Dr. Jack Cush, Editor at RheumNow.com. SHOW NOTES: 1. SMILE Study: A randomized, placebo-controlled trial of hydroxychloroquine in incomplete lupus https://t.co/NnrA8ohiGX 2. Equal Safety of JAK Inhibitors and TNF Inhibitors in H2H IMID trials JAMA systematic review. https://t.co/HI1KBKZiXR 3. SMART study - Single vs. Split Dose Methotrexate https://t.co/lizsrtVHwf 4. Vegan diets don't work in RA - Metanalysis of 7 studies https://t.co/jeh6gN5Byg 5. No association between IL-17 inhibitors & MACEs (vs TNFi Rx) https://t.co/fJuPFYKnSr https://t.co/Vscnsq0DTA 6. Successful Phase 3 UP-AA Trial evaluating Upadacitinib in Alopecia Areata (AA) https://t.co/8p1FvJx0s0 7. Anifrolumab effective & safe in refractory Cutaneous LE - OL Study in 15 CLE https://t.co/umEYz0XDyt 8. "Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it's the only thing that ever has." - Margaret Mead https://t.co/OFGN223bPa
Amy and T.J. did a deep dive on the recent and conflicting research on whether acetaminophen- the active ingredient in Tylenol - has a proven link to an increased risk of Autism. From some of the most respected scientific minds - we’re talking Harvard, Johns Hopkins and JAMA - there is no simple explanation, so why are Trump and RFK Jr claiming they have the answer? See omnystudio.com/listener for privacy information.
About this Episode Episode 49 of “The 2 View” – New IDSA Complicated UTI Guidelines, Pediatric Nicotine OD, Hepatitis C Screening in the ED, High-Risk Delta Troponins Segment 1A – Pediatric Nicotine Ingestion Madelyn O, Hays HL, Kistamgari S, et al. Nicotine Ingestions Among Young Children: 2010–2023. Pediatrics. 2025;156(2):e2024070522. doi:10.1542/peds.2024-070522. Segment 1B – Finger Thoracostomy and Traumatic Pneumothorax/Hemothorax Blank, J, de Moya MA. Traumatic pneumothorax and hemothorax: What you need to know. J Trauma Acute Care Surg. Published online July 3, 2025. doi:10.1097/TA.0000000000004692 Beyer CA, Ruf AC, Alshawi AB, Cannon JW. Management of traumatic pneumothorax and hemothorax. Curr Probl Surg. 2025;63. doi:10.1016/j.cpsurg.2024.101707. Weingart, S. EMCrit 62 – Needle vs. Knife II: Needle Thoracostomy (Decompression)? EMCrit. Published online December 11, 2011. https://emcrit.org/emcrit/needle-finger-thoracostomy/ Lange C, Sharma M. Podcast #223 - ATLS Episode 4: Thoracic Trauma (Chapter 4). Total EM. October 27, 2020. https://www.totalem.org/emergency-professionals/podcast-223-atls-episode-4-thoracic-trauma-chapter-4 Segment 2A – Hepatitis C Screening in EDs Haukoos J, Rothman RE, Galbraith JW, et al. Hepatitis C Screening in Emergency Departments: The DETECT Hep C Randomized Clinical Trial. JAMA. 2025;334(6):497–507. doi:10.1001/jama.2025.10563 Segment 2B – Serial HS-Troponin Patterns Huggins C, Saltarell Ni, Swoboda TK, et al. Kinetic changes in high-sensitivity cardiac troponin for risk stratification of emergency department chest pain patients. Am J Emerg Med. 2025;93:176-181. doi:10.1016/j.ajem.2025.04.010. Segment 3 - Updated IDSA Guidelines on Complicated Urinary Tract Infections Splete H. IDSA Updates Guidelines on Complicated UTIS. Medscape. Published online July 18, 2025. https://www.medscape.com/viewarticle/idsa-updates-guidelines-complicated-utis-2025a1000j3l Trautner BW, Cortes-Penfield NW, Gupta K, et al. Complicated Urinary Tract Infections (cUTI): Clinical Guidelines for Treatment and Management. IDSA. Published online July 17, 2025. https://www.idsociety.org/practice-guideline/complicated-urinary-tract-infections/ Roberts M, Sharma M. 34 - Pertussis, Computer Interpretation of EKGs, Tuberculosis, Fluoroquinolone Side Effects. The 2 View. Published online April 10, 2024. https://2view.fireside.fm/34 Roberts M, Sharma M. 46 - Heat Stroke Tx, A New Virus, Oral Cephalosporins Vs Pyelo, Safe Discharges. The 2 View. Published online June 11, 2025. https://2view.fireside.fm/46 Bonus Reference – Ponytail Headache Blau JN. Ponytail Headache: A Pure Extracranial Headache. Headache. 2004;44(5):411-413. doi: 10.1111/j.1526-4610.2004.04092.x. Recurring Sources Center for Medical Education. http://ccme.org The Proceduralist. http://www.theproceduralist.org The Procedural Pause. https://journals.lww.com/em-news/blog/theproceduralpause/pages/default.aspx The Skeptics Guide to Emergency Medicine. http://www.thesgem.com Be sure to keep tuning in for more great prizes and fun trivia questions! Once you hear the question, please email us your guesses at 2viewcast@gmail.com and tell us who you want to give a shout-out to.
