Podcasts about uspstf

Hosts ASN CEO & EVP Tod Ibrahim and Senior Policy & Govt. Affairs Coordinator Lauren Ahearn discuss the upcoming summer rulemaking season, ASN's USPSTF nomination, the annual AMA meeting in Chicago, IL, and more.

Hosts ASN CEO & EVP Tod Ibrahim and Senior Policy & Govt. Affairs Coordinator Lauren Ahearn discuss the upcoming summer rulemaking season, ASN's USPSTF nomination, the annual AMA meeting in Chicago, IL, and more.

Hannah Anderson on MAHA, Prevention, and Cutting Through Healthcare Bureaucracy On The Healthy CEO, host Jason interviews Hannah Anderson, AFPI's director of health policy and former deputy chief of staff for Robert F. Kennedy at HHS, about advancing MAHA from a wellness rallying cry into actionable policy. Anderson describes her Texas roots, her path into health policy, and the challenge of executing reforms inside a massive bureaucracy where incentives favor slowness and process can be used to obstruct priorities. She explains AFPI's role in transition planning and in developing patient-first ideas, especially around prevention, wearables, and making healthcare dollars support proactive health rather than only government-defined “preventive” services under the USPSTF framework. The discussion contrasts U.S. acute-care excellence with poor prevention, critiques diagnose-and-prescribe medicine, and emphasizes practical, broadly accessible MAHA principles: solutions for everyone, realistic 70% adherence, and individual responsibility for taking back one's health. 00:00 Welcome and Guest Intro 00:44 Sponsor Foundational Stack 02:22 Meet Hannah On Air 04:55 Texas Roots and MAHA 06:20 From Spring to DC 08:09 Making HHS About Health 13:33 Cutting Through Bureaucracy 22:24 Why She Joined AFPI 25:56 Prevention and Wearables 29:07 Obamacare Prevention Rules 29:58 Symptoms Over Root Causes 32:23 Primary Care Burnout 34:17 Prevention Versus Rescue Care 35:13 Wearables For Self Insight 37:47 CGM Sleep Food Lessons 40:25 Data Driven Prevention Policy 48:21 Making Maha For Everyone 53:21 Incentives For Healthy Metrics 55:40 Take Back Your Health 57:13 Closing And Medical Disclaimer

Salam Alikoum! Today, travel medicine specialists Drs. Paul Pottinger & Chris Sanford answer your travel health questions, including:Is there a connection between blue light and jet lag?What about jet lag and liver cancer?Who really needs an mpox vaccine?What is RFK Jr up to with the USPSTF?Why are airline ticket costs currently so high?Can I purchase travel insurance for any destination?What is the best diamox dose when climbing tall mountains?We hope you enjoy this podcast! If so, please follow us on the socials @germ.and.worm, subscribe to our RSS feed and share with your friends! We would so appreciate your rating and review to help us grow our audience. And, please visit our website: germandworm.com where you can find all our content and send us your questions and travel health anecdotes. Or, just send us an email: germandworm@gmail.com.Our Disclaimer: The Germ and Worm Podcast is designed to inform, inspire, and entertain. However, this podcast does NOT establish a doctor-patient relationship, and it should NOT replace your conversation with a qualified healthcare professional. Please see one before your next adventure. The opinions in this podcast are Dr. Sanford's & Dr. Pottinger's alone, and do not necessarily represent the opinions of the University of Washington or UW Medicine.

