Podcasts about nejm

Deb Cohen is an award winning investigative journalist and correspondent who trained as a physician and has worked with the BBC and BMJ. She just published BAD INFLUENCE, a book which takes us deep into the wellness-industrial complex—the confluence of the supplement, testing, tech, and pharma industries, and how they sell health anxiety to healthy people. Here are some of the points we discussed:—The big market in healthy, well people. Tests, wearables, imaging, supplements, etc—Algorithms feed the health anxiety in an amplifying, vicious loop on the social media platforms. When the algorithm knows you better than you.—The special qualities of influencers, likable, relatable, vulnerable, appearance as friends, certainty, cultivating parasocial relationships. “I understand you, I see you, I hear you.” Often with financial conflicts of interest. Plus hidden financial benefits. —The inverted pyramid of evidence and displacement of trust. Anecdotes believed and accepted as best evidence instead of rigorous randomized trials. A big flip, doctors losing trust to influencers and the sponsors of influencers. —The Nocebo effect of harm through expectations—The epidemic of neurologic tics during the pandemic traced back to TikTok, a viral contagion with 5.8 billion views (Figure made with Notebook LM)—Potential for regulation of patient/consumers/prosumer influencers —Celebrity influencers and the recent NEJM paper—Many ideas for how we can mitigate this mess (Graphic by Notebook LM)—Many illuminating patient examples: Femtech, silicon breast implant illness (BII), beta blocker experiment, a bogus bioresonance of hair test in a woman with GI symptoms, full-body MRI of brain lesions (transmitted to the patient by an automated message) that were a false positive.—The term “wellness”—Concierge physiciansThank you jojofinance, Vote Against Billionaires, Gretchen Faucett, Mary Powers, Jessica Coffman, and hundreds of others for tuning into my live video with Bad Influence! Join me for my next live video in the app.Ground Truths has subscribers from every US state and 214 countries. There are over 302,000 followers of Ground Truths so nearly 90,000 folks who can easily convert to be free subscribers. Your subscription to these free essays and podcasts makes my work in putting them together worthwhile. If you're not a subscriber, please join!If you found this interesting PLEASE share it!A couple of other things to note:—Thanks to the voluntary paid subscribers who support our summer internship program for high school, college, and grad school students. On August 6th, we had a poster session with our SRTI summer interns (pictured below) which was an extraordinary event with about 100 posters!—I hit a publication milestone that I had not ever envisioned. More than 400,000 citations with an h-index of 259, as tallied by Google Scholar Thanks to all for your support of Ground Truths. Get full access to Ground Truths at erictopol.substack.com/subscribe

This week, we feature new research on acute respiratory failure, wheezing in childhood, lung cancer, and obesity. We review myeloproliferative neoplasms and follow a diagnostic case of a patient with myasthenia gravis who developed dyspnea and weakness. Perspectives explore medical marijuana research, AI in clinical care, sexual and gender minority health research, and the Perspectives Editor saying goodbye.

This week, we feature new research on polymyalgia rheumatica, hypercholesterolemia, prostate cancer, and multiple myeloma. We review evidence-based strategies for tobacco cessation, and follow a case of a woman with nausea, dizziness, and metabolic acidosis. We discuss recent advances in gene editing for rare metabolic diseases. Perspectives address HIV care, health care quality, medical ethics, and finding resilience in the face of serious illness.

Eric Schneider is an adjunct professor of health policy and management at the Harvard T.H. Chan 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. M. Chernew and E.C. Schneider. Rethinking the Role of Pay for Performance in Federal Health Care Quality Programs. N Engl J Med 2026;395:625-628.