In this special episode on Obstructive Sleep Apnea our host, Dr. Neil Skolnik will discuss treatment of OSA. In Part 1 we discussed an overview of OSA, in Part 2 we discussed making the diagnosis, Part 3 was treatment, and in Part 4 we bring it all together with a case to explore clinical decision making for OSA. 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 Susan Kuchera, M.D. - Clinical Associate Professor of Family and Community Medicine at the Sidney Kimmel Medical College of Thomas Jefferson University and Program Director of the Family Medicine Residency at Jefferson Health Abington. 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
Updates on current medical news, Jody's Epocrates exodus, and a review of hepatitis B pathophysiology, diagnosis, and treatment.References:Lok. A. S. F. Hepatitis B virus: Screening and diagnosis in adults. UpToDate. https://www.uptodate.com/contents/hepatitis-b-virus-screening-and-diagnosis-in-adultsLok. A. S. F., Hepatitis B virus: Overview of management. UpToDate. https://www.uptodate.com/contents/hepatitis-b-virus-overview-of-managementCDC ACIP Presentation: https://www.cdc.gov/acip/downloads/slides-2025-09-18-19/03-su-mmrv-508.pdfACIP Recommendation Statement: https://www.hhs.gov/press-room/acip-recommends-chickenpox-vaccine-for-toddlers.htmlTang LSY, Covert E, Wilson E, Kottilil S. Chronic Hepatitis B Infection: A Review. JAMA. 2018;319(17):1802–1813. doi:10.1001/jama.2018.3795. https://jamanetwork.com/journals/jama/fullarticle/2679946OpenEvidence Conversation: https://www.openevidence.com/ask/4dde6fd5-1bca-4a86-a6f3-3a335f0334a1AAP Recommended Vaccine Schedule for Children & Adolescents: https://publications.aap.org/redbook/resources/15585/AAP-Immunization-ScheduleVaccine History (Hep B Foundation): https://www.hepb.org/prevention-and-diagnosis/vaccination/history-of-hepatitis-b-vaccine/Vaccine History (CDC): https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5125a3.htm
Send us a message with this link, we would love to hear from you. Standard message rates may apply.Colon cancer screening saves lives by catching cancer early and even preventing it, yet only 69% of eligible adults are up to date with their screenings. We explore who needs screening, what tests are available, and how to choose the right one for you.• Most adults should start colon cancer screening at age 45, even if healthy• Family history may mean you need to start screening earlier• Stool-based tests like FIT and Cologuard are convenient home options• Colonoscopy remains the gold standard, allowing doctors to remove polyps• One in 23 men and one in 25 women will develop colorectal cancer• The best screening test is the one you'll actually completePlease get screened! Check with your doctor about which test is right for you based on your risk factors and preferences.References1. Screening for Colorectal Cancer in Asymptomatic Average-Risk Adults: A Guidance Statement From the American College of Physicians (Version 2). Qaseem A, Harrod CS, Crandall CJ, et al. Annals of Internal Medicine. 2023;176(8):1092-1100. doi:10.7326/M23-0779.2. AGA Clinical Practice Update on Risk Stratification for Colorectal Cancer Screening and Post-Polypectomy Surveillance: Expert Review. Issaka RB, Chan AT, Gupta S. Gastroenterology. 2023;165(5):1280-1291. doi:10.1053/j.gastro.2023.06.033.3. Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. Davidson KW, Barry MJ, Mangione CM, et al. JAMA. 2021;325(19):1965-1977. doi:10.1001/jama.2021.6238.4. Colorectal Cancer Screening and Prevention. Sur DKC, Brown PC. American Family Physician. 2025;112(3):278-283.5. Increasing Incidence of Early-Onset Colorectal Cancer. Sinicrope FA. The New England Journal of Medicine. 2022;386(16):1547-1558. doi:10.1056/NEJMra2200869.6. From Guideline to Practice: New Shared Decision-Making Tools for Colorectal Cancer Screening From the American Cancer Society. Volk RJ, Leal VB, Jacobs LE, et al. CA: A Cancer Journal for Clinicians. 2018;68(4):246-249. doi:10.3322/caac.21459.7. Screening for Colorectal Cancer: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. Lin JS, Perdue LA, Henrikson NB, Bean SI, Blasi PR. JAMA. 2021;325(19):1978-1998. doi:10.1001/jama.2021.4417.8. Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. Bibbins-Domingo K, Grossman DC, Curry SJ, et al. JAMA. 2016;315(23):2564-2575. doi:10.1001/jama.2016.5989.9. How Would You Screen This Patient for Colorectal Cancer? : Grand Rounds Discussion From Beth Israel Deaconess Medical Center. Burns RB, Mangione CM, Weinberg DS, Kanjee Z. Annals of Internal Medicine. 2022;175(10):1452-1461. doi:10.7326/M22-1961.Support the showSubscribe to Our Newsletter! Production and Content: Edward Delesky, MD & Nicole Aruffo, RNArtwork: Olivia Pawlowski
A new study shows weight loss drugs like Wegovy and Zepbound don't just help with losing weight they may also protect the heart and save lives. In this episode, we look at a new study that followed over 90,000 people with obesity, type 2 diabetes, and heart failure. The results show that drugs like Wegovy and Zepbound don't just help with weight loss, they can cut the risk of death or hospitalization for heart failure nearly in half. We'll talk about why that matters, how these medications actually work in the body, and what you should know about side effects and access. Most importantly, we'll explore why this research could change how we think about treating obesity not just as a matter of weight, but as a way to save lives. Tune in to the full episode to hear how these weight loss drugs could also protect your heart. Episode Highlights: The new JAMA study on Wegovy and Zepbound and their impact on heart health. How GLP-1 medications work in the body to lower risk. Why this matters for people with obesity, diabetes, and heart disease. Side effects, diet, and exercise considerations when using these drugs. Challenges with access and cost of these medications. Connect with Dr. Alicia Shelly: Website | drshellymd.com Facebook | www.facebook.com/drshellymd Instagram | @drshellymd Linked In | www.linkedin.com/in/drshellymd Twitter | @drshellymd About Dr. Alicia Shelly Dr. Alicia Shelly was raised in Atlanta, GA. She received her Doctorate of Medicine from Case Western Reserve University School of Medicine in Cleveland, OH. Dr. Shelly has been practicing Primary Care and Obesity medicine since 2014. In 2017, she became a Diplomat of the American Board of Obesity Medicine. She is the lead physician at the Wellstar Medical Center Douglasville. She started a weekly podcast & Youtube channel entitled Back on Track: Achieving Healthy Weight loss, where she discusses how to get on track and stay on track with your weight loss journey. She has spoken for numerous local and national organizations, including the Obesity Medicine Association, and the Georgia Chapter of the American Society of Metabolic and Bariatric Surgeons. She has been featured on CNN, Fox 5 News, Bruce St. James Radio show, Upscale magazine, and Shape.com. She was named an honoree of the 2021 Atlanta Business Chronicle's 40 under 40 award. She also is a collaborating author for the, “Made for More: Physician Entrepreneurs who Live Life and Practice Medicine on their own terms''. Resources: FREE! Discover the 5 Reasons Your Weight-Loss Journey Has Gotten Derailed (And How To Get Back On Track!)
