Podcasts about nejm

Microplastics and Stroke Risk: What a Landmark 2024 Study Found Inside Human Arteries In 2024, a team of Italian researchers published a study in the New England Journal of Medicine that stopped the cardiovascular science community in its tracks. They found microplastics, tiny synthetic fragments embedded inside the carotid artery plaque of more than half the patients they examined. And the patients who had them faced more than four and a half times the risk of a serious cardiovascular event compared to those who didn’t. This isn’t a distant, theoretical risk. These are living people who had already been identified as having carotid artery disease, and plastics were found inside their arterial walls. For stroke survivors and those at elevated risk of stroke, this study raises important questions that the medical system has not yet caught up with. What the Research Found The study by Marfella et al., published in the New England Journal of Medicine (2024), enrolled 304 patients who were undergoing carotid endarterectomy, a surgical procedure to remove plaque from the carotid arteries. Researchers analysed the excised plaque for the presence of microplastics and nanoplastics. Their findings: 58% of patients had detectable levels of polyethylene, polyvinyl chloride (PVC), or polystyrene in their arterial plaque. This was not contamination from the surgical procedure; it was already there. Over a 34-month follow-up period, patients with microplastics in their plaque had a 4.53 times higher risk of a combined endpoint: non-fatal myocardial infarction, non-fatal stroke, or death from any cause. Inflammatory markers were significantly elevated in the microplastics-positive group. IL-18 and TNF-alpha proteins associated with systemic vascular inflammation were markedly higher in plaque samples that contained plastics. This suggests the mechanism is not simply physical obstruction, but an inflammatory cascade triggered by the presence of synthetic material in arterial tissue. What This Means for Stroke Survivors The carotid arteries are the primary conduits supplying oxygenated blood to the brain. Plaque accumulation in these vessels is one of the leading causes of ischaemic stroke, and carotid artery disease is a condition many stroke survivors are already living with. “The patients with microplastics in their plaque had a 4.53 times higher risk of stroke, heart attack, or death over the 34-month follow-up. That’s not a marginal finding. That’s a signal the research community needed to take seriously.” The NEJM study doesn’t yet tell us whether removing microplastic exposure after the fact reduces risk. It doesn’t confirm that healthy individuals with no existing carotid disease are accumulating plastics at the same rate. And it cannot tell us which plastic sources are most responsible because we’re exposed to microplastics through drinking water, food packaging, air, and a dozen other vectors simultaneously. But what it does tell us clearly and with high statistical significance is that microplastics in arterial plaque are associated with dramatically worse cardiovascular outcomes. What the Research Does Not Yet Tell Us Science at the frontier moves in one direction at a time. This study establishes association, not causation. It cannot yet answer: Whether people without existing carotid disease are accumulating microplastics at comparable rates. Whether reducing exposure actively reverses or slows plaque-associated risk. Which types of microplastics are most biologically harmful? Whether there will be a clinical screening tool for this in the near future. These are the questions the next generation of research will need to answer. In the meantime, it’s reasonable to act on what we do know. Practical Steps to Reduce Exposure No clinical screening currently exists for microplastics in arterial plaque. There is no blood test, no imaging, no biomarker that your GP can order today. What you can do is reduce your ongoing exposure, particularly through food and water contact with plastics. Evidence-informed steps worth discussing with your treating team: Use glass, stainless steel, or ceramic containers rather than plastic for food and drink storage. Avoid microwaving food in plastic containers; heat accelerates the leaching of plastic particles. Filter your drinking water; some filters (carbon block and reverse osmosis) reduce microplastic levels significantly. Reduce consumption of highly processed foods in plastic packaging. Bring this study to your vascular neurologist, cardiologist, or GP and ask whether it’s relevant to your personal risk profile. This is not a recommendation to take a supplement or start a treatment. It’s an invitation to have an informed conversation with the people responsible for your care using the best available evidence. If you found this useful, my book walks through the science of stroke recovery in the same evidence-first, no-hype way. Find it at recoveryafterstroke.com/book. Want to go deeper and support the channel? Join the community at patreon.com/recoveryafterstroke. The post Plastics in Your Arteries: The Stroke Risk Study You Must Know appeared first on Recovery After Stroke.

