Podcasts about nejm

Featuring articles on myeloma, mitochondrial DNA disease, cardiac surgery, and squamous-cell carcinoma; a review article on motor vehicle crash prevention; a case report of a woman with seizure-like activity and odd behaviors; a Medicine and Society article on the evaluation of occupational pulmonary impairment; and Perspectives on Covid-19 vaccines, on public policies, and on living on the edge of the valley of the sick.

A new NEJM trial found methotrexate offers similar lung function improvements as prednisone in pulmonary sarcoidosis, but with fewer side effects—suggesting it could be a safer first-line option for some patients. A JAMA study revealed that patients trust physicians less when AI is mentioned in care ads, highlighting the importance of framing AI as a tool that supports—not replaces—clinical judgment. Another NEJM trial showed that giving take-home ondansetron to children after ED visits for gastroenteritis significantly reduced vomiting and return visits, with no added risks. Together, these studies support a shift toward individualized care, better patient communication, and practical interventions to improve outcomes.

什麼是猝睡症？ 過去如何治療猝睡症？ 你知道有一款猝睡症藥物剛通過二期臨床試驗嗎？ 本集《會談地圖》將為各位導讀刊載在《新英格蘭醫學期刊》（NEJM）一款猝睡症新藥成功開發的研究，讓我們更深入了解猝睡症與未來治療的新方向！ 本集重點：什麼是猝睡症？食慾素（orexin）於猝睡症生理機制中扮演的重要角色Oveporexton如何突破血腦屏障？臨床試驗發現的副作用以及臨床評估指標我們應如何解讀臨床試驗？ 一起透過認識這項突破性的臨床試驗研究，了解猝睡症的新藥開發過程中有哪些重要的醫學藥理發現，而這又對未來的藥物研發與臨床決策具有何種意義吧！ Powered by Firstory Hosting

Featuring articles on type 2 diabetes, gastric cancer, lung cancer, and malaria; a review article on competency-based medical education; a case report of a man with cough, dyspnea, and hypoxemia; and Perspectives on brain death in pregnancy, on the Supreme Court's failure to protect trans minors, on real-world data, and on avocado and salt.

Katie Watson is a professor of medical education, medical social sciences, and obstetrics and gynecology at the Northwestern University Feinberg School of Medicine. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. K. Watson. Brain Death in Pregnancy — Abortion, Advance-Directive, or End-of-Life Law? N Engl J Med 2025;393:313-315.

The 2017 NEJM study, ALPS, compared amiodarone, lidocaine, and placebo for refractory shockable rhythms in adults with out of hospital cardiac arrest. They found no significant difference in survival to hospital discharge or functional survival between any of the arms. If that study has left you confused, you're not alone. And you're in luck. Tanner Smida joins us again to discuss his latest paper using something called target trial emulation to assess the difference in ROSC and survival to discharge between amiodarone and lidocaine. This is a great discussion of his paper, the methodology, and how we can put his results into the context of ALPS.Citations:1.Smida T, Crowe R, Price BS, Scheidler J, Martin PS, Shukis M, Bardes J: A retrospective ‘target trial emulation' comparing amiodarone and lidocaine for adult out-of-hospital cardiac arrest resuscitation. Resuscitation. 2025;March;208:110515.2. Kudenchuk PJ, Brown SP, Daya M, Rea T, Nichol G, Morrison LJ, Leroux B, Vaillancourt C, Wittwer L, Callaway CW, et al.: Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest. N Engl J Med. 2016;May 5;374(18):1711–22.3.Hernán MA, Robins JM: Using Big Data to Emulate a Target Trial When a Randomized Trial Is Not Available: Table 1. Am J Epidemiol. 2016;April 15;183(8):758–64.

Why does maintaining weight loss feel like assembling furniture with missing instructions? Today's episode gets honest about why holding onto lost pounds is a full-time job—and why biology, mood, and your environment all play their part. Learn the science behind real setbacks, cut through the usual blame scripts, and take home proven tools for building a plan you can actually stick with.Key TakeawaysWeight regain is incredibly common (over 80% of people), not a sign of weakness or lack of effortYour hormones shift after weight loss, increasing appetite and making maintenance feel like an uphill climbMetabolism adapts by slowing down, so former dieters require fewer calories than those who have always been at a lower weightEmotional triggers, cravings, and modern food environments are part of the challenge—this is not just a “willpower” issueConsistent daily movement, high fiber intake, mindful eating (ditch screens), and small habit shifts are the foundationSupplements may help but avoid anything promising miracles—stick with well-supported options and professional adviceSupport, honest self-checks, and adjusting strategies over time matter more than chasing perfectionRegain is normal and a cue to adapt, not a reason to quitResources MentionedNational Weight Control RegistrySumithran, P. et al. (2011). "Long-Term Persistence of Hormonal Adaptations to Weight Loss." The New England Journal of Medicine.Mann, T., Tomiyama, A.J., et al. (2007). "Medicare's Search for Effective Obesity Treatments: Diets Are Not the Answer." American Psychologist, 62(3), 220–233.Wyatt, H. R., Grunwald, G. K., et al. (2002)."Long-term weight loss and breakfast in subjects in the National Weight Control Registry." Obesity Research 10(2): 78-82.Actionable Steps for ListenersAdd a 10-20 minute walk to your day—no fancy gear requiredSwap your usual snack for a high-fiber choice (berries, vegetables, or popcorn work well)Eat one screen-free meal, tuning in to your hunger cues and satisfactionWeigh in and record the number as information, not a judgementWhen a craving hits, pause and ask: habit or genuine hunger? Act on your answerRelevant Links and CitationsNational Weight Control Registry: Strategies for SuccessSumithran P, et al. NEJM 2011: Hormonal Adaptations to Weight LossMann T, Tomiyama AJ et al., American Psychologist, 2007Wyatt HR, et al. Obesity Research, 2002

