Podcasts about jama netw open

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-503 Overview: In this episode, we discuss how prescribing “food as medicine” can complement hypertension management in primary care. We review the evidence supporting legumes, soy, and DASH-based nutrition for lowering blood pressure, while providing practical counseling strategies to help patients adopt dietary patterns that enhance cardiovascular health alongside standard medical therapy. Episode resource links: Metoudi M, et al. bmjnph 2026;0:e001449. doi:10.1136/bmjnph-2025-001449 Brindal E, Baird D. Regular Flatulence Patterns Among Community-Dwelling Individuals in Australia. JAMA Netw Open. 2026;9(5):e2615637. doi:10.1001/jamanetworkopen.2026.15637 DASH - DASH Eating Plan | NHLBI, NIH Guest: Robert A. Baldor MD, FAAFP Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Send us Fan MailThis week on The Incubator Podcast, Ben and Daphna dig into four studies reshaping bedside decisions. They open questioning whether routine DAT screening for ABO and RhD incompatibility still earns its place, finding transcutaneous bilirubin alone predicts phototherapy need just as well. Next, a Swedish national registry of over two million births links missed intramuscular vitamin K, and rising oral substitution, to a near-doubling of bleeding and intracranial hemorrhage risk. Ben then presents the PHILODENDRON pilot trial out of Milan, testing initial delivery-room CPAP of 5 versus 8 cmH2O in infants under 30 weeks, feasible and safe, but not yet enough to settle the physiology question. Daphna closes Journal Club with a SART-linked study tying IVF conception to significantly higher odds of VACTERL association. The week wraps with Ben and Eli on Neo News, unpacking a study showing birth certificates miss nearly 40% of true NICU admissions, with troubling racial disparities.----Utility of DAT in Low-Risk Neonates With ABO or RhD Incompatibility. Tsai TL, Ma T, Nester T.Pediatrics. 2026 Sep 1;158(3):e2026076989. doi: 10.1542/peds.2026-076989.PMID: 42642037Vitamin K Prophylaxis in Newborns and Bleeding in Infancy. Simatou E, Tsamantioti E, Hallström A, Stephansson O, Razaz N, Persson M, Bolk J.JAMA Pediatr. 2026 Sep 1;180(9):995-1004. doi: 10.1001/jamapediatrics.2026.2606.PMID: 42440325Initial CPAP of 5 versus 8 cmH2O during delivery room stabilisation of very preterm infants: the PHILODENDROOM pilot randomised trial. Cavigioli F, Bresesti I, Castoldi F, Gatto S, Lupo E, Rossi S, La Verde A, Bianchi S, Meneghin F, Viaroli F, Pivetti V, Manfredini V, Cannata G, Bastrenta P, Fontana P, Stucchi I, Daniele I, Chiera M, Lista G.Eur J Pediatr. 2026 Aug 17;185(9):673. doi: 10.1007/s00431-026-07322-6.PMID: 42608615 Free PMC article. Clinical Trial.In Vitro Fertilization and VACTERL Birth Defects. Tark JY, Richard MA, Schraw JM, Fisher SC, Betancourt D, Stone SL, Forestieri NE, Baker VL, Cameron K, Eisenberg ML, Belva F, Lu Y, Williams CL, Sutcliffe AG, Lupo PJ, Luke B.JAMA Netw Open. 2026 Aug 3;9(8):e2629355. doi: 10.1001/jamanetworkopen.2026.29355.PMID: 42616500 Free PMC article.Birth certificate data substantially misrepresent actual NICU admissions, including among most vulnerable. Hughes CS, Lorch SA, Schmitt S, Passarella M, Phibbs CS.J Perinatol. 2026 Jul;46(7):1307-1312. doi: 10.1038/s41372-026-02726-6. Epub 2026 May 27.PMID: 42204354Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

You stayed late again, the service is still short-staffed, and when you finally say something, the answer is: you just need to be more efficient. More resilient. That's the go-to explanation for almost everything hard about residency — but what if the problem isn't your resilience at all? In the finale of Beyond the Match, Mckenzie Roebuck, Carl Engelke, Michael Brinton, and Omer Hassan of CoSEF look downstream at what happens after residents match: working conditions, culture and mental health, the practical barriers that make transferring so difficult, why residents may not trust existing reporting systems, and what real accountability and resident voice would require.Hosts:  Dr. Mckenzie Roebuck, CoSEF BTK Lead, Inova Fairfax Medical Campus, mckenzie.rowe@inova.org Dr. Carl Engelke, The Ohio State University, Carl.Engelke@osumc.edu  Dr. Michael Brinton, Medical College of Wisconsin, mbrinton@mcw.edu   Dr. Omer Hassan, University of Calgary/Alberta Children's Hospital, omerh91@gmail.com CoSEF: X @surgedfellows, cosef.org  Learning objectives: Summarize the real problems the congressional report identifies in working conditions, mistreatment reporting, and resident mental health Distinguish necessary difficulty in residency training from preventable system dysfunction, and describe its relationship to resident well-being and reporting Explain the practical barriers to resident mobility, including position availability, training requirements, funding, visa status, professional risk, and stigma Describe local and national accountability mechanisms — including program reporting, GMECs, ACGME pathways, and unions — and the limitations of each Identify strategies to strengthen resident voice, psychological safety, anti-retaliation protections, and institutional accountability rather than relying on individual resilience alone.  References: House Committee on the Judiciary. Medical Mis-Match: How a Residency Hiring Monopoly Harms Patients, Doctors, and the American Public. Published online March 27, 2026. Gianakos AL, Freischlag JA, Mercurio AM, et al. Bullying, Discrimination, Harassment, Sexual Harassment, and the Fear of Retaliation During Surgical Residency Training: A Systematic Review. World J Surg. 2022;46(7):1587-1599. doi:10.1007/s00268-021-06432-6PubMed Link: https://pubmed.ncbi.nlm.nih.gov/35006329/ Mata DA, Ramos MA, Bansal N, et al. Prevalence of Depression and Depressive Symptoms Among Resident Physicians: A Systematic Review and Meta-analysis. JAMA. 2015;314(22):2373-2383. doi:10.1001/jama.2015.15845PubMed Link: https://pubmed.ncbi.nlm.nih.gov/26647259/ Malone TL, Zhao Z, Liu TY, Song PXK, Sen S, Scott LJ. Prediction of Suicidal Ideation Risk in a Prospective Cohort Study of Medical Interns. PLoS One. 2021;16(12):e0260620. doi:10.1371/journal.pone.0260620PubMed Link: https://pubmed.ncbi.nlm.nih.gov/34855821/ Drolet BC, Schwede M, Bishop KD, Fischer SA. Compliance and Falsification of Duty Hours: Reports From Residents and Program Directors. J Grad Med Educ. 2013;5(3):368-373. doi:10.4300/JGME-D-12-00375.1PubMed Link: https://pubmed.ncbi.nlm.nih.gov/24404298/ National Resident Matching Program. The Match Agreement. Accessed August 2026. https://www.nrmp.org/intro-to-the-match/the-match-agreement/. Intealth (ECFMG). J-1 Physicians Training in the US (infographic). Accessed August 2026. https://www.intealth.org/pdfs/J-1_US_Infographic.pdf. (Note: Institutional PDF; no PubMed entry available). Foote DC, Rosenblatt AE, Amortegui D, et al. Experiences With Unionization Among General Surgery Resident Physicians, Faculty, and Staff. JAMA Netw Open. 2024;7(7):e2421676. doi:10.1001/jamanetworkopen.2024.21676PubMed Link: https://pubmed.ncbi.nlm.nih.gov/39018072/ Accreditation Council for Graduate Medical Education. Report an Issue. https://www.acgme.org/residents-and-fellows/report-an-issue/?utm_source. 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/listenBehind the Knife Premium: https://behindtheknife.org/premiumOral Board Review: https://behindtheknife.org/oral-boardOral Board Simulator: https://behindtheknife.org/oral-board/simulatorGeneral Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate 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-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-reviewOBGYN Oral Board Review Course: https://behindtheknife.org/course/obgyn-oral-board-reviewSurgical Critical Care Review: https://behindtheknife.org/premium/surgical-critical-care-reviewEPA Playbook: https://behindtheknife.org/course/epa-playbookSurgical Instrument Flashcards: https://behindtheknife.org/course/surgical-instrument-flashcardsABSITE Review: https://behindtheknife.org/course/absite-2026-exam-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Send us Fan MailBen and Daphna  dig into a large, population-based study linking IVF conception to VACTERL association, a rare but serious pattern of congenital anomalies spanning the vertebral, anal, cardiac, tracheoesophageal, renal, and limb systems. Drawing on over 1.5 million births across four US states and linked SART registry data, the study finds IVF-conceived infants face significantly higher odds of VACTERL and related multiple anomaly syndromes compared to naturally conceived infants. Daphna and Ben unpack what this means for clinical suspicion at the bedside, why some VACTERL phenotypes may be easy to miss, and how better tracking of conception history through delivery could change how NICU teams approach anomaly workups in IVF-conceived infants.----In Vitro Fertilization and VACTERL Birth Defects. Tark JY, Richard MA, Schraw JM, Fisher SC, Betancourt D, Stone SL, Forestieri NE, Baker VL, Cameron K, Eisenberg ML, Belva F, Lu Y, Williams CL, Sutcliffe AG, Lupo PJ, Luke B.JAMA Netw Open. 2026 Aug 3;9(8):e2629355. doi: 10.1001/jamanetworkopen.2026.29355.PMID: 42616500 Free PMC article.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

What does it say about a training system when childcare can eat up almost half a resident's monthly salary — and the physicians doing essential clinical work have almost no ability to negotiate their pay or benefits? A recent House Judiciary Committee report argues that the Match suppresses resident compensation and bargaining power. But if the Match disappeared tomorrow, would residents actually get paid more? Join Mckenzie Roebuck, Maya Hunt, Nicole Santucci, and Michael Kabbash of CoSEF as they unpack resident pay and benefits, where GME funding actually goes, why residency is not a normal labor market, and where real leverage for change might come from.Hosts: Dr. Mckenzie Roebuck, CoSEF BTK Lead, Inova Fairfax Medical Campus, mckenzie.rowe@inova.org, insta @mrowemd, X @mrowemd1  Dr. Maya Hunt, Indiana University, mayahunt@iu.edu  Dr. Nicole Santucci, Washington University in St. Louis, snicole@wustl.edu  Dr. Michael Kabbash, University of Florida, michel.kabbash@surgery.ufl.edu, X @MichaelKabbash CoSEF: X @surgedfellows, cosef.org Learning objectives: Summarize the congressional report's arguments about resident compensation and bargaining power  Explain how GME funding supports residency and why federal GME dollars do not map directly onto resident salaries  Describe how salary and benefit structures affect residents' financial well-being, family planning, and quality of life  Identify institutional, policy, and collective strategies to strengthen resident compensation and bargaining power.  References: House Committee on the Judiciary. Medical Mis-Match: How a Residency Hiring Monopoly Harms Patients, Doctors, and the American Public. Published online March 27, 2026. Association of American Medical Colleges. AAMC Survey of Resident/Fellow Stipends and Benefits. https://www.aamc.org/data-reports/students-residents/report/aamc-survey-resident/fellow-stipends-and-benefits.  Centers for Medicare and Medicaid Services. Direct Graduate Medical Education (DGME). https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/direct-graduate-medical-education-dgme.  Foote DC, Rosenblatt AE, Amortegui D, et al. Experiences With Unionization Among General Surgery Resident Physicians, Faculty, and Staff. JAMA Netw Open. 2024;7(7):e2421676. doi:10.1001/jamanetworkopen.2024.21676 https://pubmed.ncbi.nlm.nih.gov/39018072/ Tomei KL, Selby LV, Kirk LM, et al. Beyond Training the Next Generation of Physicians: The Unmeasured Value Added by Residents to Teaching Hospitals and Communities. Acad Med. 2022;97(11):1592-1596. https://pubmed.ncbi.nlm.nih.gov/35731593/ doi:10.1097/ACM.0000000000004792 Accreditation Council for Graduate Medical Education. Common Program Requirements. Accessed August 2026.https://www.acgme.org/programs-and-institutions/programs/common-program-requirements/. Rigged or Right? The Residency Match Under Fire | podcast. Behind the Knife. https://behindtheknife.org/podcast/rigged-or-right-the-residency-match-under-fire.  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/listenBehind the Knife Premium: https://behindtheknife.org/premiumOral Board Review: https://behindtheknife.org/oral-boardOral Board Simulator: https://behindtheknife.org/oral-board/simulatorGeneral Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate 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-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-reviewOBGYN Oral Board Review Course: https://behindtheknife.org/course/obgyn-oral-board-reviewSurgical Critical Care Review: https://behindtheknife.org/premium/surgical-critical-care-reviewEPA Playbook: https://behindtheknife.org/course/epa-playbookSurgical Instrument Flashcards: https://behindtheknife.org/course/surgical-instrument-flashcardsABSITE Review: https://behindtheknife.org/course/absite-2026-exam-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Ultrasound-guided nerve blocks are no longer just a niche skill for fellowship-trained ultrasound specialists—they are a core component of modern multimodal pain management in the ED. Endorsed by ACEP, nerve blocks can offer rapid, targeted pain relief without relying solely on systemic opioids, making everything from rest to imaging and procedural workups significantly more comfortable for patients. Today, Dr. Carlos Mikell, UC Davis Emergency Ultrasound Faculty and nerve block expert, joins us to share why every emergency physician should adopt nerve blocks as part of their practice. We'll break down the top ED blocks, explore innovative indications like genicular nerve blocks for knee pain, and discuss essential safety protocols and how to get started – or become more comfortable – with blocks in your ED. Why Nerve Blocks Belongs in the ED Targeted Relief: Delivers effective, localized pain management as part of a multi-modal pain control approach, sparing patients some of the systemic side effects of opioids. Facilitates ED Workup: Relieves movement-related pain, making imaging, patient transport, and local procedures far easier and more comfortable for the patient. ACEP Endorsement: ACEP's policy statement formalizes ultrasound-guided nerve blocks as an essential skill for all emergency physicians—not just ultrasound fellowship graduates. Analgesia, Not Complete Anesthesia: The goal in the ED is regional analgesia (taking pain down to a manageable, functional level safely) rather than dense, surgical anesthesia. The Most Common ED Nerve Blocks According to data from the National Ultrasound Guided Nerve Block Registry: Fascia Iliaca Plane / Femoral Nerve Block (~36%): Indications: Hip fractures, mid-shaft/distal femur fractures, hip dislocations, and severe thigh trauma. Safety Profile: Highly safe; target plane is centimeters away from the main neurovascular bundle in a easily compressible site. Erector Spinae Plane (ESP) Block: Indications: Back pain, renal colic, shingles, and rib fractures. Forearm Blocks (Median, Ulnar, Radial): Indications: Distal forearm fractures, complex lacerations, and hand procedures. Serratus Anterior Plane (SAP) Block (~7%): Indications: Rib fractures, pre/post-chest tube insertion pain, and chest wall abscesses. Tip: Hydro-dissect with normal saline first to identify the fascial plane before injecting local anesthetic, and consider adding dexamethasone to extend duration. Innovative Block Spotlight: Genicular Nerve Block Target: Three of the primary sensory branches of the sciatic/femoral nerves supplying the anterior knee. Indications: Acute knee trauma/fractures, acute-on-chronic knee pain, and severe osteoarthritic flare-ups. Safety & Execution: Low-volume block (~10 mL total). Pearl: Omit the inferior-lateral genicular injection to avoid unintentional peroneal nerve block and foot drop. Streamlining Nerve Blocks in Your Department To move nerve blocks from a rare procedure to a routine clinical tool: ED Infrastructure: Build standardized EMR order sets, procedure note templates, and dedicated nerve block supply carts/kits. Departmental Support: Designate a point person to coordinate credentialing, interdisciplinary pathways (e.g., trauma, orthopedics), and physician/nurse/tech education. Hands-on Training: Utilize cadaver labs, simulation, and scanning shifts to build faculty and resident confidence. Non-Negotiable Safety Guidelines & LAST Prevention Nerve blocks are generally low-risk, but vigilance is critical to avoid complications like Local Anesthetic Systemic Toxicity (LAST) or direct nerve injury: Patient Selection: Avoid in uncommunicative patients (who cannot report paresthesias or tinnitus), areas at high risk for compartment syndrome, or pre-existing severe nerve deficits. Monitoring: Keep patients on cardiac telemetry for 30–60 minutes post-block for central or high-volume blocks (>10 mL or above the elbow/knee). Dosing Buffer: Calculate maximum weight-based local anesthetic doses every time; stay within 60–70% of the maximum dose to maintain a safety buffer. Intralipid Availability: Ensure 20% Intralipid is immediately accessible in the ED pharmacy or brought directly to the bedside. Injection Technique: Never point the needle directly at a nerve. Inject into the fascial plane, stop immediately if you encounter resistance, and perform frequent aspirations every 3–5 mL. What is your favorite ultrasound-guided nerve block? What barriers do you encounter to doing blocks in the ED? We'd love to hear form you! Connect with us on social media @empulsepodcast or connect with us on ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Professor of Pediatric Emergency Medicine at UC Davis Guest: Dr. Carlos Mikell, Assistant Professor of Emergency Medicine and Ultrasound Faculty at UC Davis Resources: ACEP Policy Satement: Ultrasound Guidelines: Emergency, Point-of-care, and Clinical Ultrasound Guidelines in Medicine, June 2016 ACEP Now: How To Build an Ultrasound-Guided Nerve Block Program By Arun Nagdev, MD; Kaitlen Howell, MD; Akash Desai, MD; David Martin, MD; and Daniel Mantuani, MD, MPH | on January 6, 2023  ACEP Sonoguide: Nerve Blocks NURVE Block Registry Brown J, Milgrim F, Driver L, et al. Efficacy and Safety of Adjunct Medications in ED Ultrasound-Guided Nerve Blocks: A National Ultrasound-Guided NeRVE (NURVE) Block Registry Study. Acad Emerg Med. 2025 Dec;32(12):1299-1308. doi: 10.1111/acem.70128. Epub 2025 Aug 27. PMID: 40873157. Goldsmith A, Driver L, Duggan NM, et al. Complication Rates After Ultrasonography-Guided Nerve Blocks Performed in the Emergency Department. JAMA Netw Open. 2024 Nov 4;7(11):e2444742. doi: 10.1001/jamanetworkopen.2024.44742. Erratum in: JAMA Netw Open. 2024 Dec 2;7(12):e2455847. doi: 10.1001/jamanetworkopen.2024.55847. PMID: 39535792; PMCID: PMC11561692. *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services. Disclaimer: The opinions expressed on this podcast are those of the hosts or guests and do not necessarily reflect the views of UC Davis Department of Emergency Medicine, UC Davis Health, or their parent organizations.

