Podcasts about nejm

This week, we look at new research on potassium optimization in patients with defibrillators, reducing antihypertensive therapy in nursing homes, an mRNA influenza vaccine, and belzutifan for rare neuroendocrine tumors. We review long QT syndrome and present a case of abnormal behavior and seizures in a young man. We also explore perspectives on primary care reform, tobacco cessation in HIV and tuberculosis care, corporate control in health care, and the simple power of compassion with ice cream.

Send us a textBe honest—have you ever rescued a French fry from the floor? In this bite-size myth episode, I test the famous “5-second rule.” I walk through what actually transfers to your food (fast), when that matters, and why a little microbial exposure isn't always the villain—while drawing a hard line for high-risk settings and situations.Key Topics & TakeawaysThe verdict meter: The 5-second rule is false—bacteria can transfer in

Dobrovolní hasiči z Nového Veselí na Žďársku mají v jedné z garáží na stanici doslova historickou památku.

In this episode, we look at new trials on deferring arterial catheterization in shock, beta-blocker use after myocardial infarction, and a treatment for triple-negative breast cancer. We review acromegaly. A case describes a man with dyspnea, edema, and pacemaker lead displacement. We explore perspectives on the burdens of primary care, the erosion of harm reduction, child health policy, and the meaning of hospice.

Joshua Barocas is an associate professor of medicine at the University of Colorado Anschutz Medical Campus. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. J.A. Barocas. The Erosion of Harm Reduction. N Engl J Med 2025;393:1865-1867. B.A. Barsky, A. Caplan-Bricker, and C. Robertson. Religious Liberty as a Shield for Public Health — The Case of Overdose-Prevention Centers. N Engl J Med 2025;393:1867-1869.

The ARRIVE Trial and the Term Breech Trial reshaped modern birth practices in ways researchers never intended. From skyrocketing inductions to the loss of vaginal breech training, these studies reveal how even “gold-standard” science can miss the human side of birth.Clara invites you to take a mindful pause: to look beyond the data, question how evidence gets translated into policy, get curious about how the research was designed, and remember that true evidence-based care must center the individual—not just the research.You'll Learn:What the ARRIVE Trial and the Term Breech Trial actually found (and what they didn't)How these studies shifted policy, practice, and training worldwideWhy over-reliance on “evidence” can erase skills, intuition, and personal choiceHow to bring mindfulness into your decision-making about induction, breech birth, or any medical recommendationWhy traditional and holistic birth practices still matter—even if they've never been studiedMindful Reflection“Mindfulness isn't about ignoring evidence—it's about pausing long enough to ask, ‘Does this research apply to me, in my body, in this context?' True evidence-based care is a dialogue between research, clinician experience, and your own wisdom.”Resources MentionedDownload Clara's Free Birth Plan Template, used at over 5,000 births.Ready for an evidence based birth class? Check out A Path to A Powerful BirthThe Birth Advocacy Toolkit is a great option for expectant parents who have already taken a class but want to make sure their preferences are heard and want evidence based information to help make their decisions. Evidence Based Birth: Evidence on the ARRIVE Trial and Elective Induction at 39 WeeksEvidence Based Birth: Evidence on Breech BirthGrobman WA, et al. Labor Induction versus Expectant Management in Low-Risk Nulliparous Women. NEJM, 2018.Evidence Based Birth: “Evidence on the ARRIVE Trial and Elective Induction at 39 Weeks.”Nethery E, et al. Obstet Gynecol, 2023. Post-ARRIVE induction impact study.Hannah ME, et al. Planned Cesarean vs Planned Vaginal Birth for Breech. Lancet, 2000.Kotaska A. BMJ, 2004. “Inappropriateness of RCTs for complex intrapartum phenomena.”Goffinet F, et al. PREMODA Study. Am J Obstet Gynecol, 2006.RCOG Green-top Guideline No. 20b (2017).ACOG Committee Opinion No. 745 (2018).SOGC No. 384 (2019).Get 20% off your first monthly subscription with NEEDED Vitamins 

Rethinking "default lines" in the ICU

In this episode, we discuss long-term outcomes after chest-wall irradiation for breast cancer, new treatments for psoriasis and obesity, and early results on a vaccine for Lassa fever. We review opioid deprescribing and a clinical case describes spiraling into a distant past. Perspectives examine the corporatization of health care, the health effects of new energy legislation, and Medicaid cuts affecting U.S. children.