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

Why Self-Insured Employers and Clinicians Keep Missing Each Other, With Suhas Gondi, MD. The Sleeping Giants of Healthcare: Why Employers and Clinicians Keep Missing Each Other. Episode 523. Dr. Suhas Gondi, MD, MBA, chief medical officer at Health Strategy and an attending physician at Massachusetts General Hospital, co-wrote a New England Journal of Medicine article — "A Sleeping Giant of Health Care Affordability—Self-Insured Employers" — because most clinicians, he found, have little idea a self-insured employer, not an insurance carrier, is the one actually paying for their patients' care. Talking with Stacey Richter, Dr. Gondi argues that self-insured employers and clinicians are both "sleeping giants," each holding real power over cost and access, who rarely communicate directly — leaving patients caught in the gap. WHAT YOU'LL LEARN ✅ Why Dr. Suhas Gondi and his NEJM co-author, Zirui Song, MD, PhD, wrote for clinicians who, they found, have little sense that a self-insured employer — not the carrier name on the card — actually pays for a patient's care ✅ How a GLP-1 prescription can get denied at the pharmacy counter even after a clinician verifies coverage, because the employer has quietly moved GLP-1 coverage exclusively through a single third-party prescribing and coaching vendor ✅ Why GLP-1 spending alone can push a self-insured employer's pharmacy costs up 9% to 20% in a year, and why the roughly eight-year payback period employers are counting on assumes patients stay adherent far longer than most actually do ✅ How oncology site-of-care steering — an employer declining to pay a roughly 40% premium for infusion at a hospital-owned center instead of a physician's office — can look to the patient and oncologist like a denied cancer drug ✅ Why Dr. Gondi says EHRs like Epic are built to optimize revenue for hospital-system customers, not to surface a lower-cost site of care for patients or plan sponsors ✅ Dr. Gondi's advice for closing the gap: clinicians and employers should communicate directly, especially before a coverage change lands on patients, rather than assuming direct contracting is the only fix WHY THIS MATTERS Roughly half to 60% of the US population has commercial insurance, and nearly three-quarters of large employers self-insure that coverage — yet most clinicians have no visibility into the plan-level decisions those employers make, and most employers have no channel to explain those decisions to the doctors whose patients are affected. Both sides, Dr. Gondi says, usually believe they're doing the right thing — covering the GLP-1, covering the cancer drug — and the patient still gets lost in between. Closing that gap doesn't require full direct contracting, he argues, just employers and local provider groups actually talking to each other before a coverage change lands on a patient, not after. MENTIONED IN THIS EPISODE Study: New England Journal of Medicine article, "A Sleeping Giant of Health Care Affordability—Self-Insured Employers," by Suhas Gondi, MD, MBA, and Zirui Song, MD, PhD EP406 with Lauren Vela: Apple Podcasts | Spotify | Other Apps EP519 with Lisa Rosenbaum, MD: Apple Podcasts | Spotify | Other Apps EP509 with Patrick Nelli: Apple Podcasts | Spotify | Other Apps EP494 with Sarah Emond: Apple Podcasts | Spotify | Other Apps EP501 with Ivana Krajcinovic, PhD: Apple Podcasts | Spotify | Other Apps EP468 with Matt McQuide: Apple Podcasts | Spotify | Other Apps Article: Acquired's episode on how Epic quietly powers American healthcare === LINKS ===

This week, we feature new research on chronic kidney disease, high-risk prostate cancer, peripheral artery disease, and oxygen therapy after cardiac arrest. We review the evaluation and management of syncope, follow a challenging case of immune-related inflammatory illness, and report on Perspectives exploring pandemic preparedness, the Bundibugyo Ebola outbreak, and physician mental health.

Jean Nachega is a professor of infectious diseases and the director of the Biomedical Research Institute at Stellenbosch University and an associate professor at the University of Pittsburgh School of Public Health. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. A. Zumla and Others. Ebola at 50 — Lessons for Outbreak Response and Preparedness. N Engl J Med 2026;395:527-529. S. Tonen-Wolyec and L. Bélec. The Social Contract of Bundibugyo Ebola Isolation. N Engl J Med. DOI: 10.1056/NEJMp2607429.