Send us Fan MailThis week's Journal Club. Monday, nasal CPAP versus NIPPV as the bridge to minimally invasive surfactant in infants born before 30 weeks, first author Dr. Hui Zhang. Tuesday, the PAEAN trial on high-dose erythropoietin for neonatal HIE, led by Dr. Helen Liley. Wednesday, extended infusion versus bolus feeding for weight gain in extremely-low-birth-weight infants, from Dr. Haribalakrishna Balasubramanian's team in India. Thursday, the DROP-ROP trial, testing dexamethasone eye drops against treatment-requiring ROP, led by Dr. Ann Hellström. Friday, Neo News: Eli and Ben on The Pitt's viral boundary-setting scene and what it says about burnout in medicine.----Nasal Continuous Positive Airway Pressure vs Nasal Intermittent Positive Pressure Ventilation in Preterm Infants With Respiratory Distress Syndrome: A Randomized Clinical Trial. Zhang H, Zhang Y, Zeng L, Tong X, Piao M, He H, Zhao C, Xie H, Zheng Z, Cui Q, Lai Y, Wang H, Wang L, Liu H, Tian X, Wu H, Kang L, Han T.JAMA Netw Open. 2026 Jun 1;9(6):e2619785. doi: 10.1001/jamanetworkopen.2026.19785.Erythropoietin for Neonatal Hypoxic-Ischemic Encephalopathy: A Randomized Clinical Trial. Liley HG, Hunt RW, O'Connell RL, Battin MR, Novak I, Wu YW, Ballard R, Askie L, Badawi N, Ghadge A, Jacobs SE, Juul SE, Sebastian L, Wagh D, Simes RJ; PAEAN Study Investigators.JAMA Pediatr. 2026 Jul 27:e263082. doi: 10.1001/jamapediatrics.2026.3082. Online ahead of print.Effect of Extended Infusion Versus Intermittent Bolus Feedings on Hospital Weight Gain in Extremely Low Birth Weight Infants Born at

Credits: 0.75 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-500 Overview: To celebrate our 500th episode, each member of our team revisits a popular topic from the podcast's earlier installments—GLP-1s, cervical and breast cancer screening, diet and exercise, contraception, hypertension, and lipid management—to trace how the evidence and guidelines have changed since it was first covered. Whether you're catching up or reinforcing what you know, this milestone episode helps you bring the latest evidence into everyday patient care. Guest: Robert Baldor, MD, Alan Ehrlich, MD, Susan Feeney, DNP, FNP-BC; FAANP, Jillian Joseph, PA, Mariyan L. Montaque, DNP, FNP-BC, Jill Terrien PhD, ANP-BC, FAAN   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  Episode resource links:  Zhou H et al.  Evaluation and Comparison of the PREVENT and Pooled Cohort Equations for 10‐Year Atherosclerotic Cardiovascular Risk Prediction. Journal of the American Heart Association Volume 14, Number 4 Goff DC et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. Circulation. 2014;129:S49–S73. Circulation. 2018 Jul 24;138(4):345-355.  eClinicalMedicine 2025: 103741. Curry, J. (2018). Screening for cervical cancer: US Preventive Services Task Force Recommendation Statement. JAMA.320(7):674-686. doi:10.1001/jama.2018.10897 https://www.ncbi.nlm.nih.gov/pubmed/30140884  Perkins RB, Wolf AMD, Church TR, et al. Self-collected vaginal specimens for human papillomavirus testing and guidance on screening exit: An update to the American Cancer Society cervical cancer screening guideline. CA Cancer J Clin. 2026;e70041. doi:10.3322/caac.70041   Screening for Cervical Cancer (2026). Obstetrics & Gynecology, 148(1), e63-e67. https://doi.org/10.1097/AOG.0000000000006257  Jad Zeitouni, Nosayaba Osazuwa-Peters, Yusuf Dundar, Gregory Zimet, Mark A. Varvares. (2025). Two decades of the HPV vaccine: its promise, progress, prospects, projections, and posterity, The Lancet Regional Health - Americas, (51), https://doi.org/10.1016/j.lana.2025.101243 Diabetes, Obesity and Metabolism 28, no. 6 (2026): 5043–5057, https://doi.org/10.1111/dom.70698.  Relationship of early rapid weight loss to efficacy and safety of tirzepatide and semaglutide for obesity: SURMOUNT-5 post hoc analysis. Am J Med. 2026 Jul;139(7):913-921. doi: 10.1016/j.amjmed.2026.03.010 US Preventive Services Task Force; Nicholson WK, Silverstein M, Wong JB, et al. Screening for breast cancer: US Preventive Services Task Force recommendation statement. JAMA. 2024;331(22):1918–1930.  Trentham-Dietz A, Chapman CH, Jayasekera J, et al. Collaborative modeling to compare different breast cancer screening strategies: a decision analysis for the US Preventive Services Task Force. JAMA. 2024;331(22):1931–1946. Giaquinto AN, Sung H, Miller KD, et al. Breast cancer statistics, 2022. CA Cancer J Clin. 2022;72(6):524–541.  Qaseem A, Harrod CS, Balk EM, et al. Screening for breast cancer in asymptomatic, average-risk adult females: a guidance statement from the American College of Physicians (Version 2). Ann Intern Med. 2026.:  American Cancer Society. Breast Cancer Facts & Figures 2022–2024. Atlanta, GA: American Cancer Society, 2022.  Hu X, Chehal PK, Kaplan C, et al. Racial differences in patient-reported symptoms and adherence to adjuvant endocrine therapy among women with early-stage, hormone receptor-positive breast cancer. JAMA Netw Open. 2022;5(8):e2225485.  Torres JM, Sodipo MO, Hopkins MF, Chandler PD, Warner ET. Racial differences in breast cancer survival between Black and White women according to tumor subtype: a systematic review and meta-analysis. J Clin Oncol. 2024;42(35):4225–4234.  Bailey ZD, Krieger N, Agénor M, Graves J, Linos N, Bassett MT. Structural racism and health inequities in the USA: evidence and interventions. Lancet. 2017;389(10077):1453–1463. Hypertension. 2026;83:00–00. DOI: 10.1161/HYPERTENSIONAHA.125.25787 Allen RH, Bartz D. Opill: The Over-the-Counter Contraceptive Pill. Obstet Gynecol. 2024;143(2):184-188. doi:10.1097/AOG.0000000000005455  Cahill EP, Kaur S. Advances in contraception research and development. Curr Opin Obstet Gynecol. 2020;32(6):393-398. doi:10.1097/GCO.0000000000000666  Charles DN, Nagarsheth M, Oshman L. Pain Management for IUD Insertion in Primary Care. Am Fam Physician. 2025;111(4):299-301.  Chen, C., Strasser, J., Banawa, R., Luo, Q., Bodas, M., Castruccio-Prince, C., Das, K., & Pittman, P. (2022). Who is providing contraception care in the United States? An observational study of the contraception workforce. American journal of obstetrics and gynecology, 226(2), 232.e1–232.e11. https://doi.org/10.1016/j.ajog.2021.08.015  Diedrich,J., Klein, D. Peipert, J.(2017). Long-acting reversible contraception in adolescents: a systematic review and meta-analysis, Am J Ob Gyn, April 2017. http://dx.doi.org/10.1016/j.ajog.2016.12.024  Li RHW, Lo SST, Gemzell-Danielsson K, Fong CHY, Ho PC, Ng EHY. Oral emergency contraception with levonorgestrel plus piroxicam: a randomised double-blind placebo-controlled trial. Lancet. 2023;402(10405):851-858. doi:10.1016/S0140-6736(23)01240-0  Mørch LS, Meaidi A, Corn G, Hargreave M, Wessel Skovlund C. Breast Cancer in Users of Levonorgestrel-Releasing Intrauterine Systems. JAMA. 2024;332(18):1578–1580. doi:10.1001/jama.2024.18575  Nguyen AT, Curtis KM, Tepper NK, et al. U.S. Medical Eligibility Criteria for Contraceptive Use, 2024. MMWR Recomm Rep. 2024;73(4):1-126. Published 2024 Aug 8. doi:10.15585/mmwr.rr7304a1  Paradise SL, Landis CA, Klein DA. Evidence Based Contraception: Common Questions and Answers. American Family Physician. 2022. https://www.aafp.org/afp/2022/0900/contraception The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Credits: 0.75 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-500 Overview: To celebrate our 500th episode, each member of our team revisits a popular topic from the podcast's earlier installments—GLP-1s, cervical and breast cancer screening, diet and exercise, contraception, hypertension, and lipid management—to trace how the evidence and guidelines have changed since it was first covered. Whether you're catching up or reinforcing what you know, this milestone episode helps you bring the latest evidence into everyday patient care. Guest: Robert Baldor, MD, Alan Ehrlich, MD, Susan Feeney, DNP, FNP-BC; FAANP, Jillian Joseph, PA, Mariyan L. Montaque, DNP, FNP-BC, Jill Terrien PhD, ANP-BC, FAAN   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  Episode resource links:  Zhou H et al.  Evaluation and Comparison of the PREVENT and Pooled Cohort Equations for 10‐Year Atherosclerotic Cardiovascular Risk Prediction. Journal of the American Heart Association Volume 14, Number 4 Goff DC et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. Circulation. 2014;129:S49–S73. Circulation. 2018 Jul 24;138(4):345-355.  eClinicalMedicine 2025: 103741. Curry, J. (2018). Screening for cervical cancer: US Preventive Services Task Force Recommendation Statement. JAMA.320(7):674-686. doi:10.1001/jama.2018.10897 https://www.ncbi.nlm.nih.gov/pubmed/30140884  Perkins RB, Wolf AMD, Church TR, et al. Self-collected vaginal specimens for human papillomavirus testing and guidance on screening exit: An update to the American Cancer Society cervical cancer screening guideline. CA Cancer J Clin. 2026;e70041. doi:10.3322/caac.70041   Screening for Cervical Cancer (2026). Obstetrics & Gynecology, 148(1), e63-e67. https://doi.org/10.1097/AOG.0000000000006257  Jad Zeitouni, Nosayaba Osazuwa-Peters, Yusuf Dundar, Gregory Zimet, Mark A. Varvares. (2025). Two decades of the HPV vaccine: its promise, progress, prospects, projections, and posterity, The Lancet Regional Health - Americas, (51), https://doi.org/10.1016/j.lana.2025.101243 Diabetes, Obesity and Metabolism 28, no. 6 (2026): 5043–5057, https://doi.org/10.1111/dom.70698.  Relationship of early rapid weight loss to efficacy and safety of tirzepatide and semaglutide for obesity: SURMOUNT-5 post hoc analysis. Am J Med. 2026 Jul;139(7):913-921. doi: 10.1016/j.amjmed.2026.03.010 US Preventive Services Task Force; Nicholson WK, Silverstein M, Wong JB, et al. Screening for breast cancer: US Preventive Services Task Force recommendation statement. JAMA. 2024;331(22):1918–1930.  Trentham-Dietz A, Chapman CH, Jayasekera J, et al. Collaborative modeling to compare different breast cancer screening strategies: a decision analysis for the US Preventive Services Task Force. JAMA. 2024;331(22):1931–1946. Giaquinto AN, Sung H, Miller KD, et al. Breast cancer statistics, 2022. CA Cancer J Clin. 2022;72(6):524–541.  Qaseem A, Harrod CS, Balk EM, et al. Screening for breast cancer in asymptomatic, average-risk adult females: a guidance statement from the American College of Physicians (Version 2). Ann Intern Med. 2026.:  American Cancer Society. Breast Cancer Facts & Figures 2022–2024. Atlanta, GA: American Cancer Society, 2022.  Hu X, Chehal PK, Kaplan C, et al. Racial differences in patient-reported symptoms and adherence to adjuvant endocrine therapy among women with early-stage, hormone receptor-positive breast cancer. JAMA Netw Open. 2022;5(8):e2225485.  Torres JM, Sodipo MO, Hopkins MF, Chandler PD, Warner ET. Racial differences in breast cancer survival between Black and White women according to tumor subtype: a systematic review and meta-analysis. J Clin Oncol. 2024;42(35):4225–4234.  Bailey ZD, Krieger N, Agénor M, Graves J, Linos N, Bassett MT. Structural racism and health inequities in the USA: evidence and interventions. Lancet. 2017;389(10077):1453–1463. Hypertension. 2026;83:00–00. DOI: 10.1161/HYPERTENSIONAHA.125.25787 Allen RH, Bartz D. Opill: The Over-the-Counter Contraceptive Pill. Obstet Gynecol. 2024;143(2):184-188. doi:10.1097/AOG.0000000000005455  Cahill EP, Kaur S. Advances in contraception research and development. Curr Opin Obstet Gynecol. 2020;32(6):393-398. doi:10.1097/GCO.0000000000000666  Charles DN, Nagarsheth M, Oshman L. Pain Management for IUD Insertion in Primary Care. Am Fam Physician. 2025;111(4):299-301.  Chen, C., Strasser, J., Banawa, R., Luo, Q., Bodas, M., Castruccio-Prince, C., Das, K., & Pittman, P. (2022). Who is providing contraception care in the United States? An observational study of the contraception workforce. American journal of obstetrics and gynecology, 226(2), 232.e1–232.e11. https://doi.org/10.1016/j.ajog.2021.08.015  Diedrich,J., Klein, D. Peipert, J.(2017). Long-acting reversible contraception in adolescents: a systematic review and meta-analysis, Am J Ob Gyn, April 2017. http://dx.doi.org/10.1016/j.ajog.2016.12.024  Li RHW, Lo SST, Gemzell-Danielsson K, Fong CHY, Ho PC, Ng EHY. Oral emergency contraception with levonorgestrel plus piroxicam: a randomised double-blind placebo-controlled trial. Lancet. 2023;402(10405):851-858. doi:10.1016/S0140-6736(23)01240-0  Mørch LS, Meaidi A, Corn G, Hargreave M, Wessel Skovlund C. Breast Cancer in Users of Levonorgestrel-Releasing Intrauterine Systems. JAMA. 2024;332(18):1578–1580. doi:10.1001/jama.2024.18575  Nguyen AT, Curtis KM, Tepper NK, et al. U.S. Medical Eligibility Criteria for Contraceptive Use, 2024. MMWR Recomm Rep. 2024;73(4):1-126. Published 2024 Aug 8. doi:10.15585/mmwr.rr7304a1  Paradise SL, Landis CA, Klein DA. Evidence Based Contraception: Common Questions and Answers. American Family Physician. 2022. https://www.aafp.org/afp/2022/0900/contraception The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Credits: 0.75 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-500 Overview: To celebrate our 500th episode, each member of our team revisits a popular topic from the podcast's earlier installments—GLP-1s, cervical and breast cancer screening, diet and exercise, contraception, hypertension, and lipid management—to trace how the evidence and guidelines have changed since it was first covered. Whether you're catching up or reinforcing what you know, this milestone episode helps you bring the latest evidence into everyday patient care. Guest: Robert Baldor, MD, Alan Ehrlich, MD, Susan Feeney, DNP, FNP-BC; FAANP, Jillian Joseph, PA, Mariyan L. Montaque, DNP, FNP-BC, Jill Terrien PhD, ANP-BC, FAAN   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  Episode resource links:  Zhou H et al.  Evaluation and Comparison of the PREVENT and Pooled Cohort Equations for 10‐Year Atherosclerotic Cardiovascular Risk Prediction. Journal of the American Heart Association Volume 14, Number 4 Goff DC et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. Circulation. 2014;129:S49–S73. Circulation. 2018 Jul 24;138(4):345-355.  eClinicalMedicine 2025: 103741. Curry, J. (2018). Screening for cervical cancer: US Preventive Services Task Force Recommendation Statement. JAMA.320(7):674-686. doi:10.1001/jama.2018.10897 https://www.ncbi.nlm.nih.gov/pubmed/30140884  Perkins RB, Wolf AMD, Church TR, et al. Self-collected vaginal specimens for human papillomavirus testing and guidance on screening exit: An update to the American Cancer Society cervical cancer screening guideline. CA Cancer J Clin. 2026;e70041. doi:10.3322/caac.70041   Screening for Cervical Cancer (2026). Obstetrics & Gynecology, 148(1), e63-e67. https://doi.org/10.1097/AOG.0000000000006257  Jad Zeitouni, Nosayaba Osazuwa-Peters, Yusuf Dundar, Gregory Zimet, Mark A. Varvares. (2025). Two decades of the HPV vaccine: its promise, progress, prospects, projections, and posterity, The Lancet Regional Health - Americas, (51), https://doi.org/10.1016/j.lana.2025.101243 Diabetes, Obesity and Metabolism 28, no. 6 (2026): 5043–5057, https://doi.org/10.1111/dom.70698.  Relationship of early rapid weight loss to efficacy and safety of tirzepatide and semaglutide for obesity: SURMOUNT-5 post hoc analysis. Am J Med. 2026 Jul;139(7):913-921. doi: 10.1016/j.amjmed.2026.03.010 US Preventive Services Task Force; Nicholson WK, Silverstein M, Wong JB, et al. Screening for breast cancer: US Preventive Services Task Force recommendation statement. JAMA. 2024;331(22):1918–1930.  Trentham-Dietz A, Chapman CH, Jayasekera J, et al. Collaborative modeling to compare different breast cancer screening strategies: a decision analysis for the US Preventive Services Task Force. JAMA. 2024;331(22):1931–1946. Giaquinto AN, Sung H, Miller KD, et al. Breast cancer statistics, 2022. CA Cancer J Clin. 2022;72(6):524–541.  Qaseem A, Harrod CS, Balk EM, et al. Screening for breast cancer in asymptomatic, average-risk adult females: a guidance statement from the American College of Physicians (Version 2). Ann Intern Med. 2026.:  American Cancer Society. Breast Cancer Facts & Figures 2022–2024. Atlanta, GA: American Cancer Society, 2022.  Hu X, Chehal PK, Kaplan C, et al. Racial differences in patient-reported symptoms and adherence to adjuvant endocrine therapy among women with early-stage, hormone receptor-positive breast cancer. JAMA Netw Open. 2022;5(8):e2225485.  Torres JM, Sodipo MO, Hopkins MF, Chandler PD, Warner ET. Racial differences in breast cancer survival between Black and White women according to tumor subtype: a systematic review and meta-analysis. J Clin Oncol. 2024;42(35):4225–4234.  Bailey ZD, Krieger N, Agénor M, Graves J, Linos N, Bassett MT. Structural racism and health inequities in the USA: evidence and interventions. Lancet. 2017;389(10077):1453–1463. Hypertension. 2026;83:00–00. DOI: 10.1161/HYPERTENSIONAHA.125.25787 Allen RH, Bartz D. Opill: The Over-the-Counter Contraceptive Pill. Obstet Gynecol. 2024;143(2):184-188. doi:10.1097/AOG.0000000000005455  Cahill EP, Kaur S. Advances in contraception research and development. Curr Opin Obstet Gynecol. 2020;32(6):393-398. doi:10.1097/GCO.0000000000000666  Charles DN, Nagarsheth M, Oshman L. Pain Management for IUD Insertion in Primary Care. Am Fam Physician. 2025;111(4):299-301.  Chen, C., Strasser, J., Banawa, R., Luo, Q., Bodas, M., Castruccio-Prince, C., Das, K., & Pittman, P. (2022). Who is providing contraception care in the United States? An observational study of the contraception workforce. American journal of obstetrics and gynecology, 226(2), 232.e1–232.e11. https://doi.org/10.1016/j.ajog.2021.08.015  Diedrich,J., Klein, D. Peipert, J.(2017). Long-acting reversible contraception in adolescents: a systematic review and meta-analysis, Am J Ob Gyn, April 2017. http://dx.doi.org/10.1016/j.ajog.2016.12.024  Li RHW, Lo SST, Gemzell-Danielsson K, Fong CHY, Ho PC, Ng EHY. Oral emergency contraception with levonorgestrel plus piroxicam: a randomised double-blind placebo-controlled trial. Lancet. 2023;402(10405):851-858. doi:10.1016/S0140-6736(23)01240-0  Mørch LS, Meaidi A, Corn G, Hargreave M, Wessel Skovlund C. Breast Cancer in Users of Levonorgestrel-Releasing Intrauterine Systems. JAMA. 2024;332(18):1578–1580. doi:10.1001/jama.2024.18575  Nguyen AT, Curtis KM, Tepper NK, et al. U.S. Medical Eligibility Criteria for Contraceptive Use, 2024. MMWR Recomm Rep. 2024;73(4):1-126. Published 2024 Aug 8. doi:10.15585/mmwr.rr7304a1  Paradise SL, Landis CA, Klein DA. Evidence Based Contraception: Common Questions and Answers. American Family Physician. 2022. https://www.aafp.org/afp/2022/0900/contraception The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Send us Fan MailMost trials comparing CPAP and NIMV leave a lingering doubt about whether surfactant explained the difference. This one does not. Ben brings a multicenter noninferiority trial from JAMA Network Open in infants born between 24 and 29 weeks, randomized to nasal CPAP or NIMV with every baby receiving less invasive surfactant administration. The trial stopped early for futility after 312 infants. Noninvasive ventilation failure within 72 hours was 26 percent on CPAP versus 13 percent on NIMV. Ben and Daphna talk through what happens when surfactant is off the table, the unexpected NEC signal, and where the guidelines may need revisiting.----Nasal Continuous Positive Airway Pressure vs Nasal Intermittent Positive Pressure Ventilation in Preterm Infants With Respiratory Distress Syndrome: A Randomized Clinical Trial. Zhang H, Zhang Y, Zeng L, Tong X, Piao M, He H, Zhao C, Xie H, Zheng Z, Cui Q, Lai Y, Wang H, Wang L, Liu H, Tian X, Wu H, Kang L, Han T.JAMA Netw Open. 2026 Jun 1;9(6):e2619785. doi: 10.1001/jamanetworkopen.2026.19785.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