Microsoft v květnu pohřbil Skype. Vlastně to byl dlouhodobý proces. Softwarový gigant nepochopitelně promarnil potenciál slavné značky. Její význam dokládá, že se z ní stalo sloveso. Nejméně jedna generace ví, co to znamená „skajpovat“. Skype měl náskok, stejně ho ale převálcovaly WhatsApp, Messenger a spol.Část jeho obtíží vycházela z původní P2P architektury. V začátcích byla skvělá, jenže technologický svět se rychle proměnil. Nastoupily smartphony a mobilní internet. P2P se stalo kotvou a Microsoft na změny nedokázal reagovat. Skype byl nespolehlivý a klienty těžkopádné. Než se obtíže vyřešily, světu vládly jiné komunikátory. Skype už neudával směr a upadal do zapomnění.Dodnes platí za čtvrtou nejnákladnější akvizici Microsoftu. V roce 2011 za službu zaplatil 8,5 miliardy dolarů. Dnes by tato akvizice odpovídala částce přesahující 12 miliard dolarů.01:07 – P2P revoluce10:57 – Hledání obchodního modelu12:18 – P2P na obtíž26:06 – Rozpuštění Skypu30:52 – Pomalé umírání a redesigny36:00 – Horší je snad jen Google

Send us a textDr. Bobby unpacks the surge of health hype—from red light therapy to NAD⁺ boosters—and empowers listeners to stay curious yet skeptical using science-backed tools and critical thinking.Are claims like “boost your mitochondria” or “natural detox” real breakthroughs—or today's version of snake oil? Dr. Bobby explores why health hype is everywhere, why we're vulnerable to it, and how to sift compelling theories from proven treatments. He outlines examples of widely accepted beliefs that ultimately didn't hold up to rigorous scrutiny. Inserting stents to open clogged arteries seemed sensible, but studies like the COURAGE and ORBITA trials found no added benefit over medical management (NEJM). Dr. Bobby then turns to newer fads. Claims around NAD⁺ boosters (like NMN or NR), red light therapy, PRP for knee pain, and hydrogen water often rely on plausible-sounding mechanisms or mouse studies—but currently lack human RCTs to back them up. While these ideas may sound promising, human trials are either missing or preliminary.Why does this hype persist? Financial incentives are everywhere: the U.S. spends over $5 trillion annually on health, and the supplement market alone is worth $150 billion. Influencers, professionals, and even well-meaning providers may promote approaches they financially benefit from. As patients, we're often eager for solutions to symptoms like fatigue or anxiety—especially when conventional medicine doesn't have a satisfying answer. This opens the door for pseudoscience, placebo effects, and the viral spread of misinformation.To navigate this environment, Dr. Bobby outlines seven action steps. First, demand human evidence: ask if a treatment has been tested in RCTs, replicated, and proven in diverse populations. He recommends Examine.com for non-biased supplement research and revisiting his episode on evaluating health headlines (#22). Second, follow the money—financial conflicts should raise your skepticism. Third, be alert to hypey language like “miracle cure” or “doctor secrets”—phrases designed to manipulate, not inform. Fourth, understand the placebo effect, especially with vague symptoms. Fifth, ask  questions: “Compared to what?” “In whom?” “For how long?” “With what risks?” These shift the focus from excitement to real evaluation. Sixth, adopt what Dr. Bobby calls the mindset of a curious skeptic—open to ideas, but insistent on evidence. Finally, he urges listeners to consult evidence-literate doctors who will explore with you, both mainstream and emerging treatments with a critical eye—see episode #20 for more on choosing the right provider.Takeaways: Ask, “Has this been tested in people?” before jumping on a health trend. Beware buzzwords and financial conflicts—science, not sales, should guide your decisions. Embrace curiosity, but anchor it in real-world evidence to truly live long and well.