Date: July 27, 2026 2026 Guest Skeptic: Dr. Howard (Howie) Mel is an emergency physician and FACEP.  Reference: Smith JE et al. SWiFT Trial Group. Prehospital Whole Blood in Traumatic Hemorrhage – a Randomized Controlled Trial. NEJM 2026 March Case: A 36-year-old man is brought to the emergency department (ED) by air ambulance after a […] The post SGEM#516: A Whole Lotta Blood – Whole Blood Transfusion in the Prehospital Setting first appeared on The Skeptics Guide to Emergency Medicine.

This week, we feature advances that may change care for prostate cancer, multiple myeloma, acute pain, and IgA nephropathy. We review platelet factor 4 disorders and follow a case of persistent nasal ulceration. Perspectives explore medical aid in dying, federal authority in health care, public health and litigation, and the challenge of delivering life-changing news with honesty and compassion.

Jerry Avorn is a professor of medicine at Harvard Medical School and the codirector of the Program on Regulation, Therapeutics, and Law at Harvard Medical School and Brigham and Women's Hospital. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. J. Avorn. Products That Pose Health Risks — Can Litigation Protect Us When Government Fails? N Engl J Med 2026;395:421-423.

This week, we bring you advances in pancreatic and bladder cancer, preventing gonorrhea, a promising new therapy for adolescent hypertrophic cardiomyopathy, and a review of antiretroviral treatment for HIV. We also follow a striking case of vision loss that led to an unexpected diagnosis and discuss Perspectives on vaccine evidence, hepatitis C elimination, the endorsements of prescription drugs on social media, and the enduring intersection of love and loss in medicine.

Arnold Monto is a professor emeritus of epidemiology and of public health and codirector of the Center for Respiratory Virus Research and Response at the University of Michigan School of Public Health. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. A.S. Monto and H.Y. Chu. The Best of Both Worlds — Using Clinical Trial and Observational Data to Evaluate Vaccine Protection. N Engl J Med 2026;395:313-316.

This week, we present advances in the treatment of multiple myeloma, systemic lupus erythematosus, and coronary artery disease, alongside new national data on health care–associated infections. We also review fibromyalgia and the emerging Bundibugyo virus outbreak, follow a surprising diagnostic case of alpha-gal syndrome, and explore Perspectives on caring for vulnerable patients, trustworthy health information, pharmacotherapeutic decisions in autism care, and the experience of caring for a parent with dementia.

Yaara Zisman-Ilani is an associate professor in the Department of Social and Behavioral Sciences at the Barnett College of Public Health and in the Department of Psychiatry and Behavioral Science at the Lewis Katz School of Medicine, both at Temple University. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. Y. Zisman-Ilani and Others. Pharmacotherapeutic Decisions in Autism. N Engl J Med 2026;395:214-217.