Credits: 0.75 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-500 Overview: To celebrate our 500th episode, each member of our team revisits a popular topic from the podcast's earlier installments—GLP-1s, cervical and breast cancer screening, diet and exercise, contraception, hypertension, and lipid management—to trace how the evidence and guidelines have changed since it was first covered. Whether you're catching up or reinforcing what you know, this milestone episode helps you bring the latest evidence into everyday patient care. Guest: Robert Baldor, MD, Alan Ehrlich, MD, Susan Feeney, DNP, FNP-BC; FAANP, Jillian Joseph, PA, Mariyan L. Montaque, DNP, FNP-BC, Jill Terrien PhD, ANP-BC, FAAN   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  Episode resource links:  Zhou H et al.  Evaluation and Comparison of the PREVENT and Pooled Cohort Equations for 10‐Year Atherosclerotic Cardiovascular Risk Prediction. Journal of the American Heart Association Volume 14, Number 4 Goff DC et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. Circulation. 2014;129:S49–S73. Circulation. 2018 Jul 24;138(4):345-355.  eClinicalMedicine 2025: 103741. Curry, J. (2018). Screening for cervical cancer: US Preventive Services Task Force Recommendation Statement. JAMA.320(7):674-686. doi:10.1001/jama.2018.10897 https://www.ncbi.nlm.nih.gov/pubmed/30140884  Perkins RB, Wolf AMD, Church TR, et al. Self-collected vaginal specimens for human papillomavirus testing and guidance on screening exit: An update to the American Cancer Society cervical cancer screening guideline. CA Cancer J Clin. 2026;e70041. doi:10.3322/caac.70041   Screening for Cervical Cancer (2026). Obstetrics & Gynecology, 148(1), e63-e67. https://doi.org/10.1097/AOG.0000000000006257  Jad Zeitouni, Nosayaba Osazuwa-Peters, Yusuf Dundar, Gregory Zimet, Mark A. Varvares. (2025). Two decades of the HPV vaccine: its promise, progress, prospects, projections, and posterity, The Lancet Regional Health - Americas, (51), https://doi.org/10.1016/j.lana.2025.101243 Diabetes, Obesity and Metabolism 28, no. 6 (2026): 5043–5057, https://doi.org/10.1111/dom.70698.  Relationship of early rapid weight loss to efficacy and safety of tirzepatide and semaglutide for obesity: SURMOUNT-5 post hoc analysis. Am J Med. 2026 Jul;139(7):913-921. doi: 10.1016/j.amjmed.2026.03.010 US Preventive Services Task Force; Nicholson WK, Silverstein M, Wong JB, et al. Screening for breast cancer: US Preventive Services Task Force recommendation statement. JAMA. 2024;331(22):1918–1930.  Trentham-Dietz A, Chapman CH, Jayasekera J, et al. Collaborative modeling to compare different breast cancer screening strategies: a decision analysis for the US Preventive Services Task Force. JAMA. 2024;331(22):1931–1946. Giaquinto AN, Sung H, Miller KD, et al. Breast cancer statistics, 2022. CA Cancer J Clin. 2022;72(6):524–541.  Qaseem A, Harrod CS, Balk EM, et al. Screening for breast cancer in asymptomatic, average-risk adult females: a guidance statement from the American College of Physicians (Version 2). Ann Intern Med. 2026.:  American Cancer Society. Breast Cancer Facts & Figures 2022–2024. Atlanta, GA: American Cancer Society, 2022.  Hu X, Chehal PK, Kaplan C, et al. Racial differences in patient-reported symptoms and adherence to adjuvant endocrine therapy among women with early-stage, hormone receptor-positive breast cancer. JAMA Netw Open. 2022;5(8):e2225485.  Torres JM, Sodipo MO, Hopkins MF, Chandler PD, Warner ET. Racial differences in breast cancer survival between Black and White women according to tumor subtype: a systematic review and meta-analysis. J Clin Oncol. 2024;42(35):4225–4234.  Bailey ZD, Krieger N, Agénor M, Graves J, Linos N, Bassett MT. Structural racism and health inequities in the USA: evidence and interventions. Lancet. 2017;389(10077):1453–1463. Hypertension. 2026;83:00–00. DOI: 10.1161/HYPERTENSIONAHA.125.25787 Allen RH, Bartz D. Opill: The Over-the-Counter Contraceptive Pill. Obstet Gynecol. 2024;143(2):184-188. doi:10.1097/AOG.0000000000005455  Cahill EP, Kaur S. Advances in contraception research and development. Curr Opin Obstet Gynecol. 2020;32(6):393-398. doi:10.1097/GCO.0000000000000666  Charles DN, Nagarsheth M, Oshman L. Pain Management for IUD Insertion in Primary Care. Am Fam Physician. 2025;111(4):299-301.  Chen, C., Strasser, J., Banawa, R., Luo, Q., Bodas, M., Castruccio-Prince, C., Das, K., & Pittman, P. (2022). Who is providing contraception care in the United States? An observational study of the contraception workforce. American journal of obstetrics and gynecology, 226(2), 232.e1–232.e11. https://doi.org/10.1016/j.ajog.2021.08.015  Diedrich,J., Klein, D. Peipert, J.(2017). Long-acting reversible contraception in adolescents: a systematic review and meta-analysis, Am J Ob Gyn, April 2017. http://dx.doi.org/10.1016/j.ajog.2016.12.024  Li RHW, Lo SST, Gemzell-Danielsson K, Fong CHY, Ho PC, Ng EHY. Oral emergency contraception with levonorgestrel plus piroxicam: a randomised double-blind placebo-controlled trial. Lancet. 2023;402(10405):851-858. doi:10.1016/S0140-6736(23)01240-0  Mørch LS, Meaidi A, Corn G, Hargreave M, Wessel Skovlund C. Breast Cancer in Users of Levonorgestrel-Releasing Intrauterine Systems. JAMA. 2024;332(18):1578–1580. doi:10.1001/jama.2024.18575  Nguyen AT, Curtis KM, Tepper NK, et al. U.S. Medical Eligibility Criteria for Contraceptive Use, 2024. MMWR Recomm Rep. 2024;73(4):1-126. Published 2024 Aug 8. doi:10.15585/mmwr.rr7304a1  Paradise SL, Landis CA, Klein DA. Evidence Based Contraception: Common Questions and Answers. American Family Physician. 2022. https://www.aafp.org/afp/2022/0900/contraception The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Dr. Kurt Olding shares with us the latest published recommendations for conservative treatment for spinal stenosis. Dr. Kurt Olding has been in practice for over 40 years, opening Minster Chiropractic Center in 1986 after graduating from National College of Chiropractic in Lombard, IL in 1984. Through the years Dr. Kurt has enjoyed treating all age groups, from infants to athletes and parents to grandparents. He took special interest in sports medicine during his early years in practice, completing 300 hours of continuing education through the Certified Chiropractic Sports Physician program. Dr. Kurt earned Cox® Technic certification in 2009. In 2012 he began co-instructing the technique, and since 2015 has been a full-time instructor alongside Dr. James Cox, Dr. Ralph Kruse, and Dr. George Joachim. Through his work with Cox® Technic, Dr. Kurt has had several exciting opportunities. In March of 2016, he taught Cox® Technic in Bern, Switzerland as part of the Swiss Chiropractic Academy's "technique series" program. Later that month, he presented research on Cox® Technic with his mentor Dr. James Cox at the annual Association of Chiropractic Colleges Research Agenda Conference. Dr. Kurt co-authored a paper published in the June 2016 edition of the Journal of Chiropractic Medicine titled Chiropractic Distraction Spinal Manipulation on Post-surgical Continued Low Back and Radicular Pain patients: A Retrospective Case Series. In 2015, Dr. Kurt became board certified as a Chiropractic Orthopedist, and a Fellow of the Academy of Chiropractic Orthopedists (FACO). He is also a board member of the Academy of Chiropractic Orthopedists, serving since early 2016. Dr. Kurt and his wife Jackie are Minster natives. They have three children: Sunni, Kregg, and Jack. Sunni and her husband Tyler joined the practice in 2014. Resources: Minster Chiropractic Center kurt.olding@gmail.com Find a Back Doctor thebackdoctorspodcast.com The Cox 8 Table by Haven Medical References: Young I, Dunning J, Butts R, Bliton P, Zacharko N, Garcia J, Mourad F, Charlebois C, Gorby P, Fernández-de-Las-Peñas C. Spinal manipulation and electrical dry needling as an adjunct to conventional physical therapy in patients with lumbar spinal stenosis: a multi-center randomized clinical trial. Spine J. 2024 Apr;24(4):590-600. doi: 10.1016/j.spinee.2023.12.002. Epub 2023 Dec 14. PMID: 38103739. Ammendolia C, Hofkirchner C, Plener J, Bussières A, Schneider MJ, Young JJ, Furlan AD, Stuber K, Ahmed A, Cancelliere C, Adeboyejo A, Ornelas J. Non-operative treatment for lumbar spinal stenosis with neurogenic claudication: an updated systematic review. BMJ Open. 2022 Jan 19;12(1):e057724. doi: 10.1136/bmjopen-2021-057724. PMID: 35046008; PMCID: PMC8772406.   Schneider MJ, Ammendolia C, Murphy DR, Glick RM, Hile E, Tudorascu DL, Morton SC, Smith C, Patterson CG, Piva SR. Comparative Clinical Effectiveness of Nonsurgical Treatment Methods in Patients With Lumbar Spinal Stenosis: A Randomized Clinical Trial. JAMA Netw Open. 2019 Jan 4;2(1):e186828. doi: 10.1001/jamanetworkopen.2018.6828. PMID: 30646197; PMCID: PMC6324321.   Bussières A, Cancelliere C, Ammendolia C, Comer CM, Zoubi FA, Châtillon CE, Chernish G, Cox JM, Gliedt JA, Haskett D, Jensen RK, Marchand AA, Tomkins-Lane C, O'Shaughnessy J, Passmore S, Schneider MJ, Shipka P, Stewart G, Stuber K, Yee A, Ornelas J. Non-Surgical Interventions for Lumbar Spinal Stenosis Leading To Neurogenic Claudication: A Clinical Practice Guideline. J Pain. 2021 Sep;22(9):1015-1039. doi: 10.1016/j.jpain.2021.03.147. Epub 2021 Apr 12. PMID: 33857615.   Comer C, Williamson E, McIlroy S, Srikesavan C, Dalton S, Melendez-Torres GJ, Lamb SE. Exercise treatments for lumbar spinal stenosis: A systematic review and intervention component analysis of randomised controlled trials. Clin Rehabil. 2024 Mar;38(3):361-374. doi: 10.1177/02692155231201048. Epub 2023 Sep 16. PMID: 37715644; PMCID: PMC10829420.   Bise CG, Schneider M, Freburger J, Fitzgerald GK, Switzer G, Smyda G, Peele P, Delitto A. First Provider Seen for an Acute Episode of Low Back Pain Influences Subsequent Health Care Utilization. Phys Ther. 2023 Sep 1;103(9):pzad067. doi: 10.1093/ptj/pzad067. PMID: 37379349.   Hernandez-Martínez J, Cid-Calfucura I, Vásquez-Carrasco E, Perez-Carcamo J, Herrera-Valenzuela T, Aravena-Sagardia P, Barramuño-Medina M, Valdés-Badilla P. Timed Up-and-Go as a predictor of fracture risk: a systematic review and meta-analysis in a population of over 1.6 million people. Front Public Health. 2026 May 11;14:1841017. doi: 10.3389/fpubh.2026.1841017. PMID: 42200137; PMCID: PMC13199231.   Henn MC, Rae A, Fecker AL, McIntyre M, Larsen A, Wright J. A Nationwide Survey of the Spine Education of Medical Students. Cureus. 2026 Apr 4;18(4):e106443. doi: 10.7759/cureus.106443. PMID: 42093772; PMCID: PMC13139429.   James G, Ahern B, Goodwin W, Goss B, Hodges P. ISSLS Prize in Basic Science 2025: Structural changes of muscle spindles in the multifidus muscle after intervertebral disk injury are resolved by targeted activation of the muscle. Eur Spine J. 2025 May;34(5):1600-1613. doi: 10.1007/s00586-025-08646-x. Epub 2025 Jan 15. Erratum in: Eur Spine J. 2025 May;34(5):2046. doi: 10.1007/s00586-025-08744-w. PMID: 39810036.   Gong G, Yan Z, Lai Q, You P, Yu P, Li X, Wang Z, Lin S, Dai Y, Jiang H, Liu J. Inflammation preservation strategy: reconciling pain control and disc resorption in lumbar disc herniation. Front Immunol. 2025 Sep 2;16:1653681. doi: 10.3389/fimmu.2025.1653681. PMID: 40963597; PMCID: PMC12436131.