Featuring articles on gastric and gastroesophageal junction cancer, pulmonary sarcoidosis, graft-versus-host disease, gastroenteritis in children, the rapid recovery of donor hearts after circulatory death, and an on-table reanimation of a pediatric heart from donation after circulatory death; a review article on fragile X disorders; a case report of a woman with neck swelling and dysphagia; and Perspectives on vaccine policy, on new mammography tools, and on the second life of Jacqui B.

Peter Marks is the former director of the FDA Center for Biologics Evaluation and Research. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. P. Marks. The Role of Public Health Agencies in Creating Vaccine Policy. N Engl J Med 2025;393:209-211.

Send us a Text Message (please include your email so we can respond!)Episode 69! We start talking about the articles from the CCR25 conference with RESCUE-3 or "Temporary Transvenous Diaphragm Neurostimulation for Weaning from Mechanical Ventilation" published in AJRCCM by Dres et al and PROMIZING or "Proportional-Assist Ventilation for Minimizing the Duration of Mechanical Ventilation" by Bosma et al in NEJM.RESCUE-3 (pubmed): https://pubmed.ncbi.nlm.nih.gov/40498082/PROMIZING (pubmed): https://pubmed.ncbi.nlm.nih.gov/40513024/PROMIZING (NEJM): https://www.nejm.org/doi/10.1056/NEJMoa2505708If 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!

Jakou roli v jejím životě sehrály masopustní koblížky? Co činí tradici tradicí? Co všechno dnes ovlivňuje, jaký význam přikládáme tradicím a jak je prožíváme? Pomáhají nám tradice lépe souznít s přírodou a třeba i se sebou samými? Proč je nejméně tradičních svátků v létě? Jaké rituály dodržuje Martina Boledovičová se svými čtyřmi dětmi? Jak v blízkém okolí podnítit zájem o zvyky předků? Kam se vypravit za tradicemi?Všechny díly podcastu Jak to vidí... můžete pohodlně poslouchat v mobilní aplikaci mujRozhlas pro Android a iOS nebo na webu mujRozhlas.cz.

Jakou roli v jejím životě sehrály masopustní koblížky? Co činí tradici tradicí? Co všechno dnes ovlivňuje, jaký význam přikládáme tradicím a jak je prožíváme? Pomáhají nám tradice lépe souznít s přírodou a třeba i se sebou samými? Proč je nejméně tradičních svátků v létě? Jaké rituály dodržuje Martina Boledovičová se svými čtyřmi dětmi? Jak v blízkém okolí podnítit zájem o zvyky předků? Kam se vypravit za tradicemi?

In this episode, Bernie and Anthony talk about some BIG changes in cytarabine dosing in AML consolidation after a recent practice changing article. Will this change your practice? Hunault, et al. NEJM. 2025.https://evidence.nejm.org/doi/full/10.1056/EVIDoa2400326

Featuring articles on mild asthma, cardiovascular risk factors, stroke, advanced breast cancer, and transforming health care; a review article on juvenile idiopathic arthritis; a case report of a man with headache and ataxia; and Perspectives on who will care for America, on hospital financial assistance policies, and on libraries burned, and a life lived.

Patricia Mae Santos is an assistant professor in the Department of Radiation Oncology at Emory University School of Medicine. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. P.M.G. Santos, R. Jagsi, and C.I.A. Oronce. Who Will Care for America? Immigration Policy and the Coming Health Workforce Crisis. N Engl J Med 2025;393:105-107.

[1] Does the pursuit of excellence in medicine conflict with the pursuit of well-being? This is Episode #1 which was first released on 17, 2024. Description: -  Adam invites Dr. Lisa Rosenbaum to discuss her recent publication in the NEJM titled Being Well while Doing Well — Distinguishing Necessary from Unnecessary Discomfort in Training.   This thought-provoking paper is the 3rd in a series of 4 essays in the NEJM by Dr. Rosenbaum.  It's a social commentary on recent cultural and societal changes and their impact on medical education. We discuss Lisa's critical perspectives on the important notions of wellness and professional identity in our field.   Length of Episode: 40 minutes   Article discussed: Rosenbaum L. Being Well while Doing Well - Distinguishing Necessary from Unnecessary Discomfort in Training. N Engl J Med. 2024 Feb 8;390(6):568-572. doi: 10.1056/NEJMms2308228. Epub 2024 Jan 17. PMID: 38231543. https://pubmed.ncbi.nlm.nih.gov/38231543/  Resources to check out :  Dr. Rosenbaum's recent related publications    https://www.nejm.org/doi/10.1056/NEJMms2308228 Being Well while Doing Well — Distinguishing Necessary from Unnecessary Discomfort in Training   https://pubmed.ncbi.nlm.nih.gov/38265727/ Beyond Moral Injury - Can We Reclaim Agency, Belief, and Joy in Medicine?   https://pubmed.ncbi.nlm.nih.gov/38197811/ On Calling - From Privileged Professionals to Cogs of Capitalism?   https://pubmed.ncbi.nlm.nih.gov/38170694/ What Do Trainees Want? The Rise of House Staff Unions   Podcast ‘Not Otherwise Specified' https://not-otherwise-specified-podcast.nejm.org/e/tough-love/     Contact us: keylime@royalcollege.ca   Follow: Dr. Adam Szulewski https://x.com/Adam_Szulewski    