Episode 218: Statin Therapy Fundamentals What are statins? Zohal: Statins are medications that lower cholesterol by inhibiting the enzyme HMG-CoA reductase, which prevents cholesterol synthesis in the liver. By doing so, statins decrease low-density lipoprotein cholesterol (LDL-C).  Why should we lower LDL? Zohal: There are four main lipoproteins that transport fats in blood, including chylomicrons, VLDL, LDL, and HDL. This is where we get our “bad cholesterol” vs. “good cholesterol”. Of these, LDL is most associated with an increased risk in cardiovascular disease, while a higher HDL is associated with lower risk. Thus, reducing LDL subsequently reduces the risk of cardiovascular disease.  Arreaza: The lowest LDL I've seen was 25, and the highest HDL was 60. HDL doesn't really have a strict upper limit, but most people fall between 40 and 60. Extremely high HDL—above 100—may not always be protective and can sometimes signal underlying issues. Zohal: My HDL is 70! Statins are used for both primary prevention, meaning preventing cardiovascular disease before it occurs, and secondary prevention, meaning preventing disease progression in patients who already have cardiovascular disease. History of statins. Zohal: In the early 1900's, researchers were studying the association between cholesterol and atherosclerosis, and at that time, they primarily used animal subjects. These studies were initially not taken seriously, because most believed cardiovascular disease in humans were simply due to aging and was not preventable.  It wasn't until the middle of the century when researchers began observing that increased levels of LDL and decreased HDL was correlated with an increased rate of heart attacks. This finding prompted interest in determining the pathway of cholesterol synthesis in the human body.  Statins were first discovered in the 1970s when researchers identified compounds that inhibit a critical step in cholesterol synthesis. The first statin approved for clinical use was Lovastatin in 1987. Since then, multiple statins have been developed, including Atorvastatin, Rosuvastatin, Simvastatin, and Pravastatin. Further clinical trials in the 1990s and 2000s showed that statins significantly reduce myocardial infarction, stroke, and cardiovascular mortality. Why do Statins Matter in Primary Prevention Zohal: Cardiovascular disease is the most common cause of death worldwide. As previously mentioned, elevated LDL cholesterol contributes to the development of atherosclerotic plaques within arteries, which can lead to heart attack and stroke. By lowering LDL cholesterol and stabilizing plaque formation, statins implemented in a timely manner significantly reduce the risk of atherosclerotic cardiovascular disease. Arreaza: One of the things I love most about primary care is prevention. You're working upstream, often quietly, humbly, helping people avoid disease before it starts. And the truth is—you rarely see the full impact of your actions. You don't get a notification that says, “this patient didn't have a heart attack because of you.” But every time you help someone control their blood pressure, quit smoking, improve their diet, or stay consistent with their medications, you're shifting their tracks. You're reducing risk in ways that may never be fully visible. That's the paradox and the beauty of it: in primary care, your highest victories are often events that never happen.  Who Should Receive Statins for Primary Prevention? Zohal: Recommendations slightly differ depending on who you ask. We look to the U.S. Preventive Services Task Force, the American College of Cardiology, and the American Heart Association for their recommendations regarding statins for primary prevention. USPSTF on statins. The U.S. Preventive Services Task Force (or USPSTF for short) is an organization that works to improve the health of people nationwide by making evidence-based recommendations on effective ways to prevent disease & prolong life. They recommend statins for the primary prevention of cardiovascular disease in: Adults 40–75 years old With one or more cardiovascular risk factors such as dyslipidemia, diabetes, hypertension, or smoking AND a 10-year cardiovascular risk of 10% or greater Their recommendations are graded A, B, C, D, and I, depending on the strength of evidence and this is a Grade B recommendation. Arreaza: So, you have to meet all the criteria to receive a statin, according to USPSTF: 40-75, one CV risk factor and a high 10-y ASCVD score, by the way, the ASCVD risk calculator was introduced in 2013 by AHA/ACC. It is available online for free and many EHRs have integrated this tool into their software. For example, if you use EPIC, you can type .ascvd and get a score automatically. What about patients with a cardiovascular risk less than 10%? Zohal: For patients with a 7.5–10% risk, some may offer statin therapy on a case-by-case basis as this is a Grade C recommendation. But I'll get more into this later. Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week!  _____________________ References: Grundy SM, et.al, Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019 Jun 18;139(25):e1082-e1143. doi: 10.1161/CIR.0000000000000625. Epub 2018 Nov 10. Erratum in: Circulation. 2019 Jun 18;139(25):e1182-e1186. doi: 10.1161/CIR.0000000000000698. Erratum in: Circulation. 2023 Aug 15;148(7):e5. doi: 10.1161/CIR.0000000000001172. PMID: 30586774; PMCID: PMC7403606. https://pubmed.ncbi.nlm.nih.gov/30586774/ U.S. Preventive Services Task Force. (2022, August 23). Statin use for the primary prevention of cardiovascular disease in adults: Preventive medication.https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/statin-use-in-adults-preventive-medicatio American College of Cardiology ASCVD Risk Estimator: https://tools.acc.org/ascvd-risk-estimator-plus/#!/calculate/estimate/ Guideline Central. (2026, March). ACC/AHA dyslipidemia guideline spotlight (March 2026).https://www.guidelinecentral.com/insights/mar-2026-accaha-dyslipidemia-guideline-spotlight/ Endo A. A historical perspective on the discovery of statins. Proc Jpn Acad Ser B Phys Biol Sci. 2010;86(5):484-93. doi: 10.2183/pjab.86.484. PMID: 20467214; PMCID: PMC3108295. https://pubmed.ncbi.nlm.nih.gov/20467214/ Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/.