In the second edition of 'Quarterly catch-up', CMI Communications editors Emily McDonald and Erin McCreary round-up the biggest news in infectious diseases and review clinical microbiology and infectious diseases studies published in the second quarter of 2026 [1-4]. From Pneumocystis jirovecii pneumonia in solid-organ-transplant recipients to a double-blind randomised controlled trial reporting a new antibiotic for complicated urinary tract infections, Erin and Emily highlight four articles they found particularly noteworthy, and comment on whether the results can and should change clinical practice.  ReferencesAlanio A, et al. Pneumocystis jirovecii pneumonia in solid organ transplant recipients: a prospective observational cohort study, J Infect 2026. DOI: 10.1016/j.jinf.2026.106794Ramendra R, et al. Procalcitonin to guide 7 versus 14 days of antibiotics in bloodstream infections: a secondary analysis of the BALANCE trial, JAMA Netw Open 2026. DOI: 10.1001/jamanetworkopen.2026.20973Pai MP, et al. Challenging weight-tiered antibiotic prophylaxis in obese patients undergoing colorectal surgery using CT-derived body composition, CID 2026. DOI: 10.1093/cid/ciag383 Takahashi S, et al. Efficacy and safety of cefepime–nacubactam and aztreonam–nacubactam compared with imipenem–cilastatin for complicated urinary tract infection or acute uncomplicated pyelonephritis (Integral-1): a double-blind, randomised phase 3 trial. Lancet 2026. DOI: 10.1016/S0140-6736(26)00596-9 Further readingThe SNAP Trial Group. Cefazolin for Methicillin-Susceptible Staphylococcus aureus Bacteremia. NEJM 2026. DOI: 10.1056/NEJMoa2506905The SNAP Trial Group. Benzylpenicillin versus flucloxacillin or cloxacillin for the treatment of penicillin-susceptible Staphylococcus aureus bacteraemia (SNAP): an international, multicentre, open-label, non-inferiority randomised controlled trial. Lancet 2026. DOI: 10.1016/S0140-6736(26)00761-0McCreary EK, et al. Communicable episode 26: SNAP out of it – rethinking anti-staphylococcal penicillins for S. aureus bacteremia, the SNAP trial PSSA/MSSA results. Communicable Podcast 2025. https://share.transistor.fm/s/2a3c3bb4  Ilges D, et al. Anticalcitonin: limited utility of a context-dependent biomarker demonstrated in another real-world data set, CID 2026. DOI: https://doi.org/10.1093/cid/ciag396 Spellberg B. Procalcitonin–An enigmatic anxiolytic biomarker, JAMA Netw Open 2026. DOI: 10.1001/jamanetworkopen.2026.20978 

Featuring perspectives from Dr Joshua K Sabari, including the following topics: Jänne PA et al. Final analysis results and patient-reported outcomes from DESTINY-Lung02 — A dose-blinded, randomized, phase 2 study of trastuzumab deruxtecan in patients with HER2-mutant metastatic NSCLC. J Thorac Oncol 2025;20(12):1814-28. (0:00) Heymach JV et al. Circulating tumor DNA (ctDNA) analysis following zongertinib treatment (tx) in patients (pts) with human epidermal growth factor receptor 2 (HER2)-mutant non-small cell lung cancer (NSCLC): Phase Ia/Ib Beamion LUNG-1 study. ESMO 2025;Abstract 2020P. (8:30) Schram AM et al. Beamion PANTUMOR-1: Rationale and design of a phase II trial of zongertinib in HER2-overexpressed/amplified or HER2-mutant solid tumors. Future Oncol 2026;22(7):795-803. (12:53) Johnson ML et al. Beamion LUNG-2: A phase III randomized controlled trial of zongertinib (BI 1810631) versus standard of care in patients with locally advanced/metastatic non-squamous NSCLC harboring HER2 tyrosine kinase domain (TKD) mutations. ASCO 2024;Abstract TPS8654. (19:40) Le X et al. SOHO-02: Phase III trial of BAY 2927088 in patients with locally advanced or metastatic NSCLC with HER2-activating mutations. ASCO 2025;Abstract TPS8648. (21:41) Li BT et al. Open-label, randomized, multicenter, phase 3 study evaluating trastuzumab deruxtecan (T-DXd) as first-line treatment in patients with unresectable, locally advanced, or metastatic non-small cell lung cancer (NSCLC) harboring HER2 exon 19 or 20 mutations (DESTINY-Lung04). ASCO 2022;Abstract TPS9137. (22:59) Jänne PA et al. Trastuzumab deruxtecan for ERBB2-mutant metastatic NSCLC with or without brain metastases: A secondary analysis of randomized clinical trials. JAMA Netw Open 2025;8(11):e2543107. (24:37) CME information and select publications

Join Jenn Dawson and Mitchell Hanson for some quick-hitting "research hot takes!"Topical Therapies Supporting Links and Articleshttps://nextstepsinderm.com/derm-topics/expanding-the-treatment-landscape-for-atopic-dermatitis-hidradenitis-suppurativa-and-chronic-hand-eczema/https://www.dermatologytimes.com/view/advancing-topical-stewardship-and-expanding-nonsteroidal-optionshttps://www.arcutis.com/arcutis-announces-publication-of-positive-long-term-safety-and-efficacy-data-with-zoryve-roflumilast-cream-0-05-for-treatment-of-mild-to-moderate-atopic-dermatitis-in-children-ages-2-5/Social Unrest Leads to Access Barriers Supporting Links and ArticlesC. L. Presley, J. Meisenheimer VII, C. W. Rundle, S. Maguiness, I. A. Maher, and A. J. M. Anderson, “Social Unrest and Its Implications on the Pediatric Dermatological Patient: Lessons From a Single Center Academic Dermatology Department,” Pediatric Dermatology (2026): 1–2, https://doi.org/10.1111/pde.70260.Mukerjee K, Shah S, Falusi O. State Policies and Access to Care for Immigrant Children—Implications for Pediatric Health Outcomes. JAMA Netw Open. 2025;8(12):e2545833. doi:10.1001/jamanetworkopen.2025.45833Skin of Color in Pediatric Dermatology Supporting Links and ArticlesDondi, A., Ranieri, A., Andreozzi, L., Leuzzi, M., D'Alanno, G., Pierantoni, L., Zama, D., Battelli, E., Calegari, R., Borghesi, A., Lanari, M., & Neri, I. (2026). Skin of Color in Pediatric Dermatology: A Cross-Sectional Retrospective Analysis Addressing Inclusive Diagnosis and Care. Life (Basel, Switzerland), 16(4), 578. https://doi.org/10.3390/life16040578Fagan E, Reagen C, Ituarte B, Shet P, Shaver-Dominguez N, Harter N, Wei EX, Oudenhoven M. Trends in Pediatric Representation Within Skin of Color Dermatology Literature: A Decade-Long Analysis. Pediatr Dermatol. 2026 Jan-Feb;43(1):95-97. doi: 10.1111/pde.16038. Epub 2025 Aug 13. PMID: 41611238.This episode is presented by Disc Medicine. Although Disc Medicine provided funding for this PeDRA Pearls Podcast, the contents of the podcast were developed independently by PeDRA. Learn more about Disc Medicine.