In this episode of Communicable, Angela Huttner and Josh Davis are joined by Brett Mitchell, Aline Wolfensberger and Lauren Clack to discuss the HAPPEN trial to prevent hospital-acquired pneumonia led by Mitchell--and the important studies leading up to it [1-3]. The episode also explores trial designs used in their research that are both creative and practical, such as stepped-wedge and implementation trials, and how these approaches can bridge the gap between research and real-world practice.ReferencesMitchell B, “The hospital acquired pneumonia prevention (HAPPEN) study: a multi-centre randomised controlled trial” in ESCMID Global 2026. https://online.escmid.org/media-6348-hospital-and-ventilator-associated-pneumonia-new-insights-on-prevention-diagnosis-and-treatment (Presentation).White NM, et al. Effectiveness of oral care for the prevention of non-ventilator hospital-acquired pneumonia (HAPPEN): a multicentre, stepped-wedge, cluster-randomised trial in Australia. Lancet Infect Dis 2026. DOI: 10.1016/S1473-3099(26)00235-5.Wolfensberger A, et al. Prevention of non-ventilator-associated hospital-acquired pneumonia in Switzerland: a type 2 hybrid effectiveness–implementation trial. Lancet Infect Dis 2023. DOI: 10.1016/S1473-3099(22)00812-X.Further readingHAPPEN study website: Study overview and resources www.happenstudy.comCassini A, et al. Burden of Six Healthcare-Associated Infections on European Population Health: Estimating Incidence-Based Disability-Adjusted Life Years through a Population Prevalence-Based Modelling Study. PLoS Med 2016. DOI:  10.1371/journal.pmed.1002150. Pronovost P, et al. An Intervention to Decrease Catheter-Related Bloodstream Infections in the ICU. NEJM. DOI: 10.1056/NEJMoa061115. Bion J, et al. ‘Matching Michigan': a 2-year stepped interventional programme to minimise central venous catheter-blood stream infections in intensive care units in England. BMJ Quality & Safety 2013. DOI: 10.1136/bmjqs-2012-001325.Dixon-Woods M, et al. Explaining Matching Michigan: an ethnographic study of a patient safety program. Implementation Sci 2013. DOI: 10.1186/1748-5908-8-70.  Clack L, et al. Hybrid effectiveness-implementation studies in infection prevention and infectious diseases: a narrative review. CMI 2025. DOI: 10.1016/j.cmi.2025.10.022.Hospital Acquired Pneumonia Prevention (HAPPEN) Study: Statistical Analysis Planhttps://www.medrxiv.org/content/10.1101/2025.08.14.25333719v1 Oral care practices and hospital-acquired pneumonia prevention: A national survey of Australian nurseshttps://pubmed.ncbi.nlm.nih.gov/38724299/ Nurses' experiences of providing oral care to hospitalised patients: A qualitative studyhttps://pubmed.ncbi.nlm.nih.gov/40450434/

You might think microplastics are just an environmental nuisance that passes through your body, but the latest tissue studies tell a very different story. As a physician, Dr. Gabrielle Lyon breaks down where the science lands, past both the fear-mongering and the dismissiveness.In this solo episode, Dr. Gabrielle Lyon discusses:Why over 58% of patients in a landmark NEJM study had plastic embedded in their arterial plaque and the 4.5x higher risk of heart attack, stroke, and death that came with itHow microplastics act as a "Trojan horse," carrying endocrine-disrupting chemicals into your blood, testes, brain, and reproductive tissueWhy perimenopause and menopause are an especially vulnerable window for plastic-driven hormone disruptionThe five low-cost "Lyon Protocol" rules to cut your exposure, starting with never microwaving plastic and letting food cool before you store itThis matters because you don't need to overhaul your life or wait twenty years for perfect data to protect your cellular health; you just need the handful of small, automated decisions that move the needle on your metabolic and hormonal baseline.Thank you to our sponsors:Our Place - Upgrade your kitchen with Our Place today. Visit https://bit.ly/3RnCYH0 and use code DRYLON for 10% off sitewide. That's F-R-O-M-O-U-R-P-L-A-C-E DOT COM / D-R-L-Y-O-N and use code DRLYON for 10% off sitewide. With a 100-day trial, you can try it completely risk-free.Timeline - Get 20% off your Mitopure order at https://bit.ly/4wJpFzZ Bon Charge - Save 15% at https://bit.ly/44bIoYx with code DRLYON Explore More from Dr. Gabrielle LyonWeekly newsletter: Recipes, podcast updates, and practical weekly insights https://drgabriellelyon.com/sign-up/Apply to become a patient: Personalized care with Dr. Lyon's clinical team https://drgabriellelyon.com/new-patient-inquiry/Connect with Dr. Gabrielle Lyon:Instagram: https://www.instagram.com/drgabriellelyon/TikTok: https://www.tiktok.com/@drgabriellelyon X (Twitter): https://x.com/drgabriellelyonFacebook: https://www.facebook.com/doctorgabriellelyon Chapters00:00 - Introduction01:30 - What microplastics and nanoplastics are03:00 - Where plastics show up inside us04:30 - The UCSF systematic review06:10 - Inflammation, cytokines, and thyroid07:40 - Plastic in arterial plaque and the 4.5x risk10:10 - The strongest skeptic arguments13:00 - Lead, asbestos, and trans fats14:40 - The Trojan horse for hormone disruptors16:10 - Reproductive aging and menopause17:50 - Where Dr. Lyon lands19:40 - The Lyon protocol: five rulesIf you found this episode valuable, share it with someone who would benefit from it.Disclaimers: This episode includes paid sponsorships. The Dr. Gabrielle Lyon Podcast and YouTube are for general information purposes only and do not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast, YouTube, or materials linked from this podcast or YouTube is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professional for any such conditions.