Description:  In this episode of the SMFM Podcast, we continue our American Heart Month series highlighting Patient Safety and Quality (PSQI) tools designed to improve cardiovascular outcomes in pregnancy. Dr. Melissa Spiel is joined by Dr. Andy Combs and Dr. Jamie Morgan to discuss the updated 2026 SMFM Checklist for Preeclampsia Risk-Factor Screening to Guide Recommendations for Prophylactic Low-Dose Aspirin. The conversation reviews key updates to the USPSTF recommendations, how the checklist supports systematic identification of eligible patients, and practical strategies for implementation in diverse practice settings. The episode also explores the companion process-based quality metric aimed at improving aspirin initiation by 16 weeks and helping practices measure adherence and equity in care. Resources:  Society for Maternal-Fetal Medicine Special Statement: Updated checklists for preeclampsia risk-factor screening to guide recommendations for prophylactic low-dose aspirin - SMFM Publications and Clinical Guidelines Society for Maternal Fetal-Medicine Special Statement: Prophylactic low-dose aspirin for preeclampsia prevention—quality metric and opportunities for quality improvement - SMFM Publications and Clinical Guidelines Disclaimer: "The Public Health System Components: Clinicians who are related to Maternal-Fetal Medicine program is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award to the Society for Maternal-Fetal Medicine (SMFM) totaling $1,278,000 with 100 percent funded by CDC/HHS. The contents are those of the authors and do not necessarily represent the official views of nor endorsement, by CDC/HHS or the U.S. Government."

Breast cancer screening fails most often where access is constrained: limited appointments, geographic gaps, dense breast tissue, and reliance on self-exams that depend entirely on human touch. Awareness alone doesn't close those gaps.In this episode, Dr. Karny Ilan, co-founder and CEO of Feminai, shares how physician-led product design, multidisciplinary collaboration, and rigorous clinical trials shaped a new model for breast screening access. The conversation explores a shift in how breast health is managed—from episodic screening to continuous, individualized monitoring. Rather than relying on infrequent appointments alone, it examines tools designed to track changes over time, at home, while remaining connected to clinical decision-making. Timestamps(00:11) Breast cancer risk shaped by genetics and lived exposure(08:37) Limits of traditional self-breast exams(09:09) Personal experience shaping breast health urgency(10:15) How at-home breast scanning detects change over time(12:42) Designing screening tools for dense breast tissue(17:03) Addressing breast size, shape, and post-surgical variation(18:31) Clinical trials revealing real-world usability gaps(20:13) Why ease of use affects screening reliability(29:29) Access gaps amplified by pandemic-era screening delays(38:09) Broad inclusion across age, risk, and body types Guest BioDr. Karny Ilan — Co-Founder and CEO, FeminaiDr. Karny Ilan is a general surgery resident at Sheba Medical Center and the co-founder and CEO of Feminai, a breast health company developing an AI-enabled disposable wearable patch and app for at-home breast exams. With a strong family history of breast cancer, she brings clinical experience and patient-centered design to building scalable screening tools that expand access and personalization.LinkedIn: https://www.linkedin.com/in/karny-ilan/Key PointsAccess constraints drive missed detection: Feminai targets screening gaps caused by geography, capacity, and avoidance.Physician-led design builds trust: Clinical credibility accelerated adoption with providers and investors.Dense breast tissue is a priority use case: The technology is designed to perform well where mammography often struggles.Personalized baselines change detection logic: Each scan is compared against the user's own prior data.Usability directly affects accuracy: Instructions, fit, and behavior shape downstream AI performance.Deep Dives1. At-home breast exams as infrastructureDesigned for frequent, low-friction useComplements rather than replaces imaging2. Patch and app workflowRisk stratification via medical questionnaireBluetooth-enabled scan uploads to secure cloudAI analysis with physician review3. Designing for every bodyStretch materials accommodate size variationDense tissue explicitly accounted forAdditional sizes planned as rollout expands4. Clinical trials beyond performance metricsUsability drove multiple design iterationsInstruction format affected adherenceShape changes required algorithm updates5. Personalized longitudinal trackingEach woman compared only to herselfChanges flagged based on deviation, not population averages6. Leadership and multidisciplinary teamsEngineers exposed to clinical sitesPatient stories shared to reinforce missionStability in leadership communication protected executionLinks & ReferencesBreast cancer screening beyond mammography (Mayo Clinic): https://www.mayoclinic.org/tests-procedures/mammogram/in-depth/breast-cancer/art-20047233Breast cancer screening recommendations (USPSTF): https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening

Dr. Lauren Rybolt, Assistant Professor of Medicine at the USF Morsani College of Medicine, presents a talk on how to to tailor strategies for Pre-exposure prophylaxis, or “PREP,” to the individual patient. Dr. Rybolt begins by discussing USPSTF recommendations. She then moves on to compare and contrast the currently available options for PREP therapy, including TDF/FTC versus TAF/FTC, Cabotegravir, and Lenacapavir. Dr. Rybolt then discusses laboratory monitoring while on the drugs and modifications of PREP therapy in a patient who also has chronic hepatitis B. She closes with her final points regarding the individualization of PREP treatment and the need to continuously assess the patient’s ongoing risk factors.