Chris Booth joins the show to discuss his recent NEJM paper that demonstrated significant DFS and OS improvements with a structured exercise program after adjuvant chemo in colorectal cancer. We discuss implications for GU and other malignancies.

In this week's episode, we dig into two deceptively simple questions: When does someone become a cancer survivor, and should palliative care be in the business of caring for them? Spoiler: It's more complicated than it seems. We've invited two palliative care doctors to talk about survivorship with us: Laura Petrillo, a physician-researcher at Mass General Hospital and Harvard Medical School, and Laura Shoemaker, an outpatient palliative care doctor at the Cleveland Clinic. This episode is a must-listen for those navigating the evolving landscape of cancer care, and asking not just how we treat cancer, but how we support people who are living with it.  If you want some further reading on survivorship, check out some of these articles: A NEJM article titled “Time to Study Metastatic-Cancer Survivorship” A ASCO publication that includes a section on survivorship - Patient-Centered Palliative Care for Patients With Advanced Lung Cancer A webinar on survivorship - Blending Survivorship and Palliative Care (NCI)

Featuring articles on structured exercise after chemotherapy for colon cancer, and treatments in obesity, in head and neck cancer, and in patients at high risk for cardiovascular events; a review article on forensic pathology; a Clinical Problem-Solving on caving in to pressure; a Sounding Board on climate change and human health; and Perspectives on the corporatization of U.S. health care, on self-neglect in older people, on Medicare drug price negotiation, and on the autopsy report.

Erin Fuse Brown is a professor of health services, policy, and practice at the Brown University School of Public Health and a member of the Journal's Perspective Advisory Board. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. E.C. Fuse Brown. Defining Health Care “Corporatization”. N Engl J Med 2025;393:1-3.

Featuring articles on routine cerebral embolic protection for TAVI, and treatments for cirrhosis due to MASH, BRAF V600E metastatic colorectal cancer, and Pompe's disease; a new review article series on medical education; a case report of a woman with dyspnea on exertion; and Perspectives on addressing ultraprocessed foods, on the costs of dismantling DEI, and on a brother's keeper.

Dariush Mozaffarian is the director of the Food is Medicine Institute at the Friedman School of Nutrition Science and Policy at Tufts University and a professor of medicine at Tufts University School of Medicine. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. D. Mozaffarian. Regulatory Policy to Address Ultraprocessed Foods. N Engl J Med 2025;392:2393-2396.

In this episode, Dr. Janet Abrahm shares transformative insights from ASCO 2025, focusing on palliative care and supportive care in oncology. Topics discussed include the role of exercise in cancer survival, cannabis use for symptom management, and the challenges of chemotherapy-induced peripheral neuropathy. We also highlight the importance of communication with patients, particularly in the context of grief and transition to palliative care, as well as the pervasive issue of burnout among oncology professionals.Studies discussed in the episode:Cannabis [Educational session re: ASCO 2024 Guideline; abstrs 120831; 12061]Hot flashes [508]Is local estrogen therapy safe for breast cancer survivors [578]Duloxetine: Disappointing results [12010]2021 study report [9005] with discussion of 2023 updatesChallenge Trial - Exercise extends life in Colon CA pts: already in NEJM and reported earlier in ASCO GI meeting LBA3510AND MORE!Check out Janet's page for more palliative care information: https://janetabrahm.com/ For more episodes, resources and blog posts, visit www.inquisitiveonc.comPlease find us on Twitter @InquisitiveOnc!If you want us to look at a specific trial or subject, email us at inquisitiveonc@gmail.comArt courtesy of Taryn SilverMusic courtesy of AlisiaBeats: https://pixabay.com/users/alisiabeats-39461785/Disclaimer: This podcast is for educational purposes only. If you are unwell, seek medical advice.Oncology for the Inquisitive Mind is recorded with the support of education grants from our foundation partners Pfizer, Gilead Pharmaceuticals and Merck Pharmaceuticals. Our partners have access to the episode at the same time you do and have no editorial control over the content. Hosted on Acast. See acast.com/privacy for more information.