This week on the Osterholm Update, Dr. Michael Osterholm and Chris Dall focus on the developing Ebola outbreak in the Democratic Republic of Congo, discussing the U.S. response, whether transmission can be airborne, and addressing travel concerns to Africa. We'll also bring you the latest on the hantavirus outbreak, review a long-awaited report from the FDA on pediatric deaths linked to COVID vaccines, and provide updates on measles and other respiratory viruses. Plus, a Public Health History segment highlighting the first EMS service in the U.S.  Links:‘Among the things he feared most was death': the doctors and nurses dying on the Ebola frontline (The Guardian) Inside the Ebola Epicenter, the Virus Rages With Little to Stop It (The New York Times) Opinion: This Ebola outbreak is a test the world doesn't have to fail (The Washington Post)People with Ebola pose little risk to public in US, experts say (CIDRAP) Transmission of Ebola Viruses: What We Know and What We Do Not Know (ASM Journals) Public Health Alerts: Andes Hantavirus Outbreak on a Cruise Ship, 2026 (NEJM and CIDRAP)  Resources for vaccine and public health advocacy: Voices for Vaccines Families Fighting Flu Vaccinate Your Family Shot@Life Medical Reserve Corps Learn more about the Vaccine Integrity Project MORE EPISODES       SUPPORT THIS PODCAST   Music: "Beauty Flow" Kevin MacLeod (incompetech.com)Licensed under Creative Commons: By Attribution 4.0 License

„Být v domácím prostředí a v klidu se tam léčit, je určitě nejlepší a nejpohodlnější,“ popisuje jeden z bonusů primář oddělení Jednodenní péče šternberské nemocnice Peter Gálóczy.

Počet obytných vozidel v Česku podle dat Asociace karavaningu dlouhodobě roste. Od roku 2012 se zvedl o víc než 60 procent.

Send us a Text Message (please include your email so we can respond!)Episode 93! In this episode we go over TOWAR or "Prehospital Resuscitation with Type O Whole Blood for Trauma and Hemorrhage" by Sperry et all published in NEJM and "Remote Multicomponent Rehabilitation in Intensive Care Unit Survivors" published by O'Neill et al in JAMA both in May 2026 and presented at the ATS International Conference! Then we talk a little bit about some current events with Hantavirus and sepsis that has hit the news cyclesTOWAR (NEJM): https://www.nejm.org/doi/full/10.1056/NEJMoa2602167iRehab (JAMA): https://jamanetwork.com/journals/jama/fullarticle/2849320If you enjoy the show be sure to like and subscribe, leave that 5 star review! Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music! 

We sit down with Joshua Oommen to get nerdy about clinical reasoning, FDA standards, and why “good evidence” is harder to define than most of us admit. We challenge the reflex to trust p-values and meta-analyses, then test our instincts against real OBGYN examples where the literature has whiplashed practice. • why the podcast is called Thinking About OBGYN and how clinical reasoning shapes our work • the NEJM proposal to make one pivotal trial the FDA default and what “confirmatory evidence” might mean • medical reversal, surrogate endpoints, and how trust erodes when practice changes late • why Bayesian thinking fits how clinicians interpret tests, trials, and prior beliefs • how meta-analyses fail through small study effects, publication bias, p-hacking, and heterogeneity • the amnioinfusion comeback as a case study in applicability and overconfident conclusions Be sure to check out thinking about obgyn.com for more information and be sure to follow us on Instagram. 0:00 Welcome And Today's Big Question3:48 Why “Thinking About OBGYN” Exists11:54 The NEJM Push For One Trial16:38 Medical Reversal And Trust Problems24:43 AI Proteins And CRISPR Pressure Tests32:33 Bayes Thinking Beyond P Values36:43 Why Meta-Analyses Often Mislead41:08 Bias And Heterogeneity Red Flags46:24 Amnioinfusion And A Meta-Analysis Comeback1:02:29 Final Warnings And How To LearnFollow us on Instagram @thinkingaboutobgyn.

This week, we present new research guiding treatment of pulmonary embolism, early progress in cardiac regeneration with engineered heart tissue, and treatments for gastroesophageal cancer and Chiari malformation. We review leishmaniasis and follow a revealing neurologic case. Perspectives discuss nutrition policy, tickborne illness, structural competence in medicine, and the arrival of closure.

Deirdre Tobias is an associate professor in the Department of Nutrition at the Harvard T.H. Chan School of Public Health and Brigham and Women's Hospital. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. D.K. Tobias and F.B. Hu. The 2025–2030 Dietary Guidelines for Americans — Progress, Pitfalls, and the Path Forward. N Engl J Med 2026;394:1969-1971.

Eric Rubin is the Editor-in-Chief of the Journal. Lindsey Baden is a Deputy Editor of the Journal. Angela Hewlett is Director of the Nebraska Biocontainment Unit. Steven Kornfeld is a physician who was a passenger on the MV Hondius. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. E.J. Rubin and Others. NEJM Outbreaks Update — Andes Hantavirus. N Engl J Med. DOI: 10.1056/NEJMe2505379.