Yashaswini Singh is an assistant professor of health services, policy, and practice at Brown University. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. Y. Singh. The Antitrust Antidote to Hospital and Nursing Home Corporatization — Promises and Pitfalls. N Engl J Med 2025;393:1761-1764.

Right on the heels of the release of the 2025 AHA guidelines, including one on preferentially using IVs over IOs, comes two RCTs in the same edition of NEJM that compare intial attempts with IVs to IOs in out of hospital cardiac arrest. Dr Jarvis discusses these two papers while answer a listeners question, and tries to put this, and early epinephrine, into context. And he might throw in some commentary about the AHA's recommendations on mCPR and Heads Up CPR.Citations:1. Couper K, Ji C, Deakin CD, et al. A Randomized Trial of Drug Route in Out-of-Hospital Cardiac Arrest. N Engl J Med. 2025;392(4):336-348. doi:10.1056/NEJMoa24077802. Vallentin MF, Granfeldt A, Klitgaard TL, et al. Intraosseous or Intravenous Vascular Access for Out-of-Hospital Cardiac Arrest. N Engl J Med. 2025;392(4):349-360. doi:10.1056/NEJMoa2407616

Here's a polished podcast blurb suitable for LinkedIn, BlueSky, or Apple Podcasts listings — written in the JIMD Podcast tone and style: ⸻ It's one of the most talked-about breakthroughs of 2025, a first-in-human demonstration of in vivo gene editing to treat an inherited metabolic disease. In this episode, Kiran Musunuru and Rebecca Ahrens-Nicklas are joined by Julien Baruteau to unpack what this means for the field. They explore the science behind gene editing, the importance of ethical design, and the emotional weight of stopping therapy once enzyme function is restored. The conversation bridges the NEJM landmark paper (Musunuru et al., 2025) and the accompanying JIMD editorial (Rahman & Baruteau, 2025), reflecting on what this moment tells us about the future of metabolic medicine and how ready we are for it. First in Human Gene Editing for an Inherited Metabolic Disease Shamima Rahman, Julien Baruteau https://doi.org/10.1002/jimd.70056 Patient-Specific In Vivo Gene Editing to Treat a Rare Genetic Disease Kiran Musunuru, et al https://www.nejm.org/doi/10.1056/NEJMoa2504747

The FiltrateJoel Topf‍ ‍@kidneyboy.bsky.social‬Swapnil Hiremath@hswapnil.medsky.socialAC @medpeedskidneys.bsky.socialSpecial GuestMike Walsh Associate Professor in the Departments of Medicine and Health Research Methods, Evidence, and Impact, McMaster University as well as a Scientist at the Population Health Research Institute and a nephrologist at St. Joseph's Healthcare Hamilton where he is the Chair of the Clinical Nephrology Research Group. Editing and Show Notes bySophia AmbrusoThe Kidney Connection written and performed by Tim YauShow NotesALCHEMIST (NephJC Shorts, Rossignol et al Lancet 2025)AC is in her 83rd year of med-peds fellowship.Joel's monologue brings us all down.Prophylactic ICD therapy doesn't improve sudden cardiac death or all-cause mortality in HD patients in the ICD2 trial (Jukema JW et al. Circulation 2019)Initiation with statins do not impact MACE endpoints or atherosclerotic events (4D AURORA trial Fellstrom BC et al. NEJM 2009 & SHARP trial Baigent C et al. Lancet 2011)Mike tries to liven up the mood by mentioning positive outcomes with iron therapy in heart failure with the PIVOTAL trial (Macdougall IC et al. NEJM 2018)TOPHAT trial revealed treatment with spironolactone in HFpEF did not affect MACE outcomes. (Pitt B et al. NEJM 2014)NephTrials ‘Run-in periods in clinical trials: What can we ACHIEVE?'SPIN D trial - spironolactone dose finding trial in ESRD (Charytan DM et al. Kidney Int 2018)Mike shares the human experience of the trial after being instructed to end the trial prematurely and being told they have “answered their question”Study in Japan - spironolactone predominantly benefits male over females (cannot find this)Male vs female benefit not observed in ACHIEVE despite Mike's initial hypothesisSwap compares and contrasts ACHIEVE, ALCHEMIST & Meta-analysis (Pyne L et al. Lancet 2025)Mike discusses how nonadherence to spironolactone impacted the intention to treat outcomes in the trial.What is a high risk of bias for dummies?Mike, Swap & Joel ponder future nsMRA or ASI trials hemodialysis?Tubular secretionsSwap is probably stalking Martha Wells by now, has moved on from Witch King, now onto Queen Demon on Good ReadsAC is adding to her brood, 2 dogs (Snickers & Harper), 1 childDungeon Crawler Call - a science fantasy book series by Matt Dinniman (on goodreads), which he lovingly referred to as complete nerd trash.Joel is binging on the series Task on HBO max, featuring Mark Ruffalo as FBI agent.NephJC is having its annual fundraiser (get your tickets here) at ASN. Providing a party shuttle that is leaving every 30 minutes from the conference center. As always, it will feature a live podcast recording covering the ASN late breaking, high impact clinical trials.Swap describes the high impact model at ASN this year - go big or go home.