A big, deep dive into CTA and fractional flow reserve CT, and a sobering report on the new EVOQUE valve are discussed by John Mandrola, MD, in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Listener Feedback and Correction CRAAFT HF https://clinicaltrials.gov/study/NCT06505798 II Imaging and Behavior Change SCOT HEART 1 https://www.nejm.org/doi/full/10.1056/NEJMoa1805971 Five Reasons I Don't Believe an Imaging Test Improves Outcomes https://www.medscape.com/viewarticle/901204 SCOT HEART 2 https://www.jacc.org/doi/10.1016/j.jcmg.2024.05.016 III. More on Imaging and CT FFR Symptoms Don't Always Indicate the Severity of Coronary Artery Disease https://www.medscape.com/viewarticle/symptoms-dont-always-indicate-severity-coronary-artery-2025a1000ge6 ADVANCE Registry Protocol https://www.journalofcardiovascularct.com/article/S1934-5925(16)30288-X/abstract Research Letter JACC CV Imaging  https://doi.org/10.1016/j.jcmg.2025.05.002 ADVANCE Registry Paper 2018 https://doi.org/10.1093/eurheartj/ehy530 Cook et al JAMA Card https://jamanetwork.com/journals/jamacardiology/fullarticle/2629072 Low diagnostic yield Patel paper NEJM https://www.nejm.org/doi/full/10.1056/NEJMoa0907272 Venk Murthy thread https://x.com/venkmurthy/status/1033379922679660544 IV EVOQUE Real World Data JACC has published a sobering research letter on the Transcatheter Tricuspid Valve Replacement called EVOQUE valve. Lupu et al JACC IV https://doi.org/10.1016/j.jcin.2025.03.019 TRISCEND II https://www.nejm.org/doi/full/10.1056/NEJMoa2401918 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Featuring articles on mismatch repair–deficient tumors, generalized myasthenia gravis, HER2-mutant non–small-cell lung cancer, a Corynebacterium diphtheriae outbreak, and hereditary and sporadic papillary kidney cancer; a review article on unruptured intracranial aneurysms; a case report of a man with respiratory failure and shock after kidney transplantation; and Perspectives on medical AI and clinician surveillance, on pathobiology, and on unrest.

I. Glenn Cohen is a professor of law and deputy dean at Harvard Law School and faculty director of the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard University. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. I.G. Cohen, I. Ajunwa, and R.B. Parikh. Medical AI and Clinician Surveillance — The Risk of Becoming Quantified Workers. N Engl J Med 2025;392:2289-2291.

Information on COVID vaccines is moving fast. On May 27th, HHS Secretary Robert F. Kennedy Jr. announced that COVID vaccines will no longer be universally recommended for healthy children or healthy pregnant women. That's a big shift, and understandably, it's raised a lot of questions. We're going to cut through the noise and take a look at where things really stand, who's getting vaccinated, how current guidance is evolving, and what this means for both children and adults as we look ahead to the next respiratory season.  Joining us to help sort it all out is Dr. John Schoen, Senior Clinical Manager of Drug Information at Vizient.     Guest speakers:  John Schoen, PharmD, BCPS  Senior Clinical Manager of Drug Information   Vizient Center for Pharmacy Practice Excellence    Host:  Stacy Lauderdale, PharmD, BCPS  Associate Vice President Vizient Center for Pharmacy Practice Excellence    Show Notes:  [01:38-05:32] What changed in the recent CDC update for healthy children [05:33-09:32] Discussion of COVID-19 outcomes and vaccination in children [09:33-11:47] Specific risk factors for pediatric patients [11:48-12:47] Is the US an outlier for not universally recommending the COVID-19 vaccine for healthy children and making no recommendation in healthy pregnant women? [12:48-14:03] The FDA's proposed regulatory framework for COVID-19 vaccine approval [14:04-15:18] FDA's approach to implementing revised requirements for randomized controlled trials [15:19-16:57] Key discussion points from the May meeting of the Vaccines and Related Biological Products Advisory Committee [17:00-18:27] Topics requiring further clarification about COVID-19 vaccine   Links | Resources: Vizient resources: Minute Market Insight: Potential ACIP COVID-19 recommendation changes April 2025: https://www.vizientinc.com/download?342668 Minute Market Insight: May 2025 COVID-19 vaccine recommendation and policy updates: https://www.vizientinc.com/download?352336 Additional resources: FDA perspective piece published in NEJM: https://www.nejm.org/doi/full/10.1056/NEJMsb2506929 ACIP meeting information: https://www.cdc.gov/acip/meetings/index.html CDC childhood immunization schedule: https://www.cdc.gov/vaccines/hcp/imz-schedules/child-adolescent-age.html CDC adult immunization schedule by medical condition: https://www.cdc.gov/vaccines/hcp/imz-schedules/adult-medical-condition.html CDC RESP-NET: https://www.cdc.gov/resp-net/dashboard/ WHO COVID-19 dashboard: https://data.who.int/dashboards/covid19/deaths MMWR - COVID-19–Associated Hospitalizations and Maternal Vaccination Among Infants Aged

Featuring articles on treatments for pulmonary fibrosis, for obesity and overweight, for severe hemophilia B, and for a rare genetic disease; a review article on malnutrition in older adults; a case report of a man with a nasopharyngeal mass; a Medicine and Society on John Collins Warren; and Perspectives on undermining women's health research, on addressing antifungal drug resistance, and on conversations that matter in maternal medicine.