You Were Not Meant to Be Alone : Reclaiming the Jama‘ah in an Age of Isolation by Ust. Thomas Alameddine. Hosted on Acast. See acast.com/privacy for more information.
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 13-19, 2025.
In this second-ever collaboration between SIDP's Breakpoints and ESCMID's Communicable podcasts, hosts Erin McCreary and Angela Huttner invite the two principal investigators and visionaries who spearheaded the Bacteraemia Antibiotic Length Actually Needed for Clinical Effectiveness (BALANCE) trial, Nick Daneman and Rob Fowler (Sunnybrook Health Sciences Centre, Toronto), for a “deep dive into all things that went into this trial” (1). The BALANCE trial spanned over ten years investigating - as the acronym title suggests - whether a shorter treatment duration of seven days was non-inferior to the standard of care of fourteen days for bacteraemia. The conversation covers everything from the initial hallway discussions that sparked the trial to the trial itself that screened over 36,000 patients and enrolled +3,600, its key takeaways and its impact on clinical practice as well as what's next for Daneman and Fowler.This episode was edited by Kathryn Hostettler and Megan Klatt, and peer reviewed by Dr. Arjana Zerja of Mother Theresa University Hospital Centre, Tirana, Albania.Related podcast episodesCommunicable episode 36: Finding BALANCE in antibiotic durations—the BALANCE trial https://share.transistor.fm/s/b680895eCommunicable episode 26: SNAP out of it—rethinking anti-staphylococcal penicillins for S. aureus bacteremia, the SNAP trial PSSA/MSSA results https://share.transistor.fm/s/2a3c3bb4Breakpoints episode covering IDWeek (December 2024) https://breakpoints-sidp.org/108-idweek-2024-recap-late-breaker-abstracts-and-stewardship-talks/ ReferencesBALANCE Investigators, et al. Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections. N Engl J Med. 2025 March. DOI: 10.1056/NEJMoa2404991Further reading Fowler VG. Eight days a week – BALANCING duration and efficacy. N Engl J Med. 2025 March. DOI: 10.1056/NEJMe2414037 Dulhunty JM, et al. Continuous vs Intermittent β-Lactam Antibiotic Infusions in Critically Ill Patients With Sepsis: The BLING III Randomized Clinical Trial. JAMA 2024. DOI: 10.1001/jama.2024.9779 Yahav D, et al. Seven versus 14 days of antibiotic therapy for uncomplicated Gram-negative bactermia: A noninferiority randomized controlled trial. Clin Infect Dis 2018. DOI: 10.1093/cid/ciy1054 Von Dach E, et al. Effect of C-reactive protein-guided antibiotic treatment duration, 7-day treatment, or 14-day treatment on 30-day clinical failure rate in patients with uncomplicated Gram-negative bacteremia, a randomized clinical trial. JAMA 2020. DOI: 10.1001/jama.2020.6348 Ong SWX, et al. Identifying heterogeneity of treatment effect for antibiotic duration in bloodstream infection: an exploratory post-hoc analysis of the BALANCE randomised clinical trial. EClinicalMedicine 2025. DOI: 10.1016/j.eclinm.2025.103195Wallach JD, et al. Evaluation of evidence of statistical support and corroboration of subgroup claims in randomized clinical trials. JAMA Intern Med 2017. DOI: 10.1001/jamainternmed.20169125