This week we review a landmark paper from the NEJM by the SCOUT-HCM study group assessing the impact of mavacamten on HCM in the adolescent patient. How does this agent work and what impact did it have on the LVOT gradients in obstructed HCM teens? Does this agent affect other biomarkers associated with more obstruction in this setting? Who is a good potential candidate for the use of this agent? Why must the EF be carefully monitored while using this agent? Dr. Joseph Rossano, Professor of Pediatrics at The University of Pennsylvania and the chief of pediatric cardiology at The Children's Hospital of Philadelphia joins the podcast to discuss this groundbreaking work.doi: 10.1056/NEJMoa2601103

Five longevity beliefs that millions have followed for decades have just been overturned by the latest research. Some of these will surprise you.In this explainer, Robert Lufkin MD walks through five of the most widely believed longevity myths — and what the most recent science actually says about each one. From genetics and middle age to antioxidants, alcohol, and caloric restriction, the evidence has shifted dramatically.CHAPTERS:00:00 — Introduction00:32 — Myth 1: Your Genes Determine How Long You Live01:51 — Myth 2: It's Too Late to Change After Middle Age03:24 — Myth 3: Antioxidant Supplements Prevent Disease05:22 — Myth 4: Moderate Alcohol Is Good for You07:04 — Myth 5: Caloric Restriction Is King08:50 — The Real Framework: Quality Beats Quantity09:18 — Final TakeawayKEY TAKEAWAYS:• Genetics accounts for at most 25–50% of how long you live• Quitting smoking before 40 eliminates ~90% of excess mortality risk• Antioxidant supplements have no benefit and may increase mortality• The protective J-curve for moderate alcohol disappears once you correct for the "sick quitter" effect• Caloric restriction's primate magic was rescuing animals from a high-sugar control diet• Diet quality matters more than diet quantitySTUDIES & SOURCES MENTIONED:• Herskind et al., Human Genetics 1996 — 2,872 Danish twin pairs heritability of longevity• Jha et al., NEJM 2013 — 21st-century smoking cessation and life expectancy• Saint-Maurice et al., JAMA Network Open 2019 — Adult life-course physical activity and mortality• Bjelakovic et al., Cochrane 2012 — Antioxidant supplements for prevention of mortality• Zhao et al., JAMA Network Open 2023 — Daily alcohol intake and all-cause mortality meta-analysis• Mattison et al., Nature Communications 2017 — Caloric restriction in rhesus monkeys (NIA / Wisconsin reconciliation)⭐ Enjoying the show? Please leave a 5-star review on Apple Podcasts — it takes 30 seconds and helps more people discover the science of health and longevity. Thank you!New episodes every Tuesday & Thursday. Subscribe so you don't miss one.Continue this conversation on Substack: https://robertlufkinmd.substack.comLies I Taught In Medical School — Free sample chapter: https://www.robertlufkinmd.com/lies/Web: https://www.robertlufkinmd.comYouTube: https://www.youtube.com/robertlufkinmdX: https://x.com/robertlufkinmdInstagram: https://www.instagram.com/robertlufkinmd/TikTok: https://www.tiktok.com/@robertlufkinLinkedIn: https://www.linkedin.com/in/robertlufkinmd/

This week, we present a promising new therapy for dermatomyositis, evolving approaches to stroke care, the prevention of Covid-19 after household exposure, and new treatments for kidney disease. We review inflammatory myopathies and follow a complex case of multisystem illness. Perspectives discuss AI and uncertainty in clinical care, health equity, the forces shaping affordability in health care, and on unpacking the ordinary.

Raja-Elie Abdulnour is the Chief Clinical Innovation Officer at NEJM Group and an associate physician in the Pulmonary and Critical Care Medicine Division at Brigham and Women's Hospital. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. A. Sikora, L.A. Celi, and R.-E.E. Abdulnour. Can AI Say “I Don't Know”? N Engl J Med 2026;394:1873-1875.

This week, we present research on high-risk coronary intervention strategies, targeted therapy for pancreatic cancer, an mRNA influenza vaccine, and treatments for severe scabies and sickle cell disease. We review cerebral amyloid angiopathy and follow a complex case of a disseminated infection. Perspectives address the impact of corporate medicine on medical training and drug pricing policy.

Jatin Vyas is a professor of medicine and associate dean for academic innovation at the Columbia University Vagelos College of Physicians and Surgeons. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. J.M. Vyas. From Mission to Margin in Academic Medicine — The Impact of Corporate Medicine on Medical Training. N Engl J Med 2026;394:1769-1772.

Can AI think like a physician?

A quiet revolution in tuberculosis diagnostics is here.