Fontes do episódio aqui:⁠https://portal.afya.com.br/podcasts/afya-news/09-07-2026Nesta quinta-feira, o boletim analisa os alertas de segurança sobre compostos estéticos, novas fronteiras na condução de quadros inflamatórios agudos e ferramentas preditivas digitais. Abordamos os riscos do uso de peptídeos não regulamentados comercializados na internet, que acendem o alerta de especialistas por gerarem complicações hormonais severas, especialmente no público feminino. Detalhamos um artigo do NEJM que revisita os critérios para a seleção do tratamento conservador com antimicrobianos em casos de apendicite aguda não complicada, priorizando a decisão compartilhada. Por fim, trazemos no Radar um estudo do BMJ demonstrando como algoritmos de inteligência artificial conseguiram antecipar o diagnóstico de diabetes tipo 1 meses antes dos primeiros sinais clínicos. Afya News. Informação médica confiável e atualizada no seu tempo.

Cognitive Atrophy, Referral Incentives, Fragmented Care: Is Primary Care Inevitable or Fixable? Episode 519. Primary care physicians are leaving traditional practice for concierge medicine in visible numbers—and the question is whether that exodus is an unavoidable consequence of how the system is built, or something we've simply chosen not to fix. Stacey Richter talks with Dr. Lisa Rosenbaum, a cardiologist at Beth Israel Deaconess Medical Center (BIDMC) and national correspondent for the New England Journal of Medicine, who recently devoted an entire season of her NEJM podcast, Not Otherwise Specified, to the state of primary care. Together they test three forces reshaping the field—cognitive atrophy, referral incentives, and care fragmentation—against a single question: inevitable, or fixable? WHAT YOU'LL LEARN ✅ Why Dr. Lisa Rosenbaum calls the risk of "cognitive atrophy" among primary care physicians a generational threat rather than an individual one—and why she believes it is not inevitable ✅ How financial incentives that pay far more for a specialist visit than a primary care visit (roughly 5% of healthcare dollars for close to 35% of outpatient visits) structurally push referrals earlier and more often than necessary ✅ Why "relational expertise"—the judgment a doctor builds by knowing a patient over time—is, in Dr. Rosenbaum's view, primary care's real and undervalued skill set ✅ How care fragmentation, illustrated by Miriam Paramore's LinkedIn essay about her father's end-of-life care, leaves patients bouncing among specialists with no one taking ownership of the whole picture ✅ Why Dr. Rosenbaum argues that blaming everything on structural constraints "strip[s] ourselves of our own agency," and what she thinks physicians and healthcare buyers should each do about it WHY THIS MATTERS Roughly 70% of physicians are employed today, and about 5% of every healthcare dollar goes to primary care despite it covering close to 35% of all outpatient visits—numbers that, per Dr. Rosenbaum, reflect choices the system has made, not laws of nature. When primary care doctors lose the time and incentive to build relationships with patients, the system loses its quarterback, and patients end up fragmented across specialists with no one accountable for the whole picture. Dr. Rosenbaum's core argument is that none of this is inevitable, but fixing it requires both structural change and individual physicians and healthcare buyers reclaiming their own agency. MENTIONED IN THIS EPISODE EP504 with Ryan Jacobs: Apple Podcasts | Spotify | Other Apps EP473 with Kenny Cole, MD: Apple Podcasts | Spotify Other Apps EP391 with Scott Conard, MD: Apple Podcasts | Spotify | Other Apps Article: "Ordinary Rural Death: My Father's End-of-Life Journey" by Miriam Paramore EP409 with Larry Bauer, MSW, MEd: Apple Podcasts | Spotify | Other Apps === LINKS ===