When you're preparing for NP boards, screening guidelines can seem a little dry, but these recommendations show up consistently on exams and form the foundation of primary care practice.   In this episode, Courtney and I run through an overview of the adult screening recommendations you'll need to know for primary care NP boards, leaning heavily on USPSTF recommendations.   Discover how to think through screening questions without getting lost in the nitty gritty detail.   Get full show notes, transcript, and more information here: https://blog.npreviews.com/primary-care-screening-guidelines-pass-np-boards   Follow us on Instagram: instagram.com/smnpreviewsofficial        

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-468 Overview: We first discussed aspirin use for primary prevention of cardiovascular disease in 2022 when the USPSTF recommended against it. In this follow-up episode, we review new trial data reinforcing that guidance and help you translate the evidence into safer prevention strategies. Build confidence in supporting patients with evidence-based approaches to reduce cardiovascular risk. Episode resource links: Aspirin, cardiovascular events, and major bleeding in older adults: extended follow-up of the ASPREE trial. Eur Heart J. 2025 Aug 12:ehaf514. doi: 10.1093/eurheartj/ehaf514. Epub ahead of print. PMID: 40796244. Guest: Robert A. Baldor MD, FAAFP   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-468 Overview: We first discussed aspirin use for primary prevention of cardiovascular disease in 2022 when the USPSTF recommended against it. In this follow-up episode, we review new trial data reinforcing that guidance and help you translate the evidence into safer prevention strategies. Build confidence in supporting patients with evidence-based approaches to reduce cardiovascular risk. Episode resource links: Aspirin, cardiovascular events, and major bleeding in older adults: extended follow-up of the ASPREE trial. Eur Heart J. 2025 Aug 12:ehaf514. doi: 10.1093/eurheartj/ehaf514. Epub ahead of print. PMID: 40796244. Guest: Robert A. Baldor MD, FAAFP   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-464 Overview: Beyond detecting disease early, lung cancer screening provides an opportunity to encourage smoking cessation. In this episode, we review USPSTF guidelines, compare screening effectiveness, and explore how the use of a pulmonary function test (PFT) and a lung age estimator can help people who smoke better understand their risks and inspire behavior change. Episode resource links: USPSTF: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancer-screening BMJ (Clinical Research Ed.). 2008;336(7644):598-600. doi:10.1136/bmj.39503.582396.25. BMC Public Health. 2022;22(1):1164. doi:10.1186/s12889-022-13583-1. Guest: Robert A. Baldor MD, FAAFP Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-464 Overview: Beyond detecting disease early, lung cancer screening provides an opportunity to encourage smoking cessation. In this episode, we review USPSTF guidelines, compare screening effectiveness, and explore how the use of a pulmonary function test (PFT) and a lung age estimator can help people who smoke better understand their risks and inspire behavior change. Episode resource links: USPSTF: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancer-screening BMJ (Clinical Research Ed.). 2008;336(7644):598-600. doi:10.1136/bmj.39503.582396.25. BMC Public Health. 2022;22(1):1164. doi:10.1186/s12889-022-13583-1. Guest: Robert A. Baldor MD, FAAFP Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  