The NACE Journal Club with Dr. Neil Skolnik, provides review and analysis of recently published journal articles important to the practice of primary care medicine. In this episode Dr. Skolnik and guests review the following publications:1. Evolocumab to Reduce First Major Cardiovascular Events in Patients Without Known Significant Atherosclerosis and With Diabetes Results From the VESALIUS-CV Trial. JAMA 2026. Discussion by:Guest:Jessica Stieritz, MDResident - Abington Family Medicine Residency Program Jefferson Health2. A treat-to-target strategy versus symptom-driven management of gout in the Netherlands (GO TEST Overture): a multicentre, open-label, pragmatic, superiority, randomized controlled trial. Lancet Rheumatology 2026. Discussion by:Guest:Neil Skolnik, MDProfessor of Family and Community MedicineSidney  Kimmel  Medical College Thomas Jefferson UniversityAssociate Director - Family Medicine Residency ProgramJefferson Health – Abington3. Oral Nirmatrelvir–Ritonavir for Covid-19 in Higher-Risk Outpatients. NEJM 2026 Discussion by: Guest:Steven Leonard, MD Resident - Abington Family Medicine Residency Program Jefferson HealthMedical Director and Host, Neil Skolnik, MD, is an academic family physician who sees patients and teaches residents and medical students as professor of Family and Community Medicine at the Sidney Kimmel Medical College, Thomas Jefferson University and Associate Director, Family Medicine Residency Program at Abington Jefferson Health in Pennsylvania. Dr. Skolnik graduated from Emory University School of Medicine in Atlanta, Georgia, and did his residency training at Thomas Jefferson University Hospital in Philadelphia, PA. This Podcast Episode does not offer CME/CE Credit. Please visit  http://naceonline.com to engage in more live and on demand CME/CE content.

This week, we feature advances in targeted therapy for HER2-mutant lung cancer, interventions to reduce maternal infection, an emerging treatment for hemophilia A, and a new diagnostic test for tuberculosis. We review Barrett's esophagus and follow a case of systemic illness with kidney failure. Perspectives address GLP-1 drugs and eating disorders, directed blood donation, generic drug safety, and an in-flight medical emergency.

Amanda Banks is a consultant and a physician at the Corporal Michael J. Crescenz VA Medical Center. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. A. Banks. GLP-1 Receptor Agonists and Eating Disorders — Cause for Concern. N Engl J Med 2026;394:1665-1667.

This week, we explore new strategies for blood-pressure control after intracerebral hemorrhage, Covid-19 treatment in higher-risk patients, hormonal therapy for prostate cancer, and anesthesia for tracheal intubation. We review spinal epidural abscess and follow a case of progressive weakness and liver lesions. We examine advances in tRNA research, and Perspectives discuss the use AI in prescribing, pediatric drug research, the impact of pharmaceutical mergers, and the goals of care.

Sara Gerke is an associate professor of law and at the European Union Center at the University of Illinois Urbana-Champaign. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. S. Gerke, R.B. Parikh, and I.G. Cohen. Utah's Prescription-Renewal Pilot Program — Autonomous AI Managing Patient Care. N Engl J Med 2026;394:1561-1563.

A thoughtful, practice-shaping study in NEJM explores a long-standing clinical dilemma: can we truly move the needle in post-thrombotic syndrome?   The C-TRACT trial shows that endovascular therapy (iliac-vein stenting) significantly improves symptom burden and quality of life in patients with moderate–severe disease—measured rigorously using VCSS, VEINES-QOL, and SF-36. The magnitude of benefit is clinically meaningful.   But every intervention casts a shadow.  

Yes we have covered antenatal corticosteroids in the late preterm interval on several episodes in the past- it's DEJA VU! However, there is new data in the American Journal of Perinatology (April 2026 ) that is helpful for us as clinicians as we do “shared decision making” with patients in offering betamethasone in the late preterm interval. Listen in for details.1. Zigron R, Rotem R, Erlichman I, Rottenstreich M, Rosenbloom JI, Porat S, Rottenstreich A. Factors associated with the development of neonatal hypoglycemia after antenatal corticosteroid administration: It's all about timing. Int J Gynaecol Obstet. 2022 Aug;158(2):385-389. doi: 10.1002/ijgo.13975. Epub 2021 Oct 30. PMID: 34625970.2. Asirwatham A, Loke R, Rose S, Ho J, Leung K, Leftwich HK. Neonatal Hypoglycemia after Antenatal Late Preterm Steroids. Am J Perinatol. 2026 Apr;43(5):616-620. doi: 10.1055/a-2663-5798. Epub 2025 Aug 4. PMID: 40759170.3. ALPS Trial. NEJM. Published April 7, 2016;374:1311-1320

This week, we present new research on stroke prevention, Kawasaki disease, ICU infection strategies, and immune thrombocytopenia. We review hormone therapy and thrombotic risk. A case highlights an evolving diagnosis of severe fatigue and sleep disturbance. Perspectives explore nursing workforce policy, the role of nurse scientists in rebuilding trust, and the health consequences of environmental rollbacks.

Amy Stimpfel is an assistant professor at the New York University Rory Meyers College of Nursing. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. A.W. Stimpfel and M. Djukic. Using Data to Inform Decision Making — Borrowing Limits for Graduate Nursing Students. N Engl J Med 2026;394:1457-1459. P. Joseph and Others. Nurse Scientists as Trusted Voices in Health Communication. N Engl J Med 2026;394:1459-1461.