This week, we present advances in the treatment of idiopathic pulmonary fibrosis, hypothalamic obesity, and lung cancer. We review nutrition in critical illness and follow a diagnostic case involving a patient who had a lung transplant. The Editors warn about the politicization of science. We discuss the dead donor rule in an era of voluntary euthanasia. Perspectives explore the forthcoming crisis in long-term care, reproductive medicine, and the realities of caring for loved ones at the end of life.

Mark Unruh is an associate professor of population health sciences at Weill Cornell Medical College. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. M.A. Unruh, V. Mor, and H.-Y. Jung. Colliding Forces — The Aging of the Baby Boom Generation and Contracting Nursing-Home Supply. N Engl J Med 2026;395:105-107. A.R. Olenski and D.C. Grabowski. Caring for an Aging America — The Looming Crisis of the Long-Term–Care Workforce. N Engl J Med 2026;395:107-110.

Fontes do episódio aqui:⁠https://portal.afya.com.br/podcasts/afya-news/06-07-2026Nesta segunda-feira, o boletim analisa um marco terapêutico em infectologia crônica, o uso de inteligência artificial em desfechos perinatais e atualizações de vigilância internacional. Abordamos um estudo publicado no NEJM revelando que o oligonucleotídeo antissenso bepirovirsen induziu remissão funcional sustentada em pacientes com hepatite B crônica. Detalhamos o relatório da Organização Mundial da Saúde que destaca o uso de modelos preditivos digitais de alta precisão para antecipar riscos neonatais críticos. Por fim, trazemos no Radar o acompanhamento epidemiológico de patologias emergentes raras no continente africano e as estratégias de preparação de sistemas de saúde. Afya News. Informação médica confiável e atualizada no seu tempo.

This piece is essential listening for anyone interested in modern academic publishing. Recorded at the Collaborative Clinical Trials Meeting in Prato, Italy, TopMedTalk hosts Kate Leslie and Mike Grocott speak with Eric Rubin (Editor-in-Chief, New England Journal of Medicine) and Jocalyn Clark (International Editor, BMJ) about medical publishing. The conversation covers, engaging with clinical researchers and seeing impactful work. How AI can help authors—especially non-native English speakers—while raising concerns about confidentiality, inaccurate or fabricated content, reviewer misuse, governance policies that struggle to keep pace, and AI-generated correspondence overwhelming journals. They explore how AI affects originality and idea generation, note an NEJM AI experiment using AI reviews, and consider how journals should communicate beyond clinicians to address misinformation and declining attention, while maintaining trust and collaborating more across publishing and science. -- The 2026 International Practicum on Cardiopulmonary Exercise Testing will be held at the Balmer Lawn Hotel in Brockenhurst, UK, from September 16th to 18th this year. It is organised by iPOETTS , the international perioperative testing and training society. Come and join us at this premier educational event designed for clinicians, scientists, and healthcare professionals interested in sport, exercise, and perioperative medicine. This is an International Perioperative Testing and Training Society accredited event so when you attend you can get your iPOETTS accreditation, showing that you are a practitioner who has reached a high, standardized level of competence in performing and interpreting Cardiopulmonary Exercise Testing (CPET) for patients preparing for major surgery. Go now to http://www.ebpom.org

This week, we discuss less-invasive approaches to guiding coronary intervention, new strategies for preventing kidney cancer recurrence, and head-to-head treatment data in multiple sclerosis. We review advances in multiple sclerosis, follow a diagnostic journey involving gait instability, and discuss correcting false narratives. Perspectives examine physicians and the body politic, chronic pain and OUD, and the often-overlooked burden of cognitive symptoms.