Dr Dave teaches Dr Jo about Suicide prevention with new NHS and NICE guidance discouraging risk stratification tools and instead emphasising relational safety, a biopsychosocial approach, dynamic safety planning, inclusivity, and clear communication. Dr Dave covers paediatric gastroenteritis, a recent NEJM study confirms oral ondansetron's effectiveness in reducing vomiting in children, with NZFC guidance supporting its use for dehydration-related cases. Privacy and safety intersect in the discussion of HIPC Rule 11, which allows clinicians to disclose health information without consent if there is a serious threat to life or health, provided specific criteria are met and documentation is thorough. In diabetes care, once-weekly insulin icodec is found to be as effective as daily long-acting insulins, though it is not yet approved in New Zealand and is more costly. Insomnia management advances include the approval of lemborexant, a DORA, with evidence supporting its efficacy and safety, though it remains unsubsidised. COPD management is updated with guidance on triple therapy and the role of eosinophil counts, while iron deficiency is clarified with new diagnostic and monitoring recommendations. Finally, Dr Jo learns about some adult ADHD management resources and gets recent insights into QTc-prolonging medications.

Witam Państwa, nazywam się Jarosław Drożdż, pracuję w Centralnym Szpitalu Klinicznym Uniwersytetu Medycznego w Łodzi, skąd nagrywam podcast Kardio Know-How. W tym odcinku rozpoczynam omawianie doniesień z tegorocznego kongresu TCT.Właśnie zakończył się kongres TCT 2025 w San Francisco, jedno z najważniejszych spotkań kardiologów interwencyjnych na świecie. W centrum uwagi znalazły się nowe przezskórne zastawki mitralne, ale dziś skupmy się na klasyce – TAVI i stenozie aortalnej. Przezskórna implantacja zastawki aortalnej stała się rewolucją – minimalnie inwazyjna, bezpieczna i o skuteczności porównywalnej z chirurgiczną wymianą. Seria badań PARTNER (1–3) zmieniła leczenie ciężkiej stenozy aortalnej, poszerzając wskazania do TAVI od pacjentów wysokiego po niskie ryzyko operacyjne. PARTNER 1 wykazał przewagę TAVI nad leczeniem zachowawczym i porównywalność z AVR u chorych wysokiego ryzyka: https://www.sciencedirect.com/science/article/pii/S0140673615603087?via=ihub. PARTNER 2 potwierdził równoważność TAVI i AVR u pacjentów umiarkowanego ryzyka: https://www.nejm.org/doi/10.1056/NEJMoa1514616. PARTNER 3 objął chorych niskiego ryzyka (STS

This week, we look at new findings from the European prostate cancer screening study, advances in lung cancer therapy, physical therapy for meniscal tear, and a promising vaccine for Salmonella Paratyphi A. We review noninvasive liver fibrosis assessment and a complex clinical case, and explore perspectives on concierge care, kidney disease equity, WIC enrollment, community health, FDA regulation, and standing with colleagues in Gaza.