The CHALLENGE trial at ASCO 2025 showed that increased physical activity improves survival rates in colon cancer patients, with the exercise group demonstrating better health outcomes and survival rates compared to those receiving only health education. A phase 3 trial in The New England Journal of Medicine found that semaglutide significantly improves liver conditions in MASH patients, showing better resolution of steatohepatitis and fibrosis improvement compared to placebo. Additionally, a study in the NEJM revealed that combining finerenone and empagliflozin offers enhanced kidney protection in patients with chronic kidney disease and type 2 diabetes, significantly reducing urinary albumin levels.

Amanda Kallen is an associate professor in the Division of Reproductive Endocrinology and Infertility at the University of Vermont Larner College of Medicine and an adjunct professor at the Yale School of Medicine. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. A.N. Kallen and Others. Undermining Women's Health Research — Gambling with the Public's Health. N Engl J Med 2025;392:2185-2187.

Send us a textWhat really helps prevent injuries—and what should you do when one inevitably strikes? In this episode, I use my friend Tim's pickleball injury as a jumping-off point to explore what the evidence actually says about ice, rest, NSAIDs, stretching, and more.When Tim skipped his warm-up and pulled a calf muscle, it raised a question many of us face: was it avoidable? While ancient wisdom and modern influencers often shout conflicting advice, this episode sorts through the noise to uncover what's evidence-backed, what's outdated, and what might actually delay healing. For pain, yes, ice works—cooling slows nerve conduction and can help with comfort, as seen in this study of ankle injuries. But does it reduce inflammation in a helpful way? Possibly not. Some research suggests that vasoconstriction may hinder the delivery of reparative cells and removal of waste, as noted in this trial.The evolution from RICE to PEACE to MEAT and even PEACE & LOVE reflects our shifting understanding. A meta-analysis of 22 randomized trials found no conclusive benefit of ice when added to compression or elevation. As for NSAIDs like ibuprofen, the Cochrane Review revealed no significant advantage over acetaminophen in pain relief or swelling reduction—and no clear evidence they speed up recovery.What about rest? Surprisingly, prolonged rest may do more harm than good. The Deyo study and later NEJM data show that continued normal activity (within pain tolerance) results in faster recovery than either bed rest or structured exercises, at least for acute low back pain—offering insights that might extend to other strains or sprains.Can you prevent injuries altogether? Static stretching (think toe touches) doesn't show strong support in RCT reviews, and while a recent meta-analysis found a small reduction in muscle injuries, the impact was modest. Dynamic stretching remains inconclusive according to current evidence.The takeaway? When treatments or prevention strategies are studied over and over yet results remain ambiguous, it likely means any real benefit is small—a principle I call “Dr. Bobby's Law of Many Studies.” Compare that with fall prevention in older adults: 66 RCTs involving 47,000 people showed strength and balance training significantly reduces falls by 20–30%. When something works, it tends to show up clearly and consistently.Takeaways: If you're injured, ice and NSAIDs can ease discomfort—but don't count on them to speed up healing. Resting too much may slow recovery; try gentle movement instead. Stretching might help a bit with prevention, but don't expect miracles. Evidence

Featuring articles on metabolic dysfunction–associated steatohepatitis, lung nodules, breast cancer, and improving birth outcomes; a review article on hemoglobinopathies; a Clinical Problem-Solving on from where it stems; and Perspectives on U.S. research leadership at a crossroads, on health care in an evolving immigration landscape, and on carrying hope while facing a crisis.