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-494 Overview: Primary care visits offer a valuable opportunity to identify and address excessive screen time—a health concern that can impact adults' physical and mental well-being. This episode brings you current data on adult screen use and its health consequences, helping you recognize and respond to a growing issue in patient populations. Episode resource links: Front Psychiatry. 2022 Dec 22:13:1058572. doi: 10.3389/fpsyt.2022.1058572. eCollection 2022 BMC Med. 2025 Feb 21;23(1):107. JAMA Netw Open. 2025 Mar 3;8(3):e252493. doi: 10.1001/jamanetworkopen.2025.2493 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

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-494 Overview: Primary care visits offer a valuable opportunity to identify and address excessive screen time—a health concern that can impact adults' physical and mental well-being. This episode brings you current data on adult screen use and its health consequences, helping you recognize and respond to a growing issue in patient populations. Episode resource links: Front Psychiatry. 2022 Dec 22:13:1058572. doi: 10.3389/fpsyt.2022.1058572. eCollection 2022 BMC Med. 2025 Feb 21;23(1):107. JAMA Netw Open. 2025 Mar 3;8(3):e252493. doi: 10.1001/jamanetworkopen.2025.2493 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Antenatal corticosteroids are a MAJOR win in the management of preterm labor. An initial course of antenatal corticosteroids has been shown to reduce morbidity and mortality in patients with preterm prelabor rupture of membranes. For patients who remain undelivered after the initial course of antenatal corticosteroids, it is uncertain whether a booster course of antenatal corticosteroids reduces neonatal morbidity or increases the infection risk. The ACOG, in its current guidance, has concluded that the current evidence is insufficient to make a recommendation. Corticosteroids, especially at the doses given, are also powerful immunosuppressants. When you administer that first course, you accept a minor, calculated risk for a massive, proven benefit. But when you introduce a second course of steroids into a uterine environment that has already been ruptured and exposed to vaginal flora for weeks, you are pouring fuel on the fire. PLUS, the environment for the fetus with prolonged preterm prelabor rupture of membranes is unique. PPPROM, the chronic exposure to ruptured membranes and the resultant oligohydramnios is theorized to trigger a kind of stress response in the fetus- so the baby may make their own endogenous corticosteroid flare. So, rescue steroids after an initial course of steroids in PPROM cases has remained controversial but we have updated data that has provided new insights. In this episode, we will highlight an RCT from 2023 and a more recent systematic review and meta-analysis from May 2026 on this very subject. Listen in for details. 1. Garite TJ, Kurtzman J, Maurel K, Clark R; Obstetrix Collaborative Research Network. Impact of a 'rescue course' of antenatal corticosteroids: a multicenter randomized placebo-controlled trial. Am J Obstet Gynecol. 2009 Mar;200(3):248.e1-9. doi: 10.1016/j.ajog.2009.01.021. Erratum in: Am J Obstet Gynecol. 2009 Oct;201(4):428. PMID: 19254583.2. Tenbrink E, Quain A, Rone V, Harris K, Hadley E, Haas D, Shanks A. Risk of Neonatal Sepsis With Rescue Steroids in Preterm Premature Rupture of Membranes. Cureus. 2023 Apr 6;15(4):e37207. doi: 10.7759/cureus.37207. PMID: 37159785; PMCID: PMC10163895.3. Melamed N, Murphy KE, Pylypjuk C, et al. Timingof Antenatal Corticosteroid Administration and Neonatal Outcomes. JAMA Netw Open. 2025;8(5):e2511315. 4. Porreco R, Garite TJ, Combs CA, Maurel K, Huls CK, Baker S, Fortner KB, Longo SA, Nageotte M, Lewis D, Tran L; Obstetrix Collaborative Research Network. Booster course of antenatal corticosteroids after preterm prelabor rupture of membranes: a double-blind randomized trial. Am J Obstet Gynecol MFM. 2023 May;5(5):100896. doi: 10.1016/j.ajogmf.2023.100896. Epub 2023 Feb 14. PMID: 36796641.5. Da Costa Y, Ramanathan V, Oliveira JA, Brito J, Yousif A. Repeat versus Single Course of Antenatal Corticosteroid in Management of Preterm Premature Rupture of Membranes: A Systematic Review and Meta-analysis. Am J Perinatol. 2026 May;43(7):925-932. doi: 10.1055/a-2708-5314. Epub 2025 Oct 9. PMID: 41067234

Did you know that the average age of puberty onset in girls has been declining for decades, and that early puberty can have lasting psychological, social, and physical consequences? Roshni Patel, a fourth-year medical student at the Medical College of Georgia, and Bianca Forte, WHNP, a Women's Health Nurse Practitioner with a specialty in Pediatric and Adolescent Gynecology at Wellstar MCG Health, to discuss the recognition, evaluation, and management of precocious puberty in girls. Specifically, they will: Review the normal pubertal timeline and define precocious puberty in females Distinguish between premature thelarche, premature adrenarche, and precocious puberty through history and physical exam findings Discuss the initial diagnostic workup, including bone age studies, hormone levels, and the GnRH stimulation test Differentiate central precocious puberty from peripheral precocious puberty and outline appropriate management for each Address the mental health impact of early puberty and how to support young patients during the clinical encounter Identify when to refer patients to Pediatric Endocrinology or Pediatric and Adolescent Gynecology Special thanks to Dr. Rebecca Yang and Dr. Sarah Straka for peer reviewing this episode Free CME Available: Link Coming Soon! References: Aghaee S, Deardorff J, Quesenberry CP, Greenspan LC, Kushi LH, Kubo A. Associations Between Childhood Obesity and Pubertal Timing Stratified by Sex and Race/Ethnicity. Am J Epidemiol. 2022;191(12):2026-2036. doi:10.1093/aje/kwac148 Berberoğlu M. Precocious puberty and normal variant puberty: definition, etiology, diagnosis and current management. J Clin Res Pediatr Endocrinol. 2009;1(4):164-174. doi:10.4274/jcrpe.v1i4.3 Carel JC, Léger J. Clinical practice. Precocious puberty. N Engl J Med. 2008;358(22):2366-2377. doi:10.1056/NEJMcp0800459 Dinkelbach L, Grasemann C, Kiewert C, Leikeim L, Schmidt B, Hirtz R. Central Precocious Puberty and Psychiatric Disorders. JAMA Netw Open. 2025;8(6):e2516679. Published 2025 Jun 2. doi:10.1001/jamanetworkopen.2025.16679 Eckert-Lind C, Busch AS, Petersen JH, et al. Worldwide Secular Trends in Age at Pubertal Onset Assessed by Breast Development Among Girls: A Systematic Review and Meta-analysis. JAMA Pediatr. 2020;174(4):e195881. doi:10.1001/jamapediatrics.2019.5881 Hampl SE, Hassink SG, Skinner AC, et al. Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity. Pediatrics. 2023;151(2):e2022060640. doi:10.1542/peds.2022-060640 Joinson C, Heron J, Lewis G, Croudace T, Araya R. Timing of menarche and depressive symptoms in adolescent girls from a UK cohort. Br J Psychiatry. 2011;198(1):17-2. doi:10.1192/bp.110.080861 Kaplowitz PB. For Premature Thelarche and Premature Adrenarche, the Case for Waiting before Testing. Horm Res Paediatr. 2020;93(9-10):573-576. doi:10.1159/000512764 Klein DA, Emerick JE, Sylvester JE, Vogt KS. Disorders of Puberty: An Approach to Diagnosis and Management. Am Fam Physician. 2017;96(9):590-599. Kota AS, Sharma L, Ejaz S. Precocious Puberty. [Updated 2023 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK544313/

Join us as we discuss research on mental health and wellbeing in the surgical workforce with Drs. Yang and Collins. The episode explores key findings from recent national surveys showing that nearly one in seven surgeons report suicidal ideation in the past year, with depression, anxiety, and PTSD affecting 15–20% of the surgical population. The conversation highlights protective factors—professional fulfillment, resilience, self-valuation, and connection—while distinguishing between healthy resilience and normalized suffering. Dr. Yang and Dr. Collins discuss systemic barriers including time constraints, out-of-pocket mental health costs, and persistent stigma, alongside actionable institutional interventions: protecting dedicated wellbeing time, establishing peer support and psychological first aid programs, ensuring free mental health access, and expanding research to understand what helps surgeons thrive. The episode emphasizes that self-care is essential to patient safety and invites listeners to become advocates, engage with the literature, and help drive culture change within their institutions. For more information about the AAS wellbeing survey, please email Dr. Yang at CJYANG@MGH.HARVARD.EDU.Host:   Steven Thornton, MD (General Surgery Resident at Duke University) Agnes Premkumar (General Surgery Resident at Creighton) Guests: Jeff Yang, MD (Massachusetts General Hospital) Reagan Collins, MD (University of Pennsylvania) Publications Discussed: Hughes TM, Collins RA, Cunningham CE. Depression and Suicide Among American Surgeons-A Grave Threat to the Surgeon Workforce. JAMA Surg. 2024 Jan 1;159(1):7-8. doi: 10.1001/jamasurg.2023.4658. PMID: 37792380. [https://pubmed.ncbi.nlm.nih.gov/37792380/] Collins RA, Herman T, Snyder RA, Haines KL, Stey A, Arora TK, Geevarghese SK, Phillips JD, Vicente D, Griggs CL, McElroy IE, Wall AE, Hughes TM, Sen S, Valinejad J, Alban A, Swan JS, Mercaldo N, Jalali MS, Chhatwal J, Gazelle GS, Rangel E, Yang CJ, Donelan K, Gold JA, West CP, Cunningham C. Unspoken Truths: Mental Health Among Academic Surgeons. Ann Surg. 2024 Mar 1;279(3):429-436. doi: 10.1097/SLA.0000000000006159. Epub 2023 Nov 23. PMID: 37991182. [https://pubmed.ncbi.nlm.nih.gov/37991182/]  Yaghmour NA, Bynum WE 4th, Hafferty FW, Könings KD, Richter T, Brigham TP, Nasca TJ. Causes of Death Among US Medical Residents. JAMA Netw Open. 2025 May 1;8(5):e259238. doi: 10.1001/jamanetworkopen.2025.9238. Erratum in: JAMA Netw Open. 2025 Jul 1;8(7):e2523489. doi: 10.1001/jamanetworkopen.2025.23489. PMID: 40366660; PMCID: PMC12079293. [https://pubmed.ncbi.nlm.nih.gov/40366660/] Nasca BJ, Hunt ML, Ramirez RT, Eng JS, Li RD, Agarwal G, Bilimoria KY, Hu YY. One is too many: suicidality among general surgery residents. Acad Med. 2025 Dec 24:wvaf105. doi: 10.1093/acamed/wvaf105. Epub ahead of print. PMID: 41819820. [https://pubmed.ncbi.nlm.nih.gov/41819820/] 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/listenBehind the Knife Premium: https://behindtheknife.org/premiumOral Board Review: https://behindtheknife.org/oral-boardOral Board Simulator: https://behindtheknife.org/oral-board/simulatorGeneral Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate 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-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Send us Fan MailIn this Journal Club, Ben and Daphna dig into two new papers on PDA management in our smallest patients. First, the SMART-PDA pilot RCT from Souvik Mitra and colleagues, which uses comprehensive hemodynamic screening to selectively treat high-volume shunts in infants born before 26 weeks, and whose striking Bayesian signal for reduced pulmonary hemorrhage and NEC stopped the trial early. Then a companion JAMA Network Open comparative effectiveness study across four pharmacotherapy regimens. Along the way, Ben shares hemodynamics pearls from his Montreal training: why left ventricular output, LA:Ao ratio, and transductal velocity matter more than PDA diameter alone.----Selective early medical treatment of the patent ductus arteriosus in extremely low gestational age infants: a pilot randomised controlled trial (SMART-PDA). Mitra S, Hebert A, Castaldo MP, Disher T, El-Naggar W, Dhillon S, Alhassen Z, Koo J, Katheria AC, Hyderi A, Kumaran K, Ting J, Surak A, Larocque J, Pepper D, Hornberger L, Makoni M, Weisz DE, Jain A, Bacchini F, Cameron-Nola AJJ, Hatfield T, Dorling J, McNamara PJ, Thabane L.Arch Dis Child Fetal Neonatal Ed. 2026 May 18:fetalneonatal-2026-330462. doi: 10.1136/archdischild-2026-330462. Online ahead of print.PMID: 42150872Pharmacologic Therapies for Patent Ductus Arteriosus in Extremely Preterm Infants. Mitra S, Jain A, Ting JY, Ben Fadel N, Drolet C, Abou Mehrem A, Soraisham AS, Jasani B, Louis D, Lapointe A, Dorling J, Khurshid F, Hyderi A, Kumaran K, Toye J, Harabor A, Weisz DE, Stavel M, Morin A, Bhattacharya S, Lalitha R, Afifi J, Augustine S, Castaldo MP, Hatfield T, Su YC, Shah PS; Canadian Neonatal Network Investigators.JAMA Netw Open. 2026 Jun 1;9(6):e2617477. doi: 10.1001/jamanetworkopen.2026.17477.PMID: 42262753 Free PMC article.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

Series Description Disclosure is a three-part podcast series from the Docs with Disabilities Podcast that examines one of the most personal and consequential decisions disabled healthcare providers make: whether, when, and how to disclose a disability. Through the voices of medical students, residents, practicing physicians, psychologists, nurses, researchers, legal scholars, and disability advocates, the series explores disclosure as an ongoing process shaped by identity, institutional culture, ableism, and power. Blending lived experience with research and policy, the series challenges assumptions about disability in healthcare while illuminating pathways toward more inclusive learning, training, and practice environments. Part 2: Medical Culture, Stigma, and What Prevents Disclosure Why does disability disclosure feel so difficult—and for many, unsafe—in healthcare? In the second episode of the Disclosure series, we move beyond individual disclosure decisions to examine the culture of medicine itself. Through the perspectives of physicians, researchers, allied health professionals, disability scholars, and trainees, this episode explores how the hidden curriculum, stigma, institutional practices, and everyday interactions shape whether disabled healthcare professionals feel they belong. Contributors reflect on the burdens of seeking accommodations, the impact of ableist assumptions, the complexities of partial disclosure, and the ways colleagues, mentors, and institutional norms influence identity safety. Together, these stories reveal that disclosure is never simply an individual choice—it is a reflection of the culture in which it occurs and a catalyst for reimagining a more inclusive future for healthcare. Transcript: https://docs.google.com/document/d/103BYwMaTCBRYJB7IZU3UHfp6zMPIvBVF/edit?usp=share_link&ouid=104315301750264632478&rtpof=true&sd=true Keywords Disability disclosure Medical culture Hidden curriculum Ableism in medicine Disability stigma Psychological safety Identity safety Disability accommodations Physicians with disabilities Medical students with disabilities Healthcare workplace culture Health professions education Healthcare inclusion Disability justice Healthcare professionals Production Team Developer, Writer, Executive Producer: Sofia Schlozman Co-Producers: Rylee Betchkal and Lisa Meeks Co-Producer, Sound Selection and Editing: Gabe Abrams Sound Production: Next Day Podcast Digital Media: Katie Sullivan Citations Anderson, H. L. K., Konopasky, A. W., Bullock, J. L., Meeks, L. M., & Jain, N. R. (2025). The Call is Coming from Inside the House: Racism and Ableism in US Medical Education. Teaching and Learning in Medicine, 0(0), 1–19. https://doi.org/10.1080/10401334.2025.2581621 Evans, H. D. (2017). Un/covering: Making Disability Identity Legible. Disability Studies Quarterly, 37(1). https://doi.org/10.18061/dsq.v37i1.5556 Jain, N. R. (2020). Political disclosure: Resisting ableism in medical education. Disability & Society, 35(3), 389–412. https://doi.org/10.1080/09687599.2019.1647149 Graduation Questionnaire (GQ). (n.d.). AAMC. Retrieved July 6, 2026, from https://www.aamc.org/data-reports/students-residents/report/graduation-questionnaire-gq Stergiopoulos E, Fernando O, Martimianakis MA. "Being on Both Sides": Canadian Medical Students' Experiences With Disability, the Hidden Curriculum, and Professional Identity Construction Academic Medicine. 2018;93(10):1550-1559. doi:10.1097/ACM.0000000000002300. Pereira-Lima K, Meeks LM, Ross KET, et al. Barriers to Disclosure of Disability and Request for Accommodations Among First-Year Resident Physicians in the US. JAMA Netw Open.2023;6(5):e239981. doi:10.1001/jamanetworkopen.2023.9981  