Během Dušiček bude hřbitov otevřený, pak ho ale město nechá zavřít. Kromě odstranění staré dlažby a srovnání cestiček mezi hroby dělníci na hřbitově kácí také vzrostlé túje a osazují nové osvětlení.

Autism isn't new, but our understanding of it has changed dramatically. It's now recognized as a broad neurodevelopmental spectrum that shapes how millions of people perceive, process, and interact with the world. In this episode, we explore what autism is AND isn't, from its earliest signs in infancy to its deep genetic roots, and why misinformation about it continues to spread. We speak with three remarkable experts leading the field in early detection, genetics, and public education: DR. AMI KLIN, PhD, Director of the Marcus Autism Center at Emory University and a pioneer in early autism research, whose work shows autism can be identified in babies as young as two months old. DR. JOSEPH BUXBAUM, PhD, Director of the Seaver Autism Center at Mount Sinai and a global leader in autism genetics, uncovering hundreds of genes linked to the condition. DR. ANDREA LOVE, immunologist, microbiologist, and founder of ImmunoLogic, known for her clear, evidence-based communication about vaccines, immunity, and autism myths. Together, we discuss: • What autism really is, and how the definitions have evolved • How it develops in infancy (and why early diagnosis can be so critical) • The powerful genetic evidence behind autism • The persistence of vaccine myths, and how misinformation spreads • How technology like eye-tracking can detect autism early • The rise of “profound autism” and what it means for families • The future of genetics-based treatments and therapy Whether you're autistic yourself, a parent navigating a new diagnosis, or simply seeking understanding, we're thrilled to share this extensive, in-depth episode with you. This is... Your Brain On Autism. SUPPORTED BY: the 2026 NEURO World Retreat. A 5-day journey through science, nature, and community, on the California coastline: https://www.neuroworldretreat.com/ ‘Your Brain On' is hosted by neurologists, scientists, and public health advocates Ayesha and Dean Sherzai. ‘Your Brain On... Autism' • SEASON 6 • EPISODE 1 LINKS Dr. Ami Klin at Emory University: https://ctsn.emory.edu/faculty/klin-ami.html Dr. Ami Klin at Marcus Autism Center: https://www.marcus.org/about-marcus-autism-center/meet-our-leadership/ami-klin  Dr. Joseph Buxbaum at Mount Sinai: https://profiles.icahn.mssm.edu/joseph-d-buxbaum  Dr. Andrea Love's website: https://www.immunologic.org/ Dr. Andrea Love on Instagram: https://www.instagram.com/dr.andrealove  REFERENCES Autism Spectrum Disorder: A Review. JAMA, 2023. https://jamanetwork.com/journals/jama/article-abstract/2800182  Is There a Bias Towards Males in the Diagnosis of Autism? A Systematic Review and Meta-Analysis. https://link.springer.com/article/10.1007/s11065-023-09630-2  Acetaminophen Use During Pregnancy and Children's Risk of Autism, ADHD, and Intellectual Disability. https://pubmed.ncbi.nlm.nih.gov/38592388/  Eye-Tracking–Based Measurement of Social Visual Engagement Compared With Expert Clinical Diagnosis of Autism. https://jamanetwork.com/journals/jama/fullarticle/2808996  Rare coding variation provides insight into the genetic architecture and phenotypic context of autism. https://www.nature.com/articles/s41588-022-01104-0  Rare coding variation illuminates the allelic