In this podcast episode of Integrative Cancer Solutions Dr. Karlfeldt interviews Dr. Chris Apfel about his integrative approaches to cancer treatment. Dr. Apfel shares his journey from traditional medicine to integrative oncology, sparked by his father's lung cancer diagnosis. This personal experience led him to question conventional cancer treatments after learning about their low success rates, particularly for stage four lung cancer. Dr. Apfel discusses his development of the Onca test, which can identify effective cancer therapies within a week by culturing tumor fragments. This test evaluates a wide range of treatments including chemotherapies, targeted therapies, and repurposed drugs. He emphasizes the importance of avoiding ineffective treatments that can harm the immune system and diminish quality of life, while highlighting the potential of repurposed drugs like statins, Metformin, and Itraconazole. The conversation addresses tumor heterogeneity and the need for representative biopsy samples, particularly from metastatic sites. Dr. Apfel explains that the Onca test is commercially available, with discounts offered to patients willing to share their data for research purposes. He discusses various methods for obtaining tumor samples and the importance of timing in the collection process.Dr. Apfel emphasizes patient advocacy and the need for patients to be informed about their treatment options. He notes that the Onca test can double the odds of a positive tumor response and significantly increase median survival rates. The podcast concludes with Dr. Apfel expressing interest in collaborating with Dr. Folt's center to help more cancer patients through this innovative approach to personalized cancer treatment.About Dr Chris Apfel:Chris Apfel, MD, PhD, MBA is a physician and clinical researcher with over 100 published papers, including a six-factor clinical prediction model published in NEJM that led to the development of The Apfel Score, a clinical calculator used universally to predict the risk of postoperative nausea and vomiting, and Dr Apfel's ultimate recruitment to the US and the University of California, San Francisco.Dr. Apfel was driven to revolutionize the field of cancer patient treatment after losing his mother to a long battle with ovarian cancer and his father to lung cancer. Witnessing their suffering inspired him leave the clinical department at UCSF to develop more efficient ways to identify the best treatment plans for cancer patients.Dr Apfel received his MD and PhD from the University of Giessen in Germany and his MBA from Wharton at the University of Pennsylvania. He is the founder and CEO of SageMedic.Dr. Apfel developed the Onca test, which can identify effective cancer therapies within a week by culturing tumor fragments, potentially doubling the odds of positive tumor response.Personal experience with his father's lung cancer led Dr. Apfel to question conventional treatments after discovering their low success rates for advanced cancers.The Onca test evaluates chemotherapies, targeted therapies, and repurposed drugs like statins and Metformin, which have shown promising results in cancer treatment.Tumor heterogeneity makes it crucial to obtain representative biopsy samples, particularly from metastatic sites, to avoid ineffective treatments.Patient advocacy is essential in cancer treatment, as patients need to make informed decisions about tissue handling before surgery and find oncologists willing to consider alternative treatments based on test results.----Grab my book A Better Way to Treat Cancer: A Comprehensive Guide to Understanding, Preventing and Most Effectively Treating Our Biggest Health Threat - https://www.amazon.com/dp/B0CM1KKD9X?ref_=pe_3052080_397514860 Unleashing 10X Power: A Revolutionary Approach to Conquering Cancerhttps://store.thekarlfeldtcenter.com/products/unleashing-10x-power-Price: $24.99-100% Off Discount Code: CANCERPODCAST1Healing Within: Unraveling the Emotional Roots of Cancerhttps://store.thekarlfeldtcenter.com/products/healing-within-Price: $24.99-100% Off Discount Code: CANCERPODCAST2----Integrative Cancer Solutions was created to instill hope and empowerment. Other people have been where you are right now and have already done the research for you. Listen to their stories and journeys and apply what they learned to achieve similar outcomes as they have, cancer remission and an even more fullness of life than before the diagnosis. Guests will discuss what therapies, supplements, and practitioners they relied on to beat cancer. Once diagnosed, time is of the essence. This podcast will dramatically reduce your learning curve as you search for your own solution to cancer. To learn more about the cutting-edge integrative cancer therapies Dr. Karlfeldt offer at his center, please visit www.TheKarlfeldtCenter.com

Watch the NEJM In Studio video of this interview at NEJM.org. David Jones is the Ackerman Professor of the Culture of Medicine at Harvard University. Harleen Marwah, the interviewer, is an Editorial Fellow at the Journal. W. Xue and D.S. Jones. Debating Race and the Diagnosis of Anemia — How Medicine Moved Away from Race-Based Standards. N Engl J Med 2025;392:2168-2173.

Amar Kelkar is a physician at the Dana-Farber Cancer Institute and an instructor in medicine at Harvard Medical School. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. A.H. Kelkar. U.S. Research Leadership at a Crossroads — The Impact of Reducing NIH Indirect-Cost Coverage. N Engl J Med 2025;392:2081-2084.

In this episode, Dr. Thomas McGinn and guest expert Dr. Nezar Falluji discuss a new NEJM publication that explores the approaches for patients with symptomatic severe tricuspid regurgitation, comparing the outcomes and adverse events of transcatheter replacement to medical therapy.Guest: Dr. Nezar Falluji, Interventional CardiologistSystem Physician Vice President, CommonSpirit Health National Cardiovascular Service LineArticle discussed: https://www.nejm.org/doi/full/10.1056/NEJMoa2401918?query=WB&cid=NEJM%20Weekend%20Briefing,%20January%2011,%202025%20DM2381304_NEJM_Non_Subscriber&bid=-1550043199