What is a “good death”? How should we define it, and who gets to decide? Is the concept of a “good death” even useful? Twenty-five years ago, Karen Steinhauser published a groundbreaking study in JAMA that transformed my understanding of what it means to have a good death and questioned the usefulness of the term itself. This study examined the factors that are important at the end of life for patients, families, physicians, and other healthcare providers. In today's podcast, we are honored to have Karen join us to discuss this pivotal study and the nature of a “good death”. We are also joined by Rasa Mikelyte and Edison Vidal, co-authors of a recent study comparing the perspectives of people with dementia in the UK and Brazil on what constitutes a good death. In addition to exploring the nature of a good death and their individual studies, we will discuss: Whether an external criterion for a good death exists, or if it is entirely dependent on the perspective of the dying individual. The role of culture and spirituality in defining a good death. The role of healthcare providers in the discussion about the nature of a good death. Key references we discuss include: Our previous GeriPal podcast, “Should the Concept of ‘The Good Death' Be Buried?” with VJ Periyakoil. Karen's 2000 JAMA article, “Factors Considered Important at the End of Life by Patients, Family, Physicians, and Other Care Providers.” Rasa and Edison's article, “Comparing the Views of People with Dementia in the UK and Brazil about a Good Death.” A short video from the EPEC project that Edison mentioned during the recording of an interview with Cicely Saunders, where she shares her advice for anyone going into medicine or palliative care and her views about the principles of palliative care. Lastly, if you would like to join Eric, Edison, and I in Brazil on April 6, 2026, for the São Paulo Geriatrics & Gerontology Congress, click here to register. -Alex Smith
This week, all 3 Services of Soma Church came together as one to worship and celebrate Jesus and Community at JAMAGlobal. Before we enjoyed all the fun amenities offered by JAMA, Pastor Tony brings attention to the Charlie Kirk assassination and shares a message about how people who passionately pursue Jesus will experience both PERSECUTION and PEACE; those are The Facts Of Faith.https://www.jamaglobal.org/
Interview with Lee Wheless, MD, PhD, author of Nicotinamide for Skin Cancer Chemoprevention. Hosted by Adewole S. Adamson, MD. Related Content: Nicotinamide for Skin Cancer Chemoprevention (Original Investigation) Nicotinamide for Skin Cancer Chemoprevention (Editorial)
Special edition of the JAMA Editor's Summary featuring the JAMA Network articles published at the 2025 European Society of Cardiology Congress. Hosted by JAMA Editor in Chief Kirsten Bibbins-Domingo, PhD, MD, MAS, with JAMA Executive Editor Gregory Curfman, MD, JAMA Senior Editor Philip Greenland, MD, and JAMA Cardiology Editor Robert O. Bonow, MD, MS. Related Content: Remote Screening for Asymptomatic Atrial Fibrillation Long-Term Anticoagulation Discontinuation After Catheter Ablation for Atrial Fibrillation Systolic Blood Pressure and Microaxial Flow Pump–Associated Survival in Infarct-Related Cardiogenic Shock Helicobacter pylori Screening After Acute Myocardial Infarction Physiology-Guided Complete Revascularization in Older Patients With Myocardial Infarction Fractional Flow Reserve–Guided Complete vs Culprit-Only Revascularization in Non–ST-Elevation Myocardial Infarction and Multivessel Disease Transcatheter or Surgical Treatment of Patients With Aortic Stenosis at Low to Intermediate Risk Semaglutide and Tirzepatide in Patients With Heart Failure With Preserved Ejection Fraction Bivalent RSV Prefusion F Protein–Based Vaccine for Preventing Cardiovascular Hospitalizations in Older Adults High-Dose vs Standard-Dose Influenza Vaccine and Cardiovascular Outcomes in Older Adults Risk of Myocarditis or Pericarditis With High-Dose vs Standard-Dose Influenza Vaccine Clonal Hematopoiesis and Risk of New-Onset Myocarditis and Pericarditis Participation of Women in Cardiovascular Trials From 2017 to 2023 Prevalence, Determinants, and Time Trends of Cardiovascular Health in the WHO African Region
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