architecture, risk genes, cellular expression patterns, and phenotypic context of autism. https://www.medrxiv.org/content/10.1101/2021.12.20.21267194v1  Andrew Wakefield and the fabricated history of the alleged vaccine-autism link. https://geneticliteracyproject.org/2024/04/29/andrew-wakefield-and-the-fabricated-history-of-the-alleged-vaccine-autism-link/ VACCINES & AUTISM 1. Major Cohort Studies Hviid et al., 2019 – Annals of Internal Medicine A nationwide study of 657,461 Danish children found no increased risk of autism in vaccinated children compared to unvaccinated peers — even among those with risk factors such as a sibling with autism. Ann Intern Med. 2019;170(8):513–520 Madsen et al., 2002 – New England Journal of Medicine In 537,303 Danish children, researchers found no difference in autism rates between vaccinated and unvaccinated groups, and no relationship with age, timing, or date of vaccination. NEJM. 2002;347:1477–1482 Jain et al., 2015 – Journal of the American Medical Association (JAMA) A U.S. cohort of 95,727 children — including those with siblings with autism — showed no link between MMR vaccination and autism risk, even in genetically predisposed children. JAMA. 2015;313(15):1534–1540 Madsen et al., 2003 – JAMA A study of 467,450 Danish children found no relationship between thimerosal-containing vaccines and autism. JAMA. 2003;290(13):1763–1766 DeStefano et al., 2022 – Vaccine A retrospective cohort of over 500,000 U.S. children with ASD found no increase in adverse events or worsening of autism-related symptoms following vaccination. Vaccine. 2022;40(16):2391–2398 2. Population-Level Epidemiologic Evidence Taylor et al., 1999 – The Lancet One of the earliest large epidemiological studies found autism prevalence was the same in vaccinated and unvaccinated children, and the age of onset was unrelated to the timing of MMR vaccination. Read: Lancet. 1999;353(9169):2026–2029 Institute of Medicine (U.S.) Immunization Safety Review, 2011 A global review of studies from the U.S., Denmark, Sweden, and the U.K. concluded there is no causal relationship between vaccination status and autism, and no plausible biological mechanism linking vaccines (including thimerosal) to ASD. Read: National Academies Press / PubMed 20669467 3. Systematic Reviews and Meta-Analyses Taylor et al., 2014 – Vaccine A comprehensive meta-analysis of 10 studies including over 1.2 million children found no association between vaccination and autism or ASD. Vaccine. 2014;32(29):3623–3629 Maglione et al., 2014 – Pediatrics Review of 67 high-quality studies covering the full U.S. immunization schedule concluded that vaccines are safe, adverse events are rare, and there is no link to autism, type 1 diabetes, or other chronic conditions. Pediatrics. 2014;134(2):325–337 Parker et al., 2004 – Pediatrics Systematic review of 10 primary studies examining thimerosal exposure found no relationship between vaccines and ASD. Authors noted that studies showing an association were methodologically flawed or biased, while robust studies consistently showed safety. Pediatrics. 2004;113(6):1904–1910 Offit & Hackett, 2003 – Clinical Infectious Diseases Review of immunology and epidemiology concluded that claims that vaccines “overwhelm” or “damage” the immune system are not biologically plausible based on how the immune system actually functions. Clin Infect Dis. 2003;46(9):1450–1456