Clinical work with clients at high risk for suicide can make providers feel they are on a conveyor belt. One reason for this is that, sadly, so many people are struggling with crises and safety concerns; the demand for services seems never-ending. But another reason is more insidious: the risk of provider burnout. On today's episode, Dr. Erin Frick shares her perspective from working as a clinician and educator in the field of suicide prevention. Listen in as she encourages us to remain hopeful and connected with the “humanness” behind the crises. And if you have thoughts about how to “redefine the ‘wins' “ in this work, share them with us.Erin Frick, Psy.D., is a clinical psychologist and an Associate Director at the Consortium for Defense Psychology (CDP), located at the Uniformed Services University of the Health Sciences.. At CDP, Dr. Frick leads the VA-Safeguard Suicide Prevention Project, where her team works to identify and implement best practices for suicide prevention among special veteran populations by leveraging evidence-based psychotherapies and VA standards of care. She also leads the DoD Child Collaboratory, a team dedicated to researching and implementing training and best practices for utilizing telehealth and digital tools to enhance healthcare and support for military youth and families.Resources mentioned in this episode: Therapeutic Risk Management Tool, available on the Rocky Mountain MIRECC website: https://www.mirecc.va.gov/visn19/trm/The benefits of mindfulness for stress reduction: Ameli R, Sinaii N, West CP, Luna MJ, Panahi S, Zoosman M, Rusch HL, Berger A. Effect of a Brief Mindfulness-Based Program on Stress in Health Care Professionals at a US Biomedical Research Hospital: A Randomized Clinical Trial. JAMA Netw Open. 2020 Aug 3;3(8):e2013424. doi: 10.1001/jamanetworkopen.2020.13424. PMID: 32840621; PMCID: PMC7448827. CDP's CBT for Suicide Prevention workshops: https://cdp.usuhs.edu/training-schedule Calls-to-action: For example: Attend CDP's CBT for Suicide Prevention (CBT-SP) trainingRegularly implement self-careShare your impactful moment in the comments or via https://www.speakpipe.com/cdpp4pSubscribe to the Practical for Your Practice PodcastSubscribe to The Center for Deployment Psychology Monthly Email

Gonadal hormones have a complicated influence on appetite. Estradiol generally suppresses appetite, whereas progesterone opposes estradiol's action such that their combined presence represents a high-risk hormonal milieu for Binge Eating (BE). Testosterone is thought to be associated with increased BE in females but appears protective in males. In some reports, combination oral contraceptive (COC) use has been linked to greater BE-related appetitive processes (e.g., food intake). Now, we have 2 recent, back-to-back publications (June 2026 in JAMA Network Open, and July 2026 in Appetite) that have examined the relationship of hormonal contraception on binge eating behavior. These found seemingly opposing conclusions. Listen in for details. 1. Klump KL, Di Dio AM, Anaya C, et al. Combined Oral Contraceptive Use and Binge Eating. JAMA Netw Open. 2026;9(6):e2619047. doi:10.1001/jamanetworkopen.2026.190472. Katz JM, Yan R, Beltz AM, Gearhardt AN. Associations between reproductive hormonal milieus and binge eating: The roles of sex and hormonal contraceptive use. Appetite. 2026 Jul 1;222:108547. doi: 10.1016/j.appet.2026.108547. Epub 2026 Mar 20. PMID: 41866083.3. Bass L, Prostináková T, Silang KG, Griffiths-Gray A, McQuilliam S, Mahon E, Whitehead A, Johnson KO. Does it hold weight? The perceived effects of contraceptive use on weight status in females: A mixed-methods study. PLoS One. 2025 Dec 29;20(12):e0339323. doi: 10.1371/journal.pone.0339323. PMID: 41460817; PMCID: PMC12747328.

Series Description Disclosure is a three-part podcast series from the Docs with Disabilities Podcast that examines one of the most personal and consequential decisions disabled healthcare providers make: whether, when, and how to disclose a disability. Through the voices of medical students, residents, practicing physicians, psychologists, nurses, researchers, legal scholars, and disability advocates, the series explores disclosure as an ongoing process shaped by identity, institutional culture, ableism, and power. Blending lived experience with research and policy, the series challenges assumptions about disability in healthcare while illuminating pathways toward more inclusive learning, training, and practice environments. Part 1: The Decision to Disclose What does it really mean to disclose a disability in healthcare? In the first episode of the Disclosure series, healthcare providers across the continuum—from students and trainees to practicing clinicians—share the personal, professional, and institutional factors that shape disclosure decisions. Drawing on stories from medical students, residents, physicians, researchers, disability scholars, and legal experts, the episode explores disclosure as more than a pathway to accommodations—it can be an act of identity, advocacy, community-building, and resistance. At the same time, contributors examine the risks of stigma, discrimination, and institutional betrayal that continue to make disclosure a deeply complex and often uncertain decision. Transcript: https://docs.google.com/document/d/1IWxZcow_B9hSIGpvozadJ5pov4-Qmq97/edit?usp=share_link&ouid=104315301750264632478&rtpof=true&sd=true Keywords:  Disability disclosure Medical education Physicians with disabilities Medical students with disabilities Disability accommodations Ableism Disability inclusion Healthcare trainees Stigma Health professions education Production Team:  Developer, Writer, Executive Producer: Sofia Schozman  Co Producers: Rylee Betchkal and Lisa Meeks Co-Producer, Sound Selection and Editing: Gabe Abrams Sound Production: Next Day Podcast Digital Media: Katie Sullivan   Citations:  Anderson, H. L. K., Konopasky, A. W., Bullock, J. L., Meeks, L. M., & Jain, N. R. (2025). The Call is Coming from Inside the House: Racism and Ableism in US Medical Education. Teaching and Learning in Medicine, 0(0), 1–19. https://doi.org/10.1080/10401334.2025.2581621 Evans, H. D. (2017). Un/covering: Making Disability Identity Legible. Disability Studies Quarterly, 37(1). https://doi.org/10.18061/dsq.v37i1.5556 Jain, N. R. (2020). Political disclosure: Resisting ableism in medical education. Disability & Society, 35(3), 389–412. https://doi.org/10.1080/09687599.2019.1647149 Graduation Questionnaire (GQ). (n.d.). AAMC. Retrieved July 6, 2026, from https://www.aamc.org/data-reports/students-residents/report/graduation-questionnaire-gq Stergiopoulos E, Fernando O, Martimianakis MA. "Being on Both Sides": Canadian Medical Students' Experiences With Disability, the Hidden Curriculum, and Professional Identity Construction Academic Medicine. 2018;93(10):1550-1559. doi:10.1097/ACM.0000000000002300. Pereira-Lima K, Meeks LM, Ross KET, et al. Barriers to Disclosure of Disability and Request for Accommodations Among First-Year Resident Physicians in the US. JAMA Netw Open. 2023;6(5):e239981. doi:10.1001/jamanetworkopen.2023.9981  

Contributor: Travis Barlock, MD Educational Pearls:   First-pass success is critical to limit complications from apnea, hypoxia, and airway trauma.  Complication rate for patients intubated on the first pass is 14% Complication rates increase to 47% after two attempts, 64% after three, and 71% after the fourth attempt   How to improve likelihood of first-pass success: Use Video laryngoscopy (VL). VL increases chance of first-pass success to 85% from 71% Use a bougie, especially in patients with anatomically difficult or otherwise obstructed airways. The BEAM study cites a success rate in these patients of 96% with a bougie, compared to 82% without Use a Checklist mnemonic (SOAPME) Suction – On, ready, and within reach Oxygen – Patient is preoxygenated Adjuncts – Oral/nasal adjuncts and BVM ready Positioning - Patient positioned properly; consider obesity, using semi-Fowler/head-up positioning Medications – Rapid sequence intubation (RSI), sedation, vasopressor, and other medications prepared as necessary Equipment – Laryngoscope (blade), tube, bougie/stylet, syringe, scalpel/cric kit, others ready as necessary References Sakles, J.C., Chiu, S., Mosier, J., Walker, C. and Stolz, U. (2013), The Importance of First Pass Success When Performing Orotracheal Intubation in the Emergency Department. Acad Emerg Med, 20: 71-78. https://doi.org/10.1111/acem.12055 Prekker ME, Driver BE, Trent SA, et al. Video versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults. New England Journal of Medicine. 2023;389(5). doi:https://doi.org/10.1056/nejmoa2301601 Driver BE, Prekker ME, Klein LR, et al. Effect of Use of a Bougie vs Endotracheal Tube and Stylet on First-Attempt Intubation Success Among Patients With Difficult Airways Undergoing Emergency Intubation: A Randomized Clinical Trial. JAMA. 2018;319(21):2179–2189. doi:10.1001/jama.2018.6496 ‌Turner JS, Bucca AW, Propst SL, et al. Association of Checklist Use in Endotracheal Intubation With Clinically Important Outcomes: A Systematic Review and Meta-analysis. JAMA Netw Open. 2020;3(7):e209278. doi:10.1001/jamanetworkopen.2020.9278 Turner, Joseph S et al. "Feasibility of  upright patient positioning and intubation success rates At two academic EDs." The American journal of emergency medicine vol. 35,7 (2017): 986-992. doi:10.1016/j.ajem.2017.02.011   Summarized by Sam Pahl | Edited by Sam Pahl & Ahmed Abdel-Hafiz, NREMT-P   Donate: https://emergencymedicalminute.org/donate/   Join our mailing list: http://eepurl.com/c9ouHf  

Welche Nahrungsergänzung wirkt wirklich – und was ist nur teurer Urin?Am Ende dieser Folge hast Du den Überblick. Du weißt, welche 5 Supplements wissenschaftlich am besten dastehen, woran Du echte Qualität erkennst und wann Du Dir das Geld sparen kannst. Garantiert frei von Superlativen, dafür mit den Gedanken unseres medizinischen Beirats, des Sport- und Ernährungsmediziners Niels Schulz-Ruhtenberg.Du erfährst:warum dasselbe Supplement bei dem einen wie Magie wirkt und beim anderen nichts bringtwelche 5 sich lohnen (von Vitamin D bis Kreatin)was die neue COSMOS-Studie aus Harvard über Multivitamine zeigt (und warum Du sie trotzdem nüchtern einordnen solltest)wie Du sinnvolle Präparate von teurer Geldverbrennung unterscheidest

Send us Fan MailIn this Journal Club episode, Ben and Daphna review a nationwide Swedish cohort study examining the association between phototherapy duration and neonatal outcomes in very preterm infants (22 to 31 weeks). The study's primary outcome, late neonatal mortality on days 8 to 27, was not significantly associated with phototherapy duration. However, longer phototherapy exposure was associated with increased odds of severe neonatal morbidity, including IVH and BPD, in infants born at 26 to 31 weeks. The findings prompt an important conversation about the near-universal use of phototherapy in preterm neonates and whether current practice warrants reassessment.----Phototherapy, Morbidity, and Mortality in Very Preterm Newborns. Deschmann E, Håkansson S, Söderling J, Norman M.JAMA Netw Open. 2026 May 1;9(5):e2614107. doi: 10.1001/jamanetworkopen.2026.14107.PMID: 42166159 Free PMC article.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

Back in June 2024, we highlighted surprising data from JAMA Network Open regarding adolescent care in the ED. Because many adolescents use the ED as their primary care provider, it's a good opportunity for them to have contraception addressed regardless of why they presented. But that's not what was happening. That publication from two years ago showed significant gaps in addressing contraception in the ED to pregnancy vulnerable young women, mainly teens. We covered those results back then and said that that would be a wonderful QI project for any resident or medical students to work with their hospital ED to improve that. Well, now a similar publication, looking at a different target- STI empiric treatment among pregnant women in the ED, has been published with that same vibe. Yep, there are BIG discrepancies in what pregnant women are given- or in this case, NOT GIVEN, in the ED compared to their nonpregnant peers. This was published in mid-April 2026. Two big questions remain unanswered in this data. Listen in for details. 1. Gottlieb M, Moyer E, Slocum GW, et al. Sexually Transmitted Infection Treatment Rates Among Pregnant vs Nonpregnant Patients in Emergency Departments. JAMA Network Open. 2026. 2. Canter H, Reed J, Palmer C, et al. Contraception Use and Pregnancy Risk Among Adolescents in Pediatric Emergency Departments. JAMA Netw Open. 2024;7(6):e2418213. doi:10.1001/jamanetworkopen.2024.18213

Contributor: Aaron Lessen, MD Educational Pearls:  Back pain is a common presenting complaint in the emergency department. Challenges arise when tailoring care to elderly populations using standard medical therapy: Muscle relaxants carry the risk of CNS depression or anticholinergic effects such as urinary retention and confusion. Pain medications such as opiates have side effects including constipation, respiratory depression, and hypotension. NSAIDs carry a risk of GI bleeding and worsening kidney function with chronic use. A randomized clinical trial assessing the effects of acupuncture on low back pain took 800 adults aged 65 and older with chronic low back pain and placed them into one of three treatment arms: Usual medical care Standard acupuncture consisting of 8–15 treatment sessions over 12 weeks, plus usual medical care Standard acupuncture consisting of 8–15 treatment sessions over 12 weeks, plus 4-6 maintenance sessions during the next 12 weeks, plus usual medical care Using the Roland-Morris Disability Questionnaire (RMDQ) score, they assessed disability at 6 months and 12 months. The study found that those who had undergone treatment with acupuncture had significantly greater improvements in disability related to low back pain compared to the group that was only treated with usual medical care. Acupuncture is not used in the ER, but could represent a relatively safe adjunctive therapy for patients who are not responding to standard medical therapy alone.   References:  American College of Surgeons Committee on Trauma. Best practices guidelines: geriatric trauma management. American College of Surgeons; 2023. Accessed May 27, 2026. https://www.facs.org/media/ubyj2ubl/best-practices-guidelines-geriatric-trauma.pdf DeBar LL, Wellman RD, Justice M, et al. Acupuncture for chronic low back pain in older adults: a randomized clinical trial. JAMA Netw Open. 2025;8(9):e2531348. doi:10.1001/jamanetworkopen.2025.31348 Summarized by Ashley Lyons, OMS3 | Edited by Ashley Lyons & Ahmed Abdel-Hafiz, NREMT-P

Small hospitals bring unique stewardship challenges, but also unique opportunities. Dr. Tina Khadem and Dr. Ashley Cubillos join host Dr. Whitney Buckel to discuss the realities of antimicrobial stewardship in small and critical access hospitals. From navigating competing priorities and limited resources, to building strong provider relationships in close-knit communities, we have you covered! Join us as we unpack real-world strategies, challenge common perceptions, and highlight the practical pearls you can apply in your own setting. References: Implementation of Core Elements at Small and Critical Access Hospitals: https://www.cdc.gov/antibiotic-use/media/pdfs/core-elements-small-critical-508.pdf Stenehjem E, Hyun DY, Septimus E, Yu KC, Meyer M, Raj D, Srinivasan A. Antibiotic Stewardship in Small Hospitals: Barriers and Potential Solutions. Clin Infect Dis. 2017 Aug 15;65(4):691-696. Veillette JJ, May SS, Gabrellas AD, Gelman SS, Albritton J, Lyons MD, Stenehjem EA, Webb BJ, Dalto JD, Throneberry SK, Stanfield V, Grisel NA, Vento TJ. A Fully Integrated Infectious Diseases and Antimicrobial Stewardship Telehealth Service Improves Staphylococcus aureus Bacteremia Bundle Adherence and Outcomes in 16 Small Community Hospitals. Open Forum Infect Dis. 2022 Oct 14;9(11):ofac549. Cubillos AL, Fortier K, Hoang A. P-920. Impact of Positive Blood Culture Antimicrobial Stewardship on Staphylococcus aureus Bloodstream Infection Management across Critical Access, Small, and Medium Community Hospitals. Open Forum Infect Dis. 2026 Jan 11;13(Suppl 1):ofaf695.1126. Smith LM, Ahern JW. Establishing Antibiotic Stewardship Programs in Rural Hospitals to Decrease Fluoroquinolone Prescribing: The Vermont Experience. Infect Prev Pract. 2021 Jan 21;3(1):100121. Kassamali-Escobar Z, et al. Antimicrob Steward Healthc Epidemiol 2024. doi: 10.1017/ash.2024.458. Imlay H, Ciarkowski CE, Bryson-Cahn C, et al Infect Control Hosp Epidemiol 2025. 46: 150–155, doi: 10.1017/ice.2024.206 Ciarkowski CE, Imlay HN, Bryson-Cahn C, et al. Infect Control Hosp Epidemiol 2025. 46: 143–149, doi: 10.1017/ice.2024.171 Stenehjem E, et al. JAMA Netw Open. 2023;6(5):e2313011. doi:10.1001/jamanetworkopen.2023.13011 Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) or @breakpointspodcast_sidp (https://www.instagram.com/breakpointspodcast_sidp/)https://www.instagram.com/breakpointspodcast_sidp/?hl=en Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/ SIDP welcomes pharmacists and non-pharmacist members with an interest in infectious diseases, learn how to join here: https://sidp.org/Become-a-Member Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, Stitcher, Google Play, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/