We're back with another Rapid Fire Journal Club. Luke Hedrick and Dave Furfaro discuss the NAVIGATOR trial published in NEJM in 2021 evaluating tezepelumab for adults with asthma. Article and Reference We are talking today about the NAVIGATOR trial evaluating … Continue reading →

Editors of CMI Comms, Josh Davis, Erin McCreary and Emily McDonald return for round 2 taking turns to summarise and discuss late-breaker trials presented at ESCMID Global 2025 in Vienna, and whether or not these trials should change your practice. Part 2 covers the ALABAMA trial exploring the safety of penicillin-allergy delabelling using the penicillin allergy assessment pathway, the SOLARIO trial investigating short (≤7 days!) versus long (≥4 weeks) antibiotic courses for orthopaedic infections, the EAGLE-1 trial assessing oral gepotidacin for gonorrhoea, a randomised clinical trial (RCT) from Thailand on oral fosfomycin as carbapenem-sparing, de-escalating therapy in complicated UTIs, and a double-blind RCT from Israel comparing neutralising plasma to placebo for West Nile fever.    This episode was peer reviewed by Dr. Emanuele Rando of Hospital Universitario Virgen Macarena, Seville, Spain and is the second of this two-part series covering selected clinical trials presented at ESCMID Global 2025.  Late-breaker trialsSandoe J, et al. Penicillin allergy assessment pathway versus usual clinical care for primary care patients with a penicillin allergy record to assess safety, de-labelling and antibiotic prescribing: The ALABAMA randomised controlled trialAngkanavisan K, et al. Oral fosfomycin after carbapenems as de-escalating therapy in complicated urinary tract infection: A randomisedcontrolled trialCanetti M, et al. Neutralising plasma versus placebo for hospitalised patients with West Nile fever: a double-blind randomised controlled trialDudareva M, et al. Short or long antibiotic regimes in orthopaedics: the SOLARIO multicentre randomised controlled trialWilson, J. Phase 3 randomised trial of oral gepotidacin for the treatment of uncomplicated gonorrhoea (EAGLE-1) ReferencesIDSA. Public Comment: IDSA Guideline on Management and Treatment of Complicated Urinary Tract Infections; 19 Feb - 19 March 2025.Mostashari F, et al. Epidemic West Nile encephalitis, New York, 1999. Lancet. 2001. doi: 10.1016/S0140-6736(01)05480-0Angus DC. Optimizing the Trade-off Between Learning and Doing in a Pandemic. JAMA. 2020. doi: 10.1001/jama.2020.4984Dudareva M. In: The 42nd Annual Meeting of the European Bone & Joint Infection Society. Barcelona, Spain: 26-28 Sept 2024. Li HK, et al. Oral versus Intravenous Antibiotics for Bone and Joint Infection (OVIVA). NEJM. 2019 doi: 10.1056/NEJMoa1710926

Featuring articles on pulmonary arterial hypertension, oral semaglutide and cardiovascular outcomes, giant-cell arteritis, the loss of subsidized drug coverage and mortality, and neutralizing venom toxins; a review article on cancer of unknown primary site; a case report of a man with fever, nausea, and respiratory failure; and Perspectives on primary care and the free market, federal cuts at the VA, the GINA gap, and the meaning of goodbye.

Zirui Song is an associate professor of health care policy and medicine at Harvard Medical School and a general internist at Massachusetts General Hospital. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. Z. Song and J.M. Zhu. Primary Care — From Common Good to Free-Market Commodity. N Engl J Med 2025;392:1977-1979.

Send us a Text Message (please include your email so we can respond!)Episode 65! Though this is during ATS, this episode was pre-recorded so you will get some reactions to the conference in the coming episodes. Instead we have a short episode where we talk about risk factors for stress ulcers and transfusion threshold in upper GI bleeding!Risk factors: https://pubmed.ncbi.nlm.nih.gov/40315134/Transfusion threshold: https://pubmed.ncbi.nlm.nih.gov/23281973/Transfusion threshold (NEJM): https://www.nejm.org/doi/10.1056/NEJMoa1211801If 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 multiple sclerosis, narcolepsy type 1, antiretroviral therapy in children with HIV, and porcine kidney xenotransplantation; a review article on Ph-positive acute lymphoblastic leukemia; a case report of a woman with peritonsillar swelling and bleeding; and Perspectives on the power of physicians in dangerous times, on community health centers, on AI-driven clinical documentation, and on driving Jackson.

In this first webinar of RheumNow's Lupus Unlocked campaign, Journal Club discussed two articles: Efficacy and Safety of Obinutuzumab in Active Lupus Nephritis. Furie R, et al. NEJM. 2025 Feb 7. doi: 10.1056 Efficacy and safety of voclosporin versus placebo for lupus nephritis (AURORA 1) Rovin BH. Lancet. 2021 May 29;397(10289) Speakers: Brad Rovin, MD Richard Furie, MD Jack Cush, MD