In this episode, we look at new research on mucoactive therapy for bronchiectasis, aspirin use in anticoagulated patients with coronary disease, and sotatercept for early pulmonary arterial hypertension. We explore the genetics behind misdiagnosed common diseases and review uncertainty in medical training. We also share a case of woman with abdominal distention, edema, and pleural effusions and Perspectives on sickle cell disease, fetal personhood, and living with a genetic diagnosis.

Eberechi Nwogu-Onyemkpa is an assistant professor in the Division of Palliative Medicine at Washington University in St. Louis. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. E. Nwogu-Onyemkpa and Others. Involving Palliative Care to Improve Outcomes in Sickle Cell Disease. N Engl J Med 2025;393:1553-1556. E. Costa and Others. Thirty Years of Hydroxyurea for Sickle Cell Anemia — Scientific Progress, Global Health Gaps. N Engl J Med 2025;393:1556-1559.

The FiltrateJoel Topf @kidneyboy.bsky.social‬Swapnil Hiremath @hswapnil.medsky.socialNayan Arora captainchloride.bsky.socialSopia Ambruso @sophia-kidney.bsky.socialSpecial Guests Brendon Neuen @brendonneuen.bsky.social Associate Professor and Program Lead, Renal and Metabolic at The George Institute for Global Health. Nephrologist and Director of Kidney Trials at Royal North Shore Hospital.Neuen has had three prior appearances on Freely Filtered: EMPA Kidney, DUPLEX and Sparsentan in FSGS, FLOW and SemaglutideMuthiah Vaduganathan @mvaduganathan on X. Cardiologist at Brigham and Women's Hospital and Harvard Medical School. Assistant Professor of Medicine.Editing byJoel TopfThe Kidney Connection written and performed by Tim YauShow NotesDONATE to NephJC! Finerenone with Empagliflozin in Chronic Kidney Disease and Type 2 Diabetes NEJM | NephJC SummaryFIDELIO Bakris et al, NEJM 2020 | NephJC Summary; subgroup throws doubt on efficacy of finerenone in patients on flozinsFIGARO Pitt et al, NEJM 2021; subgroups clearly shows finerenone works, flozins or notNEJM editorial (wrongly) saying do not use Flozins unless on RASi Don't use dual RAS blockade ONTARGET Yusuf et al, NEJM 2008; VA NEPHRON-D Fried et al NEJM 2013Why we cannot study finerenone in HFrEF (RALES Pitt et al NEJM 1999) Muthu is jealous of GFR slope and albuminuria surrogate endpoints and wants to borrow them for HFpEF (Inker et al EHJ 2025)Combination therapy and CV outcomes in hypertension (Wang et al JAMA Card 2024 on low dose combinations and BP; Egan et al Blood Pressure 2022 review of topic) CONFIRMATION HF trial registry entry (Finerenone and Empagliflozin in hospitalized patients with HF)23:20: Nayan and Swap miss a chance to say ‘de-flozination' to discuss stopping a flozin which would allow a patient to be included in the trial Finerenone is a CYP3A4 substrate (Heinig et al Clin Pharmacokinetics 2023); Useful list of CYP3A4 inducers and inhibitors Everyone should get an ABPM (Bugeja et al CMAJ 2022)EASiKIDNEY study design Albuminuria mediates CKD benefits with Finerenone (Agarwal et al Ann Intern Med 2023)GFR slope and Albuminuria and the FDA (Taylor et al eClin Med 2025) Dapagliflozin and Eplerenone combination crossover trial (Provenzano et al JASN 2022)Joel gets promoted! (PBFluids reflection) Bluesky NephJC Chat discussion on ‘renal remission' Withdrawal of Finerenone and worse outcomes from FINEARTS (Vaduganathan et al JACC 2025)Combination therapies Analysis from Brendan and Muthu (Neuen et al Circulation 2024)Do not use KFRE when GFR > 60 (KDIGO Practice Point 2.2.4: Note that risk prediction equations developed for use in people with CKD G3–G5, may not be valid for use in those with CKD G1–G2) Finerenone vs Spironolactone trial in Primary Aldosteronism (Hu et al Circulation 2025)FIND CKD trial design (Heerspink et al NDT 2025) FINE-ONE trial design (Heerspink et al Diab Res Practice 2023) Tubular SecretionsNayan keeping his chin up as Yankees lose and Mariners follow (MLB Playoffs)Sophia's adventures with Beekeeping (Royal Jelly?) Brendon loves listening to ‘Susan' by Raye Muthu is back into Taekwondo Swap is still reading Martha Wells (Witch King on GoodReads)Joel will be hiking the Laugavegur trail in Iceland

On March 7, 2025, we released an episode summarizing key aspects of a NEJM publication regarding male partner therapy for women with recurrent BV. Although that study had limitations, the results were very surprising. Now, on 10/16/25 (7 months later), the ACOG has a new Clinical Practice Update (CPU) on this very issue. In this episode we will briefly summarize that March 2025 NEJM publication and highlight the TWO updated clinical recommendations from the ACOG regarding male partner therapy for the prevention of BV in women. PLUS, we will briefly discuss why although male partner therapy should be considered, partner EPT is “not recommended” at this time by the ACOG. 1. ACOG CLINICAL PRACTICE UPDATE: Concurrent Sexual Partner Therapy to Prevent Bacterial Vaginosis Recurrence Obstetrics & Gynecology ():10.1097/AOG.0000000000006102, October 16, 2025. | DOI: 10.1097/AOG.00000000000061022. Chapa Clinical Pearls March 2025 Episode: https://open.spotify.com/episode/4sW9tTe9CdYVQsCRBjqQQP3. Vodstrcil LA, Plummer EL, Fairley CK, Hocking JS, Law MG, Petoumenos K, et al. Male-partner treatment to prevent recurrence of bacterial vaginosis. N Engl J Med 2025;392:947–57. doi: 10.1056/NEJMoa2405404STRONG COFFEE PROMO: 20% Off Strong Coffee Company https://strongcoffeecompany.com/discount/CHAPANOSPINOBG