Nesta quarta-feira, analisamos marcos na saúde pública e na validação científica da tecnologia, começando pelo Dia Mundial da Doença de Chagas, que destaca o papel central das mulheres na eliminação desta patologia e na interrupção da transmissão congênita. Detalhamos um estudo longitudinal do JAMA Psychiatry sobre o impacto da idade no diagnóstico de TDAH e como intervenções precoces influenciam a trajetória escolar e reduzem comorbidades. Por fim, abordamos o lançamento do periódico NEJM AI na plataforma Ovid, um novo repositório com padrão ouro de revisão por pares dedicado a validar a inteligência artificial na prática clínica.Afya News. Informação médica confiável e atualizada no seu tempo.Fontes do episódio aqui:⁠https://portal.afya.com.br/podcasts/afya-news/15-04-2026

Nesta edição, analisamos diretrizes globais de saúde e inovações em terapias personalizadas, começando pelas novas orientações da OPAS para fortalecer o cuidado de longa duração na América Latina e no Caribe, face ao acelerado envelhecimento populacional. Detalhamos os resultados do ensaio clínico C-TRACT, publicado no NEJM, que avaliou a eficácia da terapia endovascular na Síndrome Pós-Trombótica, demonstrando melhoria na qualidade de vida apesar do maior risco de sangramento. Por fim, abordamos no Radar o progresso das vacinas de mRNA como terapia oncológica de precisão, treinando o sistema imunitário para reconhecer neoantígenos específicos do tumor.Afya News. Informação médica confiável e atualizada no seu tempo.Fontes do episódio aqui:⁠https://portal.afya.com.br/podcasts/afya-news/16-04-2026

Luke Carignan and ASHHRA Executive Director Jeremy Sadlier take a deliberate step back from the doom and gloom to look at what is actually working in healthcare HR right now — and the data is genuinely encouraging.

Nesta edição, analisamos como a genética e a tecnologia estão a redefinir a precisão e a segurança no cuidado, começando por um estudo da Nature que identifica variantes genéticas que explicam a variação de eficácia e os efeitos adversos dos agonistas de GLP-1. Detalhamos um artigo do NEJM sobre a prevalência da aspiração silenciosa em pacientes pós-extubação prolongada, revelando que a ausência de sintomas clássicos não descarta o risco. Por fim, abordamos o One Health Summit em Lyon, onde líderes globais se reúnem para institucionalizar a abordagem de Saúde Única na vigilância de zoonoses e resiliência climática.Afya News. Informação médica confiável e atualizada no seu tempo.Fontes do episódio aqui:⁠https://portal.afya.com.br/podcasts/afya-news/13-04-2026

This week, we present new research on intensive LDL cholesterol targets, team-based strategies to improve blood pressure control, emerging therapies for immune and oncologic diseases, and a next-generation yellow fever vaccine. We review celiac disease and follow a compelling case of post-procedural complications. Perspectives explore health disparities and efforts to strengthen care in vulnerable communities.

Danielle Jones is the vice president of accountability, belonging, and culture at the Association of Women's Health, Obstetric and Neonatal Nurses. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. W.T. Moore and Others. From Clinic to Community — The EveryONE Project in Family Medicine. N Engl J Med 2026;394:1353-1354.

This is the first episode of the 'Quarterly catchup' series, in which CMI Communications editors discuss important and useful articles that have come out in the last 3 months to understand their results and potential clinical impact. In this inaugural episode of 'Quarterly catchup', Emily McDonald (Canada), Thomas Tängdén (Sweden) and Navaneeth Narayanan (USA) convene to discuss clinical microbiology and infectious diseases studies published in the first quarter of 2026 [1-6]. From Wolbachia-infected mosquitoes reducing dengue infection to exploration of antibiotic combination therapies against multidrug-resistant organisms, our hosts summarize six articles they found the most interesting, and discuss whether they can and should change clinical practice.   This episode was peer reviewed by Connor Prosty of McGill University, Montréal, Canada.  ReferencesLim JT, et al. Dengue suppression by Male Wolbachia-Infected mosquitoes. NEJM 2026. doi: https://doi.org/10.1056/NEJMoa2503304 Escrihuela-Vida F, et al. Adjunctive Fosfomycin for the Treatment of Staphylococcus aureus Bacteremia: A Pooled Post Hoc Analysis of Individual Participant Data From 2 Randomized Trial. Clin Infect Dis 2026. doi: https://doi.org/10.1093/cid/ciaf387 Baldanzi G, et al. Antibiotic use and gut microbiome composition links from individual-level prescription data of 14,979 individuals. Nat Med 2026. doi: https://doi.org/10.1038/s41591-026-04284-y.Quentin Vallé, et al. Evaluating the antibacterial activity of ceftazidime/avibactam and aztreonam combinations against multidrug-resistant Stenotrophomonas maltophilia complex isolates in a hollow fibre infection model.  Clin Microbiol Infect 2026. doi: https://doi.org/10.1016/j.cmi.2026.02.010 Rana AI, et al. Cabotegravir plus Rilpivirine for Persons with HIV and Adherence Challenges. NEJM 2026. doi: https://doi.org/10.1056/NEJMoa2508228 Donovan J, et al. Genotype-stratified adjunctive dexamethasone for tuberculous meningitis in HIV-negative adults: a randomized controlled phase 3 trial. Nat Med 2026. doi: https://doi.org/10.1038/s41591-025-04138-z Further readingThwaite GE, et al. Dexamethasone for the Treatment of Tuberculous Meningitis in Adolescents and Adults. NEJM 2004. doi: https://doi.org/10.1056/NEJMoa040573 Behrmann LV. “The specimen is never wrong”: the pathologist behind Wolbachia. CMI Communications, 2026. doi: https://doi.org/10.1016/j.cmicom.2026.105185                