Send us Fan MailBen kicks things off with a major career update before we dive into a critical study from JAMA Network Open. We explore the predictive value of the five minute Apgar score when combined with umbilical artery pH in very preterm infants. While the Apgar score was originally designed for term babies, this analysis of the EPICE cohort reveals its enduring utility even in the smallest patients. We discuss how these two measures interact, which one "wins" when they conflict, and why the clinician assessment remains a powerful predictor of mortality and severe morbidity in the NICU.----Apgar Score Plus Umbilical Artery pH and Adverse Neonatal Outcomes in Very Preterm Infants. Ehrhardt H, Behboodi S, Maier RF, Aubert AM, Ådén U, Staude B, Draper ES, Gudmundsdottir A, Siljehav V, Varendi H, Weber T, Zemlin M, Zeitlin J; EPICE/SHIPS Research Group.JAMA Netw Open. 2026 Feb 2;9(2):e2557913.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

In this episode of SoundPractice, host Mike Sacopulos speaks with two physician-researchers whose landmark study is sounding an early warning about the long-term consequences of state abortion restrictions on the U.S. physician workforce. Anisha Ganguly, MD, MPH, assistant professor of medicine at the University of North Carolina at Chapel Hill, and Anna Morenz, MD, MPH, assistant clinical professor of internal medicine at the University of Arizona, discuss their study published in JAMA Network Open in March 2026. Their study analyzed nearly 24.2 million residency applications submitted to more than 4,300 programs across all medical specialties between the 2018–2019 and 2022–2023 application cycles. Using an interrupted time-series causal methodology developed in collaboration with health economist Anirban Basu, PhD, MS, at the University of Washington, the team found that applications to programs in states enacting new abortion restrictions after Dobbs dropped significantly — among both male and female applicants. Among the conversation's most striking moments: Ganguly reveals that the decline among men applicants was larger than expected — and larger than they had originally hypothesized. She and Morenz discuss why this makes Dobbs an “all of us” problem, not just a women's issue, and what it signals about the broader reproductive climate of restricted states. The episode also covers the pipeline problem: because more than half of physicians ultimately practice in the state where they trained, sustained declines in application volume could worsen existing physician shortages in primary care and emergency medicine in restricted states for years to come. Morenz shares a timely update: in the most recent March 2026 match cycle, two OB-GYN residency programs — both in Texas — failed to fill all their slots. Study Reference: Ganguly AP, Basu A, Morenz AM. State-Level Disparities in Residency Applications After Dobbs v Jackson Women's Health Organization. JAMA Netw Open. 2026;9(3):e260286. doi:10.1001/jamanetworkopen.2026.0286 Learn more about the American Association for Physician Leadership at www.physicianleaders.org.

In this episode of SoundPractice, host Mike Sacopulos speaks with two physician-researchers whose landmark study is sounding an early warning about the long-term consequences of state abortion restrictions on the U.S. physician workforce. Anisha Ganguly, MD, MPH, assistant professor of medicine at the University of North Carolina at Chapel Hill, and Anna Morenz, MD, MPH, assistant clinical professor of internal medicine at the University of Arizona, discuss their study published in JAMA Network Open in March 2026. Their study analyzed nearly 24.2 million residency applications submitted to more than 4,300 programs across all medical specialties between the 2018–2019 and 2022–2023 application cycles. Using an interrupted time-series causal methodology developed in collaboration with health economist Anirban Basu, PhD, MS, at the University of Washington, the team found that applications to programs in states enacting new abortion restrictions after Dobbs dropped significantly — among both male and female applicants. Among the conversation's most striking moments: Ganguly reveals that the decline among men applicants was larger than expected — and larger than they had originally hypothesized. She and Morenz discuss why this makes Dobbs an “all of us” problem, not just a women's issue, and what it signals about the broader reproductive climate of restricted states. The episode also covers the pipeline problem: because more than half of physicians ultimately practice in the state where they trained, sustained declines in application volume could worsen existing physician shortages in primary care and emergency medicine in restricted states for years to come. Morenz shares a timely update: in the most recent March 2026 match cycle, two OB-GYN residency programs — both in Texas — failed to fill all their slots. Study Reference: Ganguly AP, Basu A, Morenz AM. State-Level Disparities in Residency Applications After Dobbs v Jackson Women's Health Organization. JAMA Netw Open. 2026;9(3):e260286. doi:10.1001/jamanetworkopen.2026.0286 Learn more about the American Association for Physician Leadership. https://doi.org/10.55834/sp.3119622965

Send us Fan MailIn this episode of Journal Club, Ben and Daphna dive into the results of the NIRTURE trial, recently published in JAMA Network Open. Building on the lessons of SafeBoosC 3 , the NIRTURE investigators aimed to reduce the burden of cerebral hypoxia and hyperoxia in extremely preterm infants using a standardized NIRS guided treatment protocol. While the study showed a dramatic improvement in maintaining cerebral normoxia, driven largely by a reduction in hyperoxia , the clinical outcomes before discharge remained neutral. Join us as we discuss whether regional oximetry is a must have bedside tool or just another data point in search of a clear clinical benefit.  ----Cerebral Oximetry-Guided Treatment and Cerebral Oxygenation in Extremely Preterm Infants: A Randomized Clinical Trial. Jani PR, Goyen TA, Balegar KK, Maheshwari R, Saito-Benz M, Schindler T, Moore J, Merhi M, Cruz M, Song Y, McDonagh H, Luig M, Tracy M, D'Cruz D, Perdomo A, Morakeas S, Dasireddy V, Culcer M, Shingde V, Bennington K, Michalowski J, Fucek A, Querim J, Stevens S, Santanelli J, Elhindi J, Gloss B, Halliday R, Shah D, Popat H.JAMA Netw Open. 2026 Feb 2;9(2):e2557620. Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

Send us Fan MailIn this Journal Club episode, Ben reviews a secondary analysis of the CALI trial, published in JAMA Network Open, examining two-year neurodevelopmental and pulmonary outcomes in preterm infants who received early caffeine combined with LISA versus caffeine and CPAP alone. Building on the original CALI trial's finding that early caffeine prior to LISA reduced intubation rates and BPD, this follow-up asks the next logical question: does that early advantage translate into better long-term outcomes? Ben walks through the Bayley scores, gross motor function, ASQ-3, M-CHAT, and pulmonary outcomes — and delivers a reassuring if not statistically significant picture. Tune in for a deep dive into the evidence behind one of neonatology's most debated respiratory strategies!----Two-Year Outcomes of Less Invasive Surfactant Administration Among Preterm Neonates: A Secondary Analysis of a Randomized Clinical Trial. Dorner RA, Morales A, Banerji A, Uy C, Ines F, Finer N, Vaucher Y, Katheria AC.JAMA Netw Open. 2026 Mar 2;9(3):e263852. doi: 10.1001/jamanetworkopen.2026.3852.PMID: 41915392Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

Parents and clinicians are often faced with an important question: is anesthesia safe for young children? In this episode, medical student Kaavya Gudapati is joined by Dr. Maria Valeria Carrasquero and Dr. Ana Mavarez to review the current evidence on anesthesia exposure and the developing brain, and to provide practical guidance for clinical decision-making and family counseling. Specifically, they will: Review the FDA warning regarding repeated or prolonged anesthesia exposure in children under 3 years of age Compare key findings from animal studies and human clinical trials Summarize major studies including PANDA, MASK, and GAS Discuss strategies for counseling families and addressing parental concerns Identify considerations for timing of elective versus urgent procedures Review approaches to minimize exposure and explore potential neuroprotective strategies Special thanks to Dr. Heather Byrd and Dr. Rebecca Yang for peer reviewing this episode. CME available free with sign up: Link coming soon! References: 1. Vinson AE, Houck CS. Neurotoxicity of Anesthesia in Children: Prevention and Treatment. Curr Treat Options Neurol 2018; 20:1–10. https://doi.org/10.1007/S11940-018-0536-Z/TABLES/1. 2. Hansen TG. Anesthesia-related neurotoxicity and the developing animal brain is not a significant problem in children. Pediatric Anesthesia 2015; 25:65–72. https://doi.org/10.1111/PAN.12548. 3. O'Leary JD. Human Studies of Anesthesia-Related Neurotoxicity in Children: A Narrative Review of Recent Additions to the Clinical Literature. Clin Perinatol 2019; 46:637–45. https://doi.org/10.1016/j.clp.2019.08.001. 4. FDA Drug Safety Communication: FDA review results in new warnings about using general anesthetics and sedation drugs in young children and pregnant women | FDA n.d. https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-review-results-new-warnings-about-using-general-anesthetics-and (accessed August 28, 2025). 5. FDA Drug Safety Communication: FDA approves label changes for use of general anesthetic and sedation drugs in young children | FDA n.d. https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-approves-label-changes-use-general-anesthetic-and-sedation-drugs (accessed August 28, 2025). 6. SmartTots. SmartTots consensus statement on the use of anesthetic and sedative drugs in infants and toddlers.Published 2015. Updated 2017. Accessed September 17, 2025. https://smarttots.org 7. Sun LS, Li G, Miller TLK, Salorio C, Byrne MW, Bellinger DC, et al. Association between a single general anesthesia exposure before age 36 months and neurocognitive outcomes in later childhood. JAMA - Journal of the American Medical Association 2016; 315:2312–20. https://doi.org/10.1001/JAMA.2016.6967. 8. Warner DO, Zaccariello MJ, Katusic SK, Schroeder DR, Hanson AC, Schulte PJ, et al. Neuropsychological and behavioral outcomes after exposure of young children to procedures requiring general anesthesia: The mayo anesthesia safety in kids (MASK) study. Anesthesiology 2018; 129:89–105. https://doi.org/10.1097/ALN.0000000000002232. 9. McCann ME, Berde C, Soriano S, Marmor J, Bellinger D, de Graaff JC, et al. Neurodevelopmental outcome at 5 years of age after general anaesthesia or awake-regional anaesthesia in infancy (GAS): an international, multicenter, randomised controlled equivalence trial. Lancet 2019; 393:664. https://doi.org/10.1016/S0140-6736(18)32485-1. 10. Davidson AJ, Disma N, de Graaff JC, Withington DE, Dorris L, Bell G, et al. Neurodevelopmental outcome at 2 years of age after general anaesthesia and awake-regional anaesthesia in infancy (GAS): An international multicentre, randomised controlled trial. The Lancet 2016; 387:239–50. https://doi.org/10.1016/S0140-6736(15)00608-X. 11. Reighard C, Junaid S, Jackson WM, Arif A, Waddington H, Whitehouse AJO, et al. Anesthetic Exposure During Childhood and Neurodevelopmental Outcomes: A Systematic Review and Meta-analysis. JAMA Netw Open 2022;5: e2217427. https://doi.org/10.1001/JAMANETWORKOPEN.2022.17427. 12. Jadhav U, Bhanushali J, Sindhu A, Shiv Kiran Reddy B, Toshniwal A, Rashmika M. A Comprehensive Review of Pediatric Obstructive Sleep Apnea: From Assessment to Intervention 2025. https://doi.org/10.7759/cureus.78051. 13. Andropoulos DB. Neuroprotective strategies in anesthesia-induced neurotoxicity. Best Pract Res Clin Anaesthesiol 2023; 37:52–62. https://doi.org/10.1016/J.BPA.2022.11.005. 14. Ji F, Sun J, Sun L, et al. Effects of Dexmedetomidine and Remifentanil on Neurodevelopmental Outcomes After Sevoflurane Anesthesia in Infants: A Randomized Clinical Trial. Anesthesiology. 2025. 143(4), 827–834. https://doi.org/10.1097/ALN.0000000000005634 15. Saynhalath, R, Disma, N, Taverner, FJ et al. on behalf of the TREX (Trial Remifentanil DEXmedetomidine) Consortium. Short-term Outcomes in Infants after General Anesthesia with Low-dose Sevoflurane/Dexmedetomidine/Remifentanil versus Standard-dose Sevoflurane (the TREX Trial). Anesthesiology 141(6): p 1075-1085, December 2024. | DOI: 10.1097/ALN.0000000000005232 16. Ing C, Warner DO, Sun LS, Flick RP, Davidson AJ, Vutskits L, McCann ME, O'Leary J, Bellinger DC, Rauh V, Orser BA, Suresh S, Andropoulos DB. Anesthesia and Developing Brains: Unanswered Questions and Proposed Paths Forward. Anesthesiology. 2022 Mar 1;136(3):500-512. doi: 10.1097/ALN.0000000000004116. PMID: 35015802.

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-480 Overview: Tune in as we discuss nonsurgical options for managing knee osteoarthritis in primary care. This episode reviews current guidelines and highlights new research on yoga as an effective alternative to traditional strengthening exercises. Gain practical insights to help patients reduce pain, improve function, and delay surgery—all while expanding your integrative treatment toolkit. Episode resource links: Abafita BJ, Singh A, Aitken D, et al. Yoga or strengthening exercise for knee osteoarthritis: a randomized clinical trial. JAMA Netw Open. 2025;8(4):e253698. doi:10.1001/jamanetworkopen.2025.3698 Brophy, Robert H. MD; Fillingham, Yale A. MD. AAOS Clinical Practice Guideline Summary: Management of Osteoarthritis of the Knee (Nonarthroplasty), Third Edition. Journal of the American Academy of Orthopaedic Surgeons 30(9):p e721-e729, May 1, 2022. | DOI: 10.5435/JAAOS-D-21-01233 Guest: Jillian Joseph, MPAS, PA-C Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

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-480 Overview: Tune in as we discuss nonsurgical options for managing knee osteoarthritis in primary care. This episode reviews current guidelines and highlights new research on yoga as an effective alternative to traditional strengthening exercises. Gain practical insights to help patients reduce pain, improve function, and delay surgery—all while expanding your integrative treatment toolkit. Episode resource links: Abafita BJ, Singh A, Aitken D, et al. Yoga or strengthening exercise for knee osteoarthritis: a randomized clinical trial. JAMA Netw Open. 2025;8(4):e253698. doi:10.1001/jamanetworkopen.2025.3698 Brophy, Robert H. MD; Fillingham, Yale A. MD. AAOS Clinical Practice Guideline Summary: Management of Osteoarthritis of the Knee (Nonarthroplasty), Third Edition. Journal of the American Academy of Orthopaedic Surgeons 30(9):p e721-e729, May 1, 2022. | DOI: 10.5435/JAAOS-D-21-01233 Guest: Jillian Joseph, MPAS, PA-C Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