Microplastics — once dismissed as environmental debris — are now being found in the brain, placenta, heart, and bloodstream.

In this episode, we look at new research in cervical cancer, lupus, gene therapy for immune deficiency, and malaria prevention in infants. We review hair loss in women, follow a case of tuberculosis in advanced HIV, and hear perspectives on vaccines, primary care, digital health, infection surveillance, AI in disaster response, Medicare policy, and bearing witness in conflict zones.

In this episode, Dr. Jonathan Chen joins the hosts to discuss his path from teenage programmer to Stanford physician-informatician and why machine learning has both thrilled and unnerved him. From his 2017 NEJM essay warning about “inflated expectations” to his latest studies showing GPT‑4 outperforming doctors on diagnostic tasks, Dr. Chen describes a discipline learning humility at machine speed. This conversation spans medical education, automation anxiety, magic, and why empathy—not memorization—may become the most valuable clinical skill. Transcript.

Michael Liu is a resident physician at Brigham and Women's Hospital. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. M. Liu, K.T. Kadakia, and R.K. Wadhera. Proliferation of Prior Authorization in Traditional Medicare — None the WISeR? N Engl J Med 2025;393:1457-1459.

In this episode, we explore new treatments for hypertension, hereditary amyloidosis, and malaria prevention, along with insights on mosquito-borne disease control. We review idiopathic intracranial hypertension, follow a striking case of a hidden foreign body, and hear perspectives on worker safety, immigrant health care, the role of pharmaceutical wholesalers, and the arc of a medical career.

Andrew Gabrielson is a pediatric urology fellow at Lurie Children's Hospital of Chicago. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. A.T. Gabrielson and C. Corwin. Occupational Health and Safety on the Chopping Block — What's at Stake? N Engl J Med 2025;393:1353-1355.

Featuring articles on severe acute malnutrition with gastroenteritis in children, medical imaging and pediatric cancer risk, moderate hypertriglyceridemia, preventing RSV disease in healthy infants, and treating hypertension in rural South Africa; a review article on monoclonal gammopathy of undetermined significance; a Clinical Problem-Solving on a shifting frame; and Perspectives on insight into corporate governance, on pharmaceutical tariffs, and on OUD medications.

Steven Lipstein is the former chief executive officer of BJC HealthCare. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. S. Lipstein. Insight into Corporate Governance — What Motivates Hospitals and Delivery Systems. N Engl J Med 2025;393:1249-1251.

Featuring articles on heart failure, provoked venous thromboembolism, chronic lymphocytic leukemia, and acute ischemic stroke; a review article on medical education to improve diagnostic equity; a case report of a man with embolic stroke and left ventricular apical aneurysm; two articles on the 2025 Lasker–DeBakey Clinical Medical Research Award; and Perspectives on structural and scientific racism, on the Gates Foundation's final chapter, and on Dr. Kolhouse and the cowboy.

In this journal club, we will discuss two pivotal studies in ILD, the FIBRONEER study and the RECITAL study: Nerandomilast in Patients with Progressive Pulmonary Fibrosis, Maher, T.M. et al. NEJM. 2025 May 19. doi: 10.1056 Rituximab versus intravenous cyclophosphamide in patients with connective tissue disease-associated interstitial lung disease in the UK (RECITAL): a double-blind, double-dummy, randomised, controlled, phase 2b trial, Maher T.M., et al. Lancet 2023 Jan;11(1). doi: 10.1016 Panelists: Toby Maher, MD Shervin Assassi, MD Jack Cush, Moderator

Nancy Krieger is a professor of social epidemiology at the Harvard T.H. Chan School of Public Health. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. N. Krieger and M.T. Bassett. Structural and Scientific Racism, Science, and Health — Evidence versus Ideology. N Engl J Med 2025;393:1145-1148.