This week, we present new research on treatment for muscle-invasive bladder cancer, left atrial appendage closure versus medical therapy for atrial fibrillation, gene-editing approaches for sickle cell disease and β-thalassemia, and the safety of discontinuing beta-blockers after myocardial infarction. We also review GLP-1 receptor agonists and discuss a Clinical Problem-Solving case of a man with progressive confusion. Perspectives explore corporatization; biologic, as opposed to chronologic, aging; and a legal case that could affect mental-health policy.

Lawrence Casalino is a professor of population health sciences at Weill Cornell Medicine. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. L.P. Casalino. Physicians, Corporatization, and the Unmeasured Quality of Care. N Engl J Med 2026;394:1249-1251.

In this episode of the Oncology Brothers podcast, we dived into the transformative role of artificial intelligence (AI) in oncology and medical practice. Joined by Dr. Travis Zack, Chief Medical Officer of Open Evidence, we explored how large language models (LLMs) are revolutionizing the way clinicians access and utilize medical information. Listen us on: Spotify: https://open.spotify.com/show/31BXhY9FM4gPWG10WgE11o Apple Podcast: https://podcasts.apple.com/us/podcast/oncology-brothers-practice-changing-cancer-discussions/id1653340966 Follow us on social media: ⁠X/Twitter: https://twitter.com/oncbrothers ⁠Instagram: https://www.instagram.com/oncbrothers Website: https://oncbrothers.com/ Key topics included: The rapid evolution of AI in healthcare and its implications for patient care. How Open Evidence differentiates itself by focusing on reliable medical sources like NCCN, NEJM, and JAMA. The importance of integrating AI tools into clinical workflows to enhance decision-making and patient outcomes. The business model behind Open Evidence and the ethical considerations regarding data usage. Future prospects for AI in oncology, including potential integration with electronic health records (EHRs) and clinical trials. Join us as we discuss the exciting advancements in AI technology and how they can empower oncologists to provide better care for their patients. Don't miss this insightful conversation that highlights the intersection of technology and medicine! Subscribe to our channel for more episodes on FDA approvals, conference highlights, and treatment algorithms in oncology! #AIinHealthcare #Oncology #MedicalAI #CancerResearch #HealthcareInnovation #OncBrothers

This week's podcast covers three NEJM trials. First, apixaban showed over 50% less clinically relevant bleeding than rivaroxaban in acute venous thromboembolism patients, with similar efficacy. Second, romiplostim helped 84% of patients on oxaliplatin-based chemotherapy avoid dose modifications due to thrombocytopenia, versus 36% with placebo. Third, inhaled treprostinil slowed lung function decline in idiopathic pulmonary fibrosis patients over 52 weeks, though cough and discontinuation rates were higher.

This week, we present new clinical trials on immunotherapy for stage III mismatch repair–deficient colon cancer, early surgery for asymptomatic aortic stenosis, an approach to dengue virus suppression, and advances in gene and prime-editing therapies for rare disorders. We also review minipuberty. We follow the case of a 12-year-old girl with altered mental status and persistent hypoglycemia, and we explore Perspectives on corporate influences on health, vaccine communication, antitrust policy, conflicts of interest, and the meaning of the number needed to treat.

Douglas Opel is a professor in the Department of Pediatrics at the University of Washington School of Medicine. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. D.J. Opel and S.T. O'Leary. Communicating about Vaccines in a Politically Contentious Climate. N Engl J Med 2026;394:1145-1147.