We interview Katherine Rizzolo about her work with Lilia Cervantes on implementing policies to provide dialysis care in the undocumented immigrant population. We talk about how the experience of undocumented immigrants differs from those with citizenship without insurance, tools she used from implementation science in this work, the path to policy change in Colorado, and the role of implementation science in policy change. Ah, implementation science: making common sense and decency incredibly rigorous. Mentioned on today's show: Cervantes L, Rizzolo K, Tummalapalli SL, Wainstein M, Glasgow RE, Jolles MP. Use of a Context- and Equity-Focused Implementation Science Framework to Aid the Design of Clinical Trials. J Am Soc Nephrol. 2025 Jun 1;36(6):1197-1200. doi: 10.1681/ASN.0000000633. Epub 2025 Jan 17. PMID: 39823190; PMCID: PMC12147963. Cervantes L. Dialysis in the Undocumented: Driving Policy Change with Data. J Hosp Med. 2020 Aug;15(8):502-504. doi: 10.12788/jhm.3319. PMID: 31891561; PMCID: PMC7518140. Nilsen, P. Making sense of implementation theories, models and frameworks. Implementation Sci 10, 53 (2015). https://doi.org/10.1186/s13012-015-0242-0 Proctor EK, Powell BJ, Baumann AA, Hamilton AM, Santens RL. Writing implementation research grant proposals: ten key ingredients. Implement Sci. 2012 Oct 12;7:96. doi: 10.1186/1748-5908-7-96. PMID: 23062065; PMCID: PMC3541090. Rizzolo K, Ressalam J, Robledo K, et al. Participant Experiences in a Kidney Failure Care Intervention in the Navigate-Kidney Study. JAMA Netw Open. 2025;8(11):e2548506. doi:10.1001/jamanetworkopen.2025.48506

Send us Fan MailIn this Journal Club episode, Ben and Daphna review a systematic review and meta-analysis from JAMA Network Open questioning the clinical value of predischarge car seat tolerance screening (CSTS). Driven by data suggesting that testing does not reduce 30-day mortality or hospital readmissions, they discuss the high failure rates, varying definitions of bradycardia and desaturation, and the unintended consequence of prolonged NICU stays. They also highlight the practical reality of CSTS in ensuring parents actually have an appropriate car seat at discharge. Tune in for a critical look at whether this 1991 AAP recommendation still holds up today!----Predischarge Car Seat Tolerance Screening in Preterm and At-Risk Full-Term Infants: A Systematic Review and Meta-Analysis. King BC, Dalvie N, Hay S, Jensen EA, Zupancic JAF.JAMA Netw Open. 2026 Feb 2;9(2):e2558197. doi:0.1001/jamanetworkopen.2025.58197.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

Send us Fan MailIn this Daily Journal Club episode, Ben and Daphna review a massive Swedish national cohort study from JAMA Network Open examining early prophylactic hydrocortisone in extremely preterm infants. They discuss the targeted regimens used, differences in gestational age outcomes, and whether a blanket prophylactic approach is truly effective for preventing BPD. With impressive data covering 98% of all NICU admissions in Sweden, the hosts debate the nuances of targeting 24 to 25-weekers versus older preemies and the potential confounding impact of chorioamnionitis. Tune in for your daily snack of evidence-based medicine and insights into optimizing NICU steroid protocols!----Early Prophylactic Hydrocortisone and Bronchopulmonary Dysplasia-Free Survival in Extremely Preterm Infants. Smedbäck V, Björklund LJ, Flisberg A, Wróblewska J, Baud O, Wejryd E, Ådén U.JAMA Netw Open. 2026 Feb 2;9(2):e2560146. doi:10.1001/jamanetworkopen.2025.60146.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

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-477 Overview: With rising administrative demands, many clinicians are considering artificial intelligence (AI) scribes—this episode unpacks what you need to know before incorporating this technology. We explore key benefits like reduced burnout and improved workflow, along with ethical, legal, and safety considerations to help you make informed decisions about integrating AI scribing into your practice. Episode resource links: Cohen IG, Ritzman J, Cahill RF. Ambient Listening—Legal and Ethical Issues. JAMA Netw Open.2025;8(2):e2460642. doi:10.1001/jamanetworkopen.2024.60642 Olson KD, Meeker D, Troup M, et al. Use of Ambient AI Scribes to Reduce Administrative Burden and Professional Burnout. JAMA Netw Open. 2025;8(10):e2534976. doi:10.1001/jamanetworkopen.2025.34976 https://www.healio.com/news/dermatology/20251210/ai-scribes-hold-transformative-potential-for-improving-physician-burden-patient-care Guest: Jillian Joseph, MPAS, PA-C   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Episode Notes Complicated UTIs just got a whole lot less complicated—or did they? Dr. Dana Bowers and Kyle Molina (@kcmolinaID) join Dr. Whitney Buckel to break down what's new, what's controversial, and what this means for your day‑to‑day antimicrobial decisions. Join us as we dig into the biggest updates, the evidence behind them, and the clinical pearls you won't want to miss. References: Nelson Z, Aslan AT, Beahm NP, et al. Guidelines for the Prevention, Diagnosis, and Management of Urinary Tract Infections in Pediatrics and Adults: A WikiGuidelines Group Consensus Statement. JAMA Netw Open. 2024 Nov 4;7(11):e2444495. Trautner BW, Cortes-Penfield NW, Gupta K, et al. Complicated Urinary Tract Infections (cUTI): Clinical Guidelines for Treatment and Management. Published July 17, 2025. https://www.idsociety.org/practice-guideline/complicated-urinary-tract-infections/ Kadry N, Natarajan M, Bein E, Kim P, Farley J. Discordant Clinical and Microbiological Outcomes Are Associated With Late Clinical Relapse in Clinical Trials for Complicated Urinary Tract Infections. Clin Infect Dis 2023;76(10:1768-1775. https://academic.oup.com/cid/article/76/10/1768/6980780 USCAST Oral cephalosporin STIC against S. aureus and E. coli meeting recording. https://www.youtube.com/watch?v=HieaVFAC08s MacDougall C. A Cloudy Crystal Ball: Critically Assessing and Rethinking the Antibiogram. Clin Infect Dis. 2023;77(11):1501-1503. doi:10.1093/cid/ciad468 Koehl J, Spolsdoff D, Negaard B, et al. Cephalosporins for Outpatient Pyelonephritis in the Emergency Department: COPY-ED Study. Ann Emerg Med. 2025;85(3):240-248. doi:10.1016/j.annemergmed.2024.10.013 Dunne MW, Aronin SI, Das AF, et al. Sulopenem for the Treatment of Complicated Urinary Tract Infections Including Pyelonephritis: A Phase 3, Randomized Trial. Clin Infect Dis. 2023;76(1):78-88. doi:10.1093/cid/ciac704 Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) or @breakpointspodcast_sidp (https://www.instagram.com/breakpointspodcast_sidp/)https://www.instagram.com/breakpointspodcast_sidp/?hl=en Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/ SIDP welcomes pharmacists and non-pharmacist members with an interest in infectious diseases, learn how to join here: https://sidp.org/Become-a-Member Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, Stitcher, Google Play, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/

Send a textIn this Journal Club episode, Ben and Daphna review the eye-opening results of the NeoDry Trial recently published in JAMA Network Open. They explore the clinical rationale of whether drying very preterm infants before applying a plastic wrap in the delivery room improves rates of normothermia upon NICU admission. While the intervention did not significantly improve temperatures, it unexpectedly revealed an alarming increased mortality risk for the smallest neonates. Tune in as they break down the study's design, discuss the potential causes for this stark safety signal, and highlight the ongoing challenge of maintaining thermoregulation for our most vulnerable preemies!----Drying Very Preterm Infants Before Plastic Wrapping at Birth: A Randomized Clinical Trial. Cavallin F, Doglioni N, Risso FM, Monari CB, Aversa S, Troiani S, Battajon N, Moschella S, Villani PE, Vedovato S, Maiorca D, Frezza S, Lista G, Laforgia N, Mondello I, Sibona I, Staffler A, Pratesi S, Paviotti G, De Bernardo G, Lama S, Miselli F, Bua J, Gitto E, Pesce S, Baraldi E, Trevisanuto D; NEODRY Trial Group.JAMA Netw Open. 2026 Mar 2;9(3):e2556902. doi: 10.1001/jamanetworkopen.2025.56902.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

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-475 Overview: A prescribing cascade occurs when adverse effects of a medication are mistaken for a new condition and treated with additional drugs. Older adults experiencing polypharmacy are most at risk. The impact of prescribing cascades can be substantial, leading to falls, organ injury, unnecessary imaging and tests, and more. Join us as we explore how to recognize and prevent these harmful cascades in your patients. Episode resource links: Adrien  O, Mohammad  AK, Hugtenburg  JG,  et al.  Prescribing cascades with recommendations to prevent or reverse them: a systematic review.   Drugs Aging. 2023;40(12):1085-1100. doi:10.1007/s40266-023-01072-yPubMedGoogle ScholarCrossref   Brath  H, Mehta  N, Savage  RD,  et al.  What is known about preventing, detecting, and reversing prescribing cascades: a scoping review.   J Am Geriatr Soc. 2018;66(11):2079-2085. doi:10.1111/jgs.15543PubMedGoogle ScholarCrossref   Daunt R, McGettigan S, Kelly L, Curtin D, O'Mahony D. Detection of Potential Prescribing Cascades in Multimorbid Older Patients Hospitalised with Acute Illness-An Observational Prospective Prevalence Study. Drugs Aging. 2025;42(6):535-546. doi:10.1007/s40266-025-01201-9   Growdon ME, Tjota N, Campbell R, et al. Decision-Making and Downstream Outcomes of the Gabapentinoid-Diuretic Prescribing Cascade. JAMA Netw Open. 2025;8(12):e2545274. doi:10.1001/jamanetworkopen.2025.45274   McCarthy  LM, Savage  R, Dalton  K,  et al.  ThinkCascades: a tool for identifying clinically important prescribing cascades affecting older people.   Drugs Aging. 2022;39(10):829-840. doi:10.1007/s40266-022-00964-9PubMedGoogle ScholarCrossref   O'Mahony, D., Cherubini, A., Guiteras, A.R. et al. STOPP/START criteria for potentially inappropriate prescribing in older people: version 3. Eur Geriatr Med 14, 625–632 (2023). https://doi.org/10.1007/s41999-023-00777-y   Rochon, P.A., O'Mahony, D., Cherubini, A. et al. International expert panel's potentially inappropriate prescribing cascades (PIPC) list. Eur Geriatr Med 16, 1573–1584 (2025). https://doi.org/10.1007/s41999-025-01215-x   Young EH, Pan S, Yap AG, Reveles KR, Bhakta K. Polypharmacy prevalence in older adults seen in United States physician offices from 2009 to 2016. PLoS One. 2021;16(8):e0255642. Published 2021 Aug 3. doi:10.1371/journal.pone.0255642 Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Contributor: Travis Barlock, MD Educational Pearls:  Foul-smelling urine and cloudy urine are commonly misinterpreted as indicators of a UTI. However, these findings alone are not diagnostic. Criteria for UTI: Presence of localized urinary symptoms: Suprapubic pain Dysuria Hesitancy Urgency Urinalysis with WBC > 10 Urine culture with > 100,000 CFU/mL Colonization differs from infection - many patients harbor asymptomatic bacteria but do not have a true infection. Consequences of overtreatment One review showed 45% of patients treated with antibiotics for a presumed UTI actually had asymptomatic bacteriuria and were incorrectly treated. Unnecessary antibiotic treatment can have deleterious effects on the gut microbiome, increasing the risk of multidrug-resistant infections. Another problem with overdiagnosing UTI is missing the real diagnosis by explaining symptoms away as "just a UTI." Be mindful of the risk of overtesting versus not testing at all. Clinicians must navigate a balance between moving patients efficiently through the ER and testing appropriately when a UTI is truly suspected. References: Baghdadi JD, Korenstein D, Pineles L, et al. Exploration of primary care clinician attitudes and cognitive characteristics associated with prescribing antibiotics for asymptomatic bacteriuria. JAMA Netw Open. 2022;5(5):e2214268. doi:10.1001/jamanetworkopen.2022.14268 Colgan R, Williams M. Acute uncomplicated urinary tract infections in adults. Am Fam Physician. 2024;109(2):167-174. Accessed February 21, 2026. https://www.aafp.org/pubs/afp/issues/2024/0200/acute-uncomplicated-utis-adults.html#afp20240200p167-ta1 Summarized by Ashley Lyons OMS3 | Edited by Ashley Lyons & Jorge Chalit OMS4 Donate: https://emergencymedicalminute.org/donate/ Join our mailing list: http://eepurl.com/c9ouHf

There has been a shift in cervical cancer screening from primary cytology based to HPV based. Even HPV screening has had its evolution from physician collected samples to patient self-collection, either in a clinical setting or at home with an approved collection system. In May 2025, the FDA cleared the first at-home self-collection kit for HPV screening, specifically the Teal Wand by Teal Health. Now, we are seeing the advent of POSSIBLY another avenue for cervical HPV testing- although it is a bit awkward: the use of menstrual blood as an HPV screening test. In this episode we will review a new cross-sectional, population-based study from China which compared testing menstrual blood for human papillomavirus during cervical cancer screening to clinician-collected cervical samples for human papillomavirus (HPV). This concept, and these results, are not new at all! And there are important limitations to consider at this time. Listen in for details.1. Testing menstrual blood for human papillomavirus during cervical cancer screening in China: cross sectional population based study. BMJ 2026; 392 doi: https://doi.org/10.1136/bmj-2025-084831 (Published 04 February 2026)BMJ 2026;392:e084831https://www.bmj.com/content/392/bmj-2025-0848312. Naseri S, Young S, Cruz G, Blumenthal PD. Screening for High-Risk Human Papillomavirus Using Passive, Self-Collected Menstrual Blood. Obstet Gynecol. 2022 Sep 1;140(3):470-476. doi: 10.1097/AOG.0000000000004904. Epub 2022 Aug 3. PMID: 35926207; PMCID: PMC9377370.3. Fokom Domgue J, Chandra M, Oladoyin O, Desai M, Yu R, Shete S. Women's Preferences for Home-Based Self-Sampling or Clinic-Based Testing for Cervical Cancer Screening. JAMA Netw Open. 2026;9(2):e2558841. doi:10.1001/jamanetworkopen.2025.58841

In this episode, we review the clinical presentation, diagnosis, and treatment of uncomplicated urinary tract infections. Key Concepts Uncomplicated urinary tract infections (UTI) are defined as an infection localized to the bladder without any systemic signs or symptoms of infection in someone who is not immunocompromised, pregnant, catheterized, and has normal urologic anatomy. UTIs are most commonly seen in younger women. E. coli is by far the most common urinary pathogen. Symptoms alone drive most of the diagnosis of UTI; however, urinalysis and urine culture can be helpful in some circumstances. Nitrofurantoin (Macrobid) is recommended for men and women for first-line therapy in most patients. Fosfomycin, Bactrim, pivmecillinam, and certain B-lactams can be considered in certain circumstances. Women are usually treated for 3-5 days and men 5-7 days. Some evidence suggests inferior clinical outcomes for B-lactam; however, the amount of data in general is lacking for B-lactams. Recommended B-lactams (aside from pivmecillinam) include amoxicillin/clavulanate, cephalexin, cefadroxil, cefpodoxime, and cefdinir. References Nelson Z, Aslan AT, Beahm NP, et al. Guidelines for the Prevention, Diagnosis, and Management of Urinary Tract Infections in Pediatrics and Adults: A WikiGuidelines Group Consensus Statement. JAMA Netw Open. 2024;7(11):e2444495. Published 2024 Nov 4. doi:10.1001/jamanetworkopen.2024.44495 Gupta K, Hooton TM, Naber KG, et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011;52(5):e103-e120. doi:10.1093/cid/ciq257 Kurotschka PK, Gágyor I, Ebell MH. Acute Uncomplicated UTIs in Adults: Rapid Evidence Review. Am Fam Physician. 2024;109(2):167-174. https://www.wikiguidelines.org/