Justin Barr is a transplant surgeon at the Ochsner Clinic and a historian. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. S.H. Podolsky, D.S. Jones, and J. Barr. Declarations of Independence — Physicians and the U.S. Body Politic, 1776–2026. N Engl J Med 2026;395:1-3.

In 2018, the ARIVE trial was published in the NEJM revealingthat induction of labor at 39 weeks reduced cesarean deliveries and gestational hypertension/preeclampsia in low-risk nulliparous women who had labor induced,compared to expectant management. Then, in 2025, and partly in response to L&D units across the country becoming saturated with low- risk, nulliparous patients awaiting their induction of labors at 39 weeks and 0 days, the ACOGreleased its clinical practice update in Jan 2025 stating, “The optimal timing of delivery for full-term pregnancies (39 0/7 to 40 6/7 weeks of gestation has not been determined”. Now there is new data, released as an article in press(June 26, 2026), out of the AJOG that raises some interesting questions about potential benefits of induction of labor LATER in the “full term” interval (40- 40 and 6 days) compared to earlier full term (39 weeks to 39 weeks 6 days). Thesefindings are “hypothesis- generating”.  Listen in for details. Strong Coffee Company - Protein Coffee PLUS MORE; Get 20%OFF | Promo Code: CHAPANOSPINOBG https://promocode.to/strong-coffee-company/chapanospinobg-hbv​     Grobman WA, Rice MM, Reddy UM, Tita ATN, et al;Eunice Kennedy Shriver National Institute of Child Health and Human DevelopmentMaternal–Fetal Medicine Units Network. Labor Induction versus ExpectantManagement in Low-Risk Nulliparous Women. N Engl J Med. 2018 Aug9;379(6):513-523. ​     Damri NT, Sheiner E, Wainstock T, GestationalAge at Full-Term Delivery and Long-Term Offspring Morbidity in Low-RiskPregnancies: A Population-Based Cohort Study, American Journal of Obstetricsand Gynecology (2026), ​     Management of Full-Term Nulliparous IndividualsWithout a Medical Indication for Delivery: ACOG Clinical Practice Update.Obstet Gynecol. 2025 Jan 1;145(1):e45-e50. doi: 10.1097/AOG.0000000000005783.Epub 2024 Nov 7. PMID: 39513607.

This week, we discuss a promising step toward a functional cure for chronic hepatitis B, first-line pulsed field ablation for persistent atrial fibrillation, reducing the demand for transfusion in surgery, treatment for rifampicin-resistant tuberculosis, and a decade-long look at CAR T-cell therapy outcomes. We review peanut allergy and discuss a case of a man with leg weakness, pain, and weight loss; Perspectives explore GLP-1 access, air-quality policy, and the human realities of homelessness.

Stacie Dusetzina is a professor of health policy and of cancer research at the Vanderbilt University School of Medicine. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. S.B. Dusetzina. Access to GLP-1s for Medicare Beneficiaries — A Bridge to Nowhere? N Engl J Med 2026;394:2385-2387.