Send us a Text Message (please include your email so we can respond!)Episode 74! We talk about the history and current practice of SBTs with "Providers Consistently Delay Extubation After Successful Spontaneous Breathing Trials" by Barker et al in Annals of the ATS and the original 1996 SBT article by Ely et al in NEJM.SBT: https://pubmed.ncbi.nlm.nih.gov/8948561/SBT (NEJM): https://www.nejm.org/doi/10.1056/NEJM199612193352502SBT Timing: https://pubmed.ncbi.nlm.nih.gov/40393063/SBT Timing (Annals ATS): https://www.atsjournals.org/doi/10.1513/AnnalsATS.202502-188OCIf 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!

Featuring articles on PI3K-altered colorectal cancer, type 2 diabetes, oral semaglutide, and proportional-assist ventilation; a review article on tumor lysis syndrome; a case report of a girl with chest pain and bone and liver lesions; and Perspectives on integrating pharmacotherapy into tobacco control, on Medicaid enrollees with chronic conditions, and on ultraprocessed food.

A large meta-analysis in The Lancet found clopidogrel superior to aspirin for long-term secondary prevention in coronary artery disease, reducing major cardiovascular events by 14% without added bleeding risk. The REBOOT trial in NEJM showed no benefit of beta-blockers in post-MI patients with preserved ejection fraction, and even potential harm in women on high doses, prompting reevaluation of routine use. Finally, a phase 2 trial in JAMA Internal Medicine showed daily azelastine nasal spray reduced COVID-19 incidence by 67% and shortened illness duration, though larger studies are needed to confirm its prophylactic role.

John Ayanian is the director of the Institute for Healthcare Policy and Innovation at the University of Michigan. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. J.Z. Ayanian. Protecting Medicaid Enrollees with Chronic Conditions amid Work Requirements. N Engl J Med 2025;393:1044-1046.

Featuring articles on hypertrophic cardiomyopathy, rehabilitation after myocardial infarction in older adults, the 2024 Marburg virus disease outbreak in Rwanda, and medications for opioid use disorder in county jails; a case report of a woman with dyspnea and fatigue; a Medicine and Society on the race-correction debates; and Perspectives on recent efforts toward equity, on medical research funding in a divided America, and on the end of days.

Featuring articles on obesity, type 1 diabetes, syphilis, and heparin-induced thrombocytopenia; a review article on the management of acute type B aortic dissection; a Clinical Problem-Solving describing a fruitful workup; and Perspectives on the corporatization deal, on advancing physician-scientist training in China, and on the rise of drug innovation in China.

With all the attention focused on Alzheimer's biomarkers and amyloid antibodies, it's easy to forget that comprehensive dementia care is more than blood draws and infusions. On today's podcast, we buck this trend and dive into the complexities and challenges of comprehensive dementia care with the authors of two pivotal articles recently published in JAMA. We've invited David Reuben and Greg Sachs to talk about their two respective trials, published in JAMA — D-CARE and IN-PEACE — aimed at improving the evidence for care models supporting individuals diagnosed with dementia. D-CARE tested the comparative effectiveness of health system-based dementia care, a community-based program, and usual care, while IN-PEACE assessed the addition of palliative care to dementia care programs for individuals with moderate to severe dementia. Despite their pragmatic trial designs and high expectations, both studies' primary outcomes were negative, although there were some intriguing positive secondary outcomes. We discuss how some critical questions about the integration of these findings into practice, and how they fit in with previous research that did show benefits (see this past podcast on using health navigators to improve dementia care). If you want to learn more about comprehensive dementia care, check out these past podcasts: Our previous podcast on comprehensive dementia care with Lee Jennings and Chris Callahan Our podcast on the GUIDE Model with Malaz Boustani and Diane Ty Our podcast on Transforming the Culture of Dementia Care with Anne Basting, Ab Desai, Susan McFadden, and Judy Long Lastly, here is the link to Greg Sachs' NEJM article that describes his maternal grandmother decline from Alzheimer's disease.