En cette journée spéciale sur RFI consacrée à la drogue dans le monde, Anne Cantener se penche sur la situation sur le continent américain. Aux États-Unis, c'est l'épidémie de fentanyl qui préoccupe toujours. Cette drogue 50 fois plus puissante que l'héroïne, 100 fois plus que la morphine, est la principale cause d'overdoses dans le pays. Mais les choses s'améliorent peu à peu : en 2024, le nombre de décès par overdose liés aux opioïdes synthétiques, donc principalement le fentanyl, a chuté de plus de 30%. Les conséquences des politiques mises en place pour enrayer l'épidémie de fentanyl commencent à se faire sentir. Ces programmes dits de réduction des risques pour les consommateurs «ne visent pas à sevrer les consommateurs dans un premier temps, mais à ce qu'ils prennent leur dose en limitant les risques d'overdoses», explique notre correspondant à Atlanta, Edward Maille. Un outil permet d'éviter les morts liées aux opioïdes : le Naloxone qui se prend par spray nasal ou avec une seringue, est une sorte d'antidote en cas d'overdose. La distribution de ce médicament a considérablement augmenté aux États-Unis, précise encore le journaliste. Les secours et même les consommateurs en ont sur eux. De plus, des lois d'amnistie ont été votées : si vous consommez de la drogue avec une autre personne et qu'elle fait une overdose, si vous appelez les secours, vous n'aurez pas de problème avec la justice. Cette approche de la dépendance à la drogue repose sur l'idée que l'addiction est avant tout une maladie. Dans le monde médical et scientifique, on estime que ces politiques portent leurs fruits. Mais au niveau politique et dans la société, il n'y pas encore de consensus. Souvent, quand un élu veut ouvrir un centre d'échange de seringues, les habitants s'y opposent, explique Edward Maille. Le correspondant de RFI à Atlanta a également recueilli le témoignage de Robin, la vingtaine, qui prend de la drogue depuis ses 11 ans. «Aujourd'hui, elle ne plane plus et ne prend du fentanyl que pour se sentir normale», raconte le journaliste. Elle assume publiquement sa dépendance et lutte pour que les drogués ne soient pas stigmatisés. Haïti, pays «rebond» dans le trafic de drogue L'autre drogue qui inonde le monde, la cocaïne, produite essentiellement en Colombie, transite par de nombreux pays du continent. Une saisie-record a eu lieu en Haïti, au moins de juillet 2025. Mais, comme l'explique Romain Le Cour Grandmaison, docteur en Sciences politiques de l'Université Paris-1 Panthéon-Sorbonne et expert senior au sein de l'ONG Global initiative against transational organized crime, le pays ne sert que d'escale aux trafiquants sur la route vers la République dominicaine. Le pays voisin, tout comme la Jamaïque et les Antilles françaises sont les véritables «hubs stratégiques» et cette drogue n'est plus destinée aux États-Unis mais à l'Europe, analyse le chercheur. Afin d'envoyer les plus grandes quantités possibles de drogue sur le vieux continent, les trafiquants privilégient le transport maritime qui est très peu surveillé. «Pas plus de 6% des containers sont scannés et vérifiés», développe Romain Le Cour Grandmaison. «La façon la plus rentable possible d'exporter la cocaïne n'est pas forcément la plus rapide. Mais ce n'est pas grave car ce n'est pas une denrée périssable. Elle peut donc emprunter des chemins détournés» avant d'arriver à sa destination finale. Le journal de la 1ère La terre a tremblé ce lundi matin (15 septembre 2025) dans le nord de la « Grande Terre » de la Guadeloupe.
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
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.
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
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