Welcome back to the show, everybody! Today, we are diving deep into the intersection of maternal-fetal medicine and cardiology. We're tackling a condition that keeps every OB/GYN, MFM, and cardiologist up at night: Peripartum Cardiomyopathy, or PPCM. And to keep our clinical gears turning, we are framing this discussion squarely through the lens of Society for Maternal-Fetal Medicine (SMFM) Consult Series #73, which focuses on right and left heart failure in pregnancy, alongside the foundational data from ACOG Practice Bulletin #212. PPCM presents fundamentally as acute left heart failure with reduced ejection fraction. Think of the left ventricle as the primary engine pump of the systemic circulation. When it stalls, everything upstream gets backed up. While this was traditionally called IDIOPATHIC, newer data says otherwise. We are going to cover presentation, eval, care and prognosis. So, get your palpitations in check- here we go. 16% OFF TONA ACTIVE WEAR PROMO: https://tonaactive.com/discount/CHAPANOSPINOBG1. SMFM CS 73; 20252. ACOG PB 212; 20193. Arany Z. Peripartum Cardiomyopathy. The NEJM. 2024. 4. Sliwa K, Hilfiker-Kleiner D, Damasceno A, Al Farhan H, Goland S, Johnson MR, Bauersachs J. Peripartum cardiomyopathy. Lancet. 2025 Nov 22;406(10518):2483-2493. doi: 10.1016/S0140-6736(25)01451-5. Epub 2025 Oct 28. PMID: 41173010.

This week, we discuss endovascular therapy for post-thrombotic syndrome, new evidence on prehospital blood transfusion strategies in trauma patients, and a trial of cefazolin for Staph. aureus bacteremia. We examine evolving approaches to thyroid cancer and share a case of a man with pancytopenia after heart transplantation. Perspectives explore psychedelic therapy, the convergence of Down syndrome and Alzheimer's disease, and treating addiction.

Marcus Hughes is an assistant professor of psychiatry at the Yale School of Medicine and an attending psychiatrist at Yale New Haven Psychiatric Hospital. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. M. Hughes. Psychedelic Therapies in the United States — Balancing State and Federal Oversight. N Engl J Med 2026;394:2281-2283. Y. Zisman-Ilani and R. Yehuda. Patient-Driven Care in Psychedelic Therapy. N Engl J Med 2026;394:2284-2286.

Fontes do episódio aqui:⁠https://portal.afya.com.br/podcasts/afya-news/17-06-2026Nesta quarta-feira, analisamos uma nova tecnologia na urologia, o papel da anamnese no combate à dependência digital financeira e os dilemas éticos da medicina ambiental. Abordamos os avanços da ureteroscopia flexível assistida por vácuo, uma técnica menos invasiva e altamente eficaz para a eliminação de cálculos renais grandes. Detalhamos o apelo de especialistas publicado no NEJM para que médicos incluam o rastreamento rotineiro de apostas online na anamnese, visando mitigar riscos de depressão e autoextermínio. Por fim, discutimos no Radar um estudo inédito que utilizou a troca terapêutica de plasma para reduzir microplásticos na corrente sanguínea. Afya News. Informação médica confiável e atualizada no seu tempo.

This week, we present new evidence guiding coronary intervention, a molecular mechanism of inflammatory bowel disease, and gene therapy for a recessive disease. We review antidotes for anticoagulation reversal and discuss a case of hypertension in an adolescent patient. Perspectives examine cholera control, gambling-related harms, and race-based prescribing, alongside a reflection on medicine, motherhood, and what clinicians carry with them.

Edward Ryan is the director of global infectious diseases at Massachusetts General Hospital. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. E.T. Ryan, F. Qadri, and J.A. Lynch. Global Cholera-Control Efforts — Progress and Remaining Challenges. N Engl J Med 2026;394:2177-2180.

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

This week, we discuss left atrial appendage closure for atrial fibrillation, oxygen strategies in respiratory failure, an all-oral treatment for acute myeloid leukemia, CAR T-cell therapy enabling kidney transplantation, and a case of a neuroepithelial tumor that developed after gene therapy. We review childhood vaccine hesitancy, follow a complex diagnostic case, and examine Perspectives on corporatization in medicine, famine and war, and the future of health care systems.

Loren Adler is a fellow and the associate director at the Center on Health Policy at the Brookings Institution. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. L. Adler. Regulating Corporate Control in the U.S. Health Care System. N Engl J Med 2026;394:2073-2076.

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

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.

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.