Episode 206: Street Medicine and Harm Reduction.  Mohammed Wase (medical student) and Dr. Singh describe what it is like to provide health care on the streets. They share their personal experiences working in a street medicine team. They describe the practice of harm reduction and emphasize the importance of respecting autonomy and being adaptable in street medicine. Written by Mohamed Wase, MSIV, American University of the Caribbean. Editing by Hector Arreaza, MD. Hosted by Harnek Singh, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Introduction Dr. Singh: Welcome to another episode of our podcast, my name is Dr. Harnek Singh, faculty in the Rio Bravo Family Medicine Residency Program. Today we have prepared a great episode about street medicine, a field that has grown a lot during the last decade and continues to grow now. We are joined by a guest who is passionate about this topic. Wase, please introduce yourself.Wase: Hello everyone, my name is Mohammed, many know me as Wasé, I am a 4th year medical student from the American University of the Caribbean. Today we're diving into a topic that sits at the intersection of medicine, compassion, and public health — Street Medicine and Harm Reduction. We're going to step outside with this episode, literally, away from the clinic and hospital, to explore more about what care looks like in the streets. Historic background: How did street medicine start?Wase: The roots of Street Medicine in the United States go back to Dr. Jim Withers in Pittsburgh in the 1990s, who literally began by dressing as a homeless person and providing care on the streets to build trust. His efforts have shaped street medicine to what it is today. It combines primary care, mental health, and social support. Dr. Singh: For family physicians, this model aligns perfectly with our holistic approach. We don't just treat diseases; we treat people in context — their environment, their challenges, their stories. What is the main population seen by a street medicine team?Wase: This patient population includes those struggling with homelessness, housing insecurity, food insecurity, substance use disorders; with patients being preoccupied on where they will sleep that night or when their next meal comes, they do not have the luxury of prioritizing their health. Street Medicine is a powerful outreach program to bring care to them in order to provide equitable care within our community. Dr. Singh: How is street medicine different than caring for patients in the clinic?Wase: Working on the street means we have to think differently about what healthcare looks like — and that's whereharm reductioncomes in.What is Harm Reduction?Wase: Harm reduction is a public health philosophy that focuses on reducing the negative consequences of high-risk behaviors, rather than demanding complete abstinence.Dr. Singh: Preventive care is the backbone of family medicine. For example, we keep up with the USPSTF guidelines and make sure our patients are up to date with their screenings. But what does that look like in the street medicine setting? Wase: In practice, that might mean:-needle exchange program: Offering clean syringes to prevent HIV transmission and removing used needles-distributing naloxone to prevent overdose deaths-offering fentanyl test-strips to prevent use of substances that are unknowingly laced with fentanylDr. Singh: Also:-providing condoms to prevent sexually transmitted infections-providing wound care to prevent further spread of infectionWase: Yes, the idea is: people are going to engage in risky behaviors whether or not we approve of it, so let's meet them with compassion, tools, and trust instead of judgment. Harm reduction also applies beyond substance use; think about safer sex education, or even diabetic foot care among people who can't refrigerate insulin or change shoes daily. It's all about meeting people where they areandkeeping them alive and engaged in care. Planning in Street Medicine: Wase: It takes careful disposition planning and aftercare for this population. Instead of the traditional outpatient setting where we can place referrals and expect our patients to follow through with them. On street medicine, for follow up visits it requires arranging transportation, finding a pharmacy close in proximity, educating and counseling on medication adherence and how to make it, and making sure they have some sort of shelter to get by. Dr. Singh: Let's describe a typical street med encounter.Wase: A typical Street Medicine encounter might look like this: a small team — usually a physician, nurse, social worker, and sometimes a peer advocate — goes out with backpacks of supplies. They might start with wound care, blood pressure checks, or even medication refills. But what's just as important is the relationship-building. Sometimes, the first visit isn't about medicine at all — it's about showing up consistently.Over time, that trust opens the door for conversations about addiction treatment, mental health, and preventive care. For example, in some California Street Medicine programs, teams are treating chronic conditions like hypertension, diabetes, and hepatitis C, right where patients live with the same evidence-based care we'd give in a clinic. One of my favorite quotes from Street Medicine teams is: “We're not bringing people to healthcare; we're bringing healthcare to people.”Challenges in Street Medicine:Wase: The populations that you will encounter include many people who will often downplay their own health concerns and prior diagnoses. Unfortunately, this is usually from countless months or years of feeling neglected by our healthcare system. Some may even express distrust in our healthcare system and healthcare providers. Patient will, at times, be apprehensive to receive care or trust you enough to tell their story. Dr. Singh: Interviewing patients is a critical aspect of providing equitable care on the streets. It is always important to offer support and medical care, even if the patient denies it, always reassure that your street medicine clinic will be around every week and ready for them when they would like to seek care. Wase: Respecting patient autonomy is an utmost concern as well. Another element of interviewing to consider is to invite new ideas and information; instead of lecturing patients about taking medications on time or telling them they need to stop doing drugs—simply asking a patient “would you like to know more about how we can help you stop using opioids?” respects their choice but can also spark new ideas for them to consider. Singh: Adaptability is another key component to exceling patient care in street medicine. Like, performing physical exams on park benches or in the back of a minivan. Always doing good with our care but also respecting their autonomy is crucial in building a trust that these patients once lost with our system. Wase: Each patient has their own timeline, but we as providers should always assure them that our door is always open for them when they are ready to seek care. Conclusion.Wase: So, to wrap up — Street Medicine and harm reduction remind us that healthcare isn't just about hospitals and clinics. It's about relationships, trust, and dignity.Every patient deserves care, no matter where they sleep at night.If you're a resident or student listening, I encourage you to seek out these experiences — volunteer with Street Medicine teams, learn from harm reduction workers, and let it shape how you practice medicine. Thank you for listening to this episode of the Rio Bravo qWeek podcast. I'm Mohammed — and I hope this conversation inspires you to meet patients where they are and walk with them on their journey to health.Dr. Singh: If you liked this episode, share it with a friend or a colleague. This is Dr. Singh, signing off.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:Doohan, N.C. “Street Medicine: Creating a ‘Classroom Without Walls' for People Experiencing Homelessness.” PMC – National Library of Medicine, 2019.Hawk, M., et al. “Harm Reduction Principles for Healthcare Settings.” Harm Reduction Journal, vol. 14, no. 1, 2017.Withers, J.S. “Bringing Health Professions Education to Patients on the Streets.” Journal of Ethics, AMA, vol. 23, no. 11, Nov. 2021.“Our Story.” Street Medicine Institute, 2025, www.streetmedicine.org/our-story.“Principles of Harm Reduction.” National Harm Reduction Coalition, 2024, https://harmreduction.org/about-us/principles-of-harm-reduction/.Salisbury-Afshar, Elizabeth, Bryan Gale, and Sarah Mossburg. “Harm Reduction Strategies to Improve Safety for People Who Use Substances.” PSNet, Agency for Healthcare Research & Quality, 30 Oct. 2024.Douglass, A.R. “Exploring the Harm Reduction Paradigm: The Role of Boards in Drug Policy and Practice.” PMC – National Library of Medicine, 2024.Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/.