A few weeks ago, I was skimming this NEJM paper for UCSF's Division of Geriatrics Journal club on de-prescribing anti-hypertensive medications for older adults in nursing homes. Seemed to make a world of sense. The study found no difference between the deprescribing arm and the usual care arm in mortality, the primary study outcome. I thought, great! So we can deprescribe anti-hypertensives without changing mortality, that must be what the authors concluded. I was shocked, therefore, to read in the first paragraph of the discussion that the deprescribing arm did not achieve the hypothesized 25% reduction in mortality.  What?!?  Why would deprescribing be associated with reduced mortality? That's not the main reason or even the first reason I think of for deprescribing.  Reducing side effects that impair quality of life, sure. Less pill burden, of course.  But prolonged life?  Seemed a stretch. Today we hear from the first author of this study, Athanase Benetos, an esteemed geriatrician-researcher from France.  For context, we also interviewed Mike Steinman, co-chair of the Beers criteria and co-lead of the US Deprescribing Research Network. We learned about: Why the hypothesis of reduced mortality in deprescribing was justified, based on natural decreases in blood pressure with aging, and the Partridge study, an observational study that found higher risks of mortality associated with using multiple anti-hypertensive and low blood pressure. Why mortality was chosen as the primary outcome. Is a negative superiority study the same as what they might have found in a non-inferiority study? (stay with us) Variation in outcome by frailty status How to place this study in context with other research, such as the Danton study mentioned on a recent podcast about deprescribing near the end of life. Dantos was a study of deprescribing for nursing home residents with dementia that was stopped early due to safety concerns. Other studies for context include Sprint, Optimize, and an observational study by Bocheng Jing (UCSF statistician in our group). At the end, we ask our guests to put it together. With all that we know at this point, what's a clinician to do? To deprescribe or not to deprescribe? And, zoot alors! I get to sing Hymne A L'amour in French! Athanase recounts the moving story of how Edith Piaf sang this song the night she learned the man she loved, Marcel Cerdan, died in a plane crash. -Alex Smith  

This week, we explore new evidence comparing oral anticoagulants for acute venous thromboembolism, treatment for chemotherapy-induced thrombocytopenia, and early results of gene therapy for inherited deafness. We also examine evolving strategies for chronic lymphocytic leukemia, review the management of polymyalgia rheumatica, and present a case discussion of a woman with chest pain, dyspnea, and syncope. We explore gastric cancer prevention, competency-based billing, the health consequences of immigration enforcement, access to high-cost gene therapies, and we present a Perspective on good compressions.

This week, we explore a phase 3 trial of finerenone in type 1 diabetes and chronic kidney disease and guidance on timing of nonculprit-lesion PCI after STEMI. We cover an investigational therapy for Dravet syndrome and neoadjuvant treatment for high-risk intrahepatic cholangiocarcinoma. We review the effects of radiotherapy on normal tissue, a puzzling case of progressive neurologic decline after suspected foodborne illness, and Perspectives on private equity, the AHEAD model, and medical credit cards.

In this week's podcast episode in the Nutrition After Breast Cancer: Just the Facts series, I bring up the study that sparked that concern. I don't ignore things like this. I don't pretend they don't exist. If there's research being talked about, I want you to know about it. But here are the actual facts. The study was done in mice. The mice were made to consume about 40% of their diet in olive oil. And the rest of their diet was an obesogenic, high-carbohydrate diet designed to promote weight gain and metabolic dysfunction. That is not a Mediterranean diet. That is not olive oil drizzled over vegetables and salmon. That is not real life. It was a laboratory model designed to stress metabolism. Context matters. Deeply.   Resources Mentioned: Guide to Essential Fatty Acids: https://www.thebreastcancerrecoverycoach.com/oil Episode #326 Simplifying Seed Oils and Fatty Acids After Breast Cancer https://www.thebreastcancerrecoverycoach.com/326   Work with Laura: https://www.thebreastcancerrecoverycoach.com/health      REFERENCES: Obesity and Low-Fat Diet History Trends in Obesity Among Adults in the United States, 2005 to 2014 (CDC) https://www.cdc.gov/mmwr/preview/mmwrhtml/su6001a15.htm Documents obesity prevalence: 15.0% (1976-1980), 23.3% (1988-1994) Adult Obesity Prevalence Maps (CDC) https://pmc.ncbi.nlm.nih.gov/articles/PMC9611578/ 30.9% obesity prevalence (1999-2000) Adult Obesity Prevalence, 2021-2023 (CDC) https://www.cdc.gov/nchs/products/databriefs/db508.htm Current obesity prevalence: 40.3% How the Ideology of Low Fat Conquered America https://pubmed.ncbi.nlm.nih.gov/18296750/ Historical analysis of the low-fat movement Heart Disease Mortality Explaining the Decrease in U.S. Deaths from Coronary Disease, 1980–2000 (Ford et al., NEJM 2007) https://www.nejm.org/doi/full/10.1056/NEJMsa053935 ~51% decline in men, ~49% decline in women 47% from medical treatments, 44% from risk factor changes Obesity and diabetes offset gains by 8% and 10% Heart Disease Mortality in the United States, 1970 to 2022 https://www.ahajournals.org/doi/10.1161/JAHA.124.038644 89% decrease in heart attack deaths 81% increase in heart failure and other heart disease deaths Omega-3s, Inflammation, and Cancer Omega-6/Omega-3 Ratios and Modern Diets Ancestral ratios: 1:1 to 4:1 Modern Western diet: 15:1 to 20:1 Impact on eicosanoid metabolism and cellular inflammation DHA and Triple Negative Breast Cancer (Journal of Nutritional Biochemistry, 2019) DHA induced cell death in TNBC cells Mechanism: altered membrane composition, increased oxidative stress in cancer cells High-Fat Diets and TNBC Metastasis (Preclinical Studies) CD36-mediated fatty acid uptake in TNBC Oleic acid-rich diets promoting metastasis in mouse models Importance of tumor phenotype and metabolic flexibility   Let's Connect! If this episode helped you breathe a little easier, please share it with a friend or leave a review. Every share helps spread this message of hope, healing, and whole-person wellness.