No, Mammograms are Not a “One and Done” Procedure Crowd favorite Dr. Raz joins Dorothy to shed light on the importance of mammograms in detecting breast cancer early. He gets granular by explaining what a mammogram is and why it’s important to have one every year. Changing guidelines have left many women confused over the year, and Dr. Raz’s insights clear the air. He emphasizes the need for consistency and punctuality in mammogram screenings to catch cancer early and improve survivability. Support The Rose HERE. Subscribe to Let’s Talk About Your Breasts on Apple Podcasts, Spotify, iHeart, and wherever you get your podcasts. Key Questions Answered 1.) What’s a mammogram? 2.) Why should women get them done early? 3.) What are the different kinds of mammograms? 4.) How have changing guidelines had an impact on women’s health? 5.) Why is it important to get screened every year? Timestamped Overview 00:00 What is a mammogram? 01:23 Importance of annual mammograms 04:01 Role of USPSTF in setting guidelines 04:58 Impact of changing guidelines on insurance coverage 05:24 Difference between screening and diagnostic mammograms 08:10 What women need to know about mammogramsSee omnystudio.com/listener for privacy information.

Recent evidence challenges the practice of prescribing oral antibiotics after Cesarean delivery in obese patients, finding no significant reduction in infection rates compared to standard preoperative antibiotics alone. Howard and Antonia analyze studies showing why this once-promising intervention may not be necessary.• ACOG updates delayed cord clamping guidance to minimum 60 seconds for preterm infants• Baby born at 21 weeks and zero days celebrates first birthday, highlighting advances in neonatal care• Systematic reviews show no difference between chlorhexidine and iodine for vaginal prep before hysterectomy• Conservative management of placenta accreta spectrum disorders shows improved outcomes over immediate cesarean hysterectomy• Labor arrest Cesareans have highest blood loss among non-accreta cesarean indications• New HPV testing terminology recommends "HPV detected" rather than "positive" to avoid relationship misunderstandings• USPSTF preeclampsia prevention guidelines classify 89% of pregnant women as aspirin candidates despite limited evidence• Endometrial sampling best practices include stepwise approach starting with ultrasound before considering hysteroscopyIn two weeks, Jacqueline Vidosch returns to discuss her son Noah who has trisomy 18, following a feature in the New York Times.00:00:00 Episode Introduction00:06:43 Post-Cesarean Antibiotics: Evidence Review00:17:11 Delayed Cord Clamping Updates00:22:13 Extreme Preterm Survival Case00:26:40 Vaginal Prep and Placenta Accreta Management00:30:11 Cesarean Blood Loss by Indication00:34:21 HPV Testing Language Changes00:37:45 Aspirin for Preeclampsia Prevention00:51:33 Endometrial Sampling QuestionFollow us on Instagram @thinkingaboutobgyn.

MedPod Today: the podcast series where MedPage Today reporters share deeper insight into the week's biggest healthcare stories. This week, MedPage Today reporters discuss an FDA official's abrupt exit and the future of USPSTF, a major publishing slowdown at MMWR, and why FDA's so-called 'expert panels' are raising red flags. Episode produced and hosted by Rachael Robertson. Sound engineering by

Episode 199: Essential Screenings for Young AdultsDr. Lopez presents the most important screening tests for young adults. Dr. Arreaza adds some input on screening for depression and anxiety. Written by Alejandra Lopez, MD. Edits by Hector Arreaza, MD. Rio Bravo Family Medicine Residency Program. You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Dr. Lopez: Screening is testing done to help identify disease in a person or population that typically appears healthy. Our goal as clinicians is to see which children are at increased risk of disease and will merit additional testing. For clinicians, testing should be both easy to perform and interpret. Now let's talk about prevention in young adults.Dr. Arreaza: I can see it is important to talk about young adults because that population may be very hesitant to go to the doctor, in general. Tell us more about it.Dr. Lopez: We all know that early detection and prevention are key, but many young adults skip routine check-ups. Why is that? Sometimes it's lack of awareness, fear, or just not knowing where to start. That's why today, we'll focus on four key screenings that every adolescent and young adult should know about.The Annual Physical ExamDr. Arreaza: I'm excited to talk about it. Many young adults only see a doctor when they're sick, but screenings help catch issues early, sometimes before symptoms even appear. Tell us about the annual wellness exams and why they matter.Dr. Lopez: Let's start with the basics—annual wellness exams. Many young people don't feel the need to see a doctor if they're feeling fine. So, these check-ups are important because many serious health conditions start silently, meaning no symptoms at first. Dr. Arreaza: What do we look for in an annual exam?Dr. Lopez: An annual check-up:· It is important to track growth and development (especially important for adolescents)It also helps monitor blood pressure, weight, and BMI to help find out who is at risk for elevated or low BP, underweight or overweight/obesity, by analyzing both weight and body mass index.· Discuss lifestyle habits like diet, exercise, and sleep· Evaluate whether you are up to date on vaccinations or due for age-appropriate vaccines.· Address any mental health concernsIt's also a great opportunity for young people to establish a relationship with a provider they trust. This makes it easier to discuss sensitive topics like sexual health or mental health.Dr. Arreaza: So, you say that the annual physical exam helps identify all these issues early, and at the same time, you establish a relationship of trust with a doctor who you may need at any time. STI ScreeningDr. Arreaza: That brings us to our second key screening: testing for sexually transmitted infections (STIs). There are many STIs. Let's focus on gonorrhea, chlamydia, syphilis, and HIV. Dr. Lopez, can you breakit  down for us? Who needs STI screening, and why is it so important?Dr. Lopez: Absolutely. The CDC recommends that ALL sexually active women under age 25 get screened for chlamydia and gonorrhea annually. HIV testing should also be done at least once for all young adults and annually for those at higher risk. Why is this the case? Because Many STIs have no symptoms, but untreated infections can lead to serious complications like infertility or pelvic inflammatory disease (PID) in women. The good news is that these infections are easily treatable if caught early. If caught later in life, then women and men alike are at risk for worse conditions. Dr. Arreaza: Let's talk about how do we do it?Dr. Lopez: STI screening is simple:· For chlamydia and gonorrhea, it's usually a urine test or a vaginal/cervical/oral swab.· For HIV, it's a quick blood test or even an oral swab.Many young adults avoid testing because of fear, stigma, or concerns about privacy, but most clinics offer confidential or even anonymous testing. Doctors do not share any information regarding the minor or young adult or any patient for that matter. AND if we are requested to share any information with others- then it is our obligation as doctors to ALWAYS ASK THE PATIENT before sharing ANY health information with third parties/other entitiesDr. Arreaza: And that includes parents of minors. Doctors are not allowed to discuss STI test results with parents of minors unless they are authorized by the patient or if the patient is in danger, for example, if this is a result of sexual abuse.Mental Health ScreeningsDr. Arreaza: Now, let's talk about something that's just as important as physical health—mental health. Depression and anxiety are very common in young people, but many don't seek help. How do doctors screen for depression?Dr. Lopez: Screening for depression is now a standard part of primary care. The most commonly used tool is the PHQ-9 questionnaire, which asks about:· Mood changes (sadness, hopelessness)· Loss of interest in activities· Sleep