Philippe Pinel remarked in 1800 that "It is an art of no little importance to administer medicines properly, but it is an art of much greater and more difficult acquisition to know when to suspend or altogether to omit them." This insight remains profoundly relevant today, especially in hospice care, where inappropriate prescribing is a common issue. Studies show that 20%–70% of hospice patients receive at least one unnecessary medication near the end of life, including drugs like antihypertensives, statins, and vitamins. In this episode of the GeriPal Podcast, we tackle the pressing topic of deprescribing at the end of life with expert guests Jennifer Tjia, Jon Furuno, and Simon Mooijaart. The conversation focuses on identifying medications that should almost always be discontinued—such as statins, osteoporosis meds, finasteride, and vitamins, which offer minimal benefit for patients with limited life expectancy. We also delve into more nuanced cases, such as antithrombotics, which present complex decisions that challenge clinicians, particularly when prognosis spans the many weeks to months range. Finally, we explore practical strategies for engaging patients and families in deprescribing conversations. Our guests highlight tools such as the FRAME mnemonic (Focus on the goals of care, Review current medications, Assess each medication's risk/benefit, Minimize the medication burden, and Evaluate regularly) and the Goal Concurrent Prescribing tool, which helps ensure medication decisions align with patients' values and end-of-life priorities. By: Eric Widera Other resources discussed in the podcast Prevalence and Factors Associated With Receiving a Prescription for Antithrombotic Therapy on Hospice Admission," JAGS. 2025 Discontinuation of Anticoagulants and Occurrence of Bleeding and Thromboembolic Events in Vitamin K Antagonist Users with a Life-limiting Disease. 2025 Effects of the discontinuation of antihypertensive treatment on neuropsychiatric symptoms and quality of life in nursing home residents with dementia (DANTON): a multicentre, open-label, blinded-outcome, randomised controlled trial. 2024 Perspectives on deprescribing in palliative care. Expert Review of Clinical Pharmacology. 2023 Developing a decision support tool for the continuation or deprescribing of antithrombotic therapy in patients receiving end-of-life care: Results of a European Delphi study. Thrombosis Research. 2025 Human-Centered Design Development and Acceptability Testing of a Goal Concordant Prescribing Program in Hospice. JPM 2025 Reduction of Antihypertensive Treatment in Nursing Home Residents. NEJM 2025  

AtualizarO que era impensável virou pauta de governo: estabelecer uma idade mínima para o acesso de menores a redes sociais. Neste episódio, exploramos os sérios riscos (violência sexual online, danos à saúde mental, prejuízo à atenção) e os benefícios (ativismo, conexão) da vida digital.Com Sheylli Caleffi e Rodrigo Nejm, analisamos a abordagem radical da Austrália e a chegada do Estatuto Digital da Criança e do Adolescente (ECA Digital) no Brasil, que exige autorização dos pais para menores de 16 anos e responsabiliza as plataformas.Aprenda sobre os sinais de desequilíbrio e as dicas práticas para famílias, como a importância da conversa aberta e a criação do "Acordo de Geladeira". Uma discussão essencial para entender o caminho mais realista e efetivo para proteger crianças e adolescentes. Vamos juntos!

Chronic diseases like heart disease, diabetes, and obesity are killing more people than ever before. Could your diet be the biggest driver of this risk? Today, Dr Mark Hyman explains why food matters more than genetics for long-term health, and how one diet change can make the biggest difference.  Alongside Professor Tim Spector, Mark, a 15-times New York Times bestselling author and a practising family doctor, explores how modern eating is linked to chronic disease and what the science says reduces risk. We break down how food is designed to make us eat more, how this affects metabolism, insulin and inflammation, and why this matters more than your genes. By the end of the episode, you'll understand the single most important dietary change Mark believes can lower chronic disease risk, based on clinical experience. If the modern world is driving these conditions, what's one small change you can make to take back control of your future health?