disturbances· Changes in appetite· Difficulty concentratingA score on this test can help determine whether someone is at risk of depression and needs further evaluation or support.Dr. Arreaza: And why should we screen for depression?Dr. Lopez: Because early treatment makes a huge difference. Depression can affect school, work, relationships, and even physical health. But with therapy, lifestyle changes, and sometimes medication, people can and do recover.I always tell young adults: Mental health is just as important as physical health. Seeking help is a sign of strength, not weakness.Dr. Arreaza: This is a USPSTF recommendation GRADE B. We are encouraged to screen adults, including pregnant and postpartum women, as well as older adults.HPV Screening & VaccinationDr. Lopez: Dr. Arreaza, finally, let's talk about HPV—one of the most preventable causes of cancer. The human papillomavirus (HPV) is the most common STI worldwide, and it's responsible for almost all cases of cervical cancer, as well as throat, anal, and penile cancers. The good news? The HPV vaccine is over 90% effective at preventing these cancers. Dr. Arreaza: In fact, from 2015 to 2018, U.S. women ages 14 to 19 experienced an 88% decrease in HPV-related disease. That's a direct result of the vaccine's effectiveness.Dr. Lopez: It's recommended for:· All boys and girls, starting at the age of 9. ACIP gave new recommendations for use of a 2-dose schedule for girls and boys who initiate the vaccination series at ages 9-14 years. Three doses remain recommended for persons who start HPV vaccination at ages 15-26 years and for immunocompromised persons.· Catch-up vaccination is recommended for people up to age 26 (and in some cases, up to 45 with provider recommendation)Dr. Arreaza: And what about screening for HPV? How do we screen?Dr. Lopez: Great question, Dr. Arreaza. Pap smears start at age 21, for all women regardless of sexual activity, and are repeated every 3-5 years depending on HPV testing. Many people think Pap smears check for STIs, but they actually look for abnormal cervical cells that could lead to cancer. HPV vaccination plus routine screening means cervical cancer is one of the most preventable cancers today!Closing Thoughts & Call to ActionDr. Arreaza: That wraps up today's discussion on essential health screenings for young adults! Dr. Lopez, any final take-home messages?Guest: My biggest message is don't wait until something is wrong to see a doctor. Preventative care is simple, quick, and can save lives.If you're between the ages of 13-26, here's what you should do:-Get an annual wellness exam-Get tested for STIs if sexually active-Check in on your mental health and talk to someone if you need support-Get the HPV vaccine if you haven't already and follow up on screeningTaking these small steps today leads to better health for years to come!Host: That's fantastic! Dr. Lopez. I hope all our primary care providers can take these easy steps to keep our young community healthy. If you found this episode helpful, share it with a friend, and don't forget to subscribe to our podcast for more practical health discussions.Dr. Lopez: Until next time—thanks for chiming in, medical community. Take care and take charge of your health!Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:Screening Recommendations and Considerations Referenced in Treatment Guidelines and Original Sources. U.S. Centers for Disease Control and Prevention, CDC.gov, https://www.cdc.gov/std/treatment-guidelines/screening-recommendations.htm, accessed on June 26, 2025.Recommendation: Anxiety Disorders in Adults: Screening, United States Preventive Services Taskforce, June 20, 2023, https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/anxiety-adults-screening, accessed on June 26, 2025.Recommendation: Depression and Suicide Risk in Adults: Screening, United States Preventive Services Taskforce, June 20, 2023, https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/screening-depression-suicide-risk-adults, accessed on June 26, 2025.Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-442 Overview: Listen in as we review the USPSTF's recently proposed recommendations for screening women who are at risk for developing osteoporosis. Gain confidence to navigate these changes and engage patients in shared decision-making to ensure timely, evidence-based preventive care. Episode resource links: JAMA. 2025;333(6):498–508. doi:10.1001/jama.2024.27154 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-442 Overview: Listen in as we review the USPSTF's recently proposed recommendations for screening women who are at risk for developing osteoporosis. Gain confidence to navigate these changes and engage patients in shared decision-making to ensure timely, evidence-based preventive care. Episode resource links: JAMA. 2025;333(6):498–508. doi:10.1001/jama.2024.27154 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  

Editor's Summary by Kirsten Bibbins-Domingo, PhD, MD, MAS, Editor in Chief, and Linda Brubaker, MD, Deputy Editor of JAMA, Deputy Editor of JAMA, the Journal of the American Medical Association, for articles published from June 21-27, 2025.

Prostate cancer screening isn't just clinical—it's personal. Especially when headlines make it political.In this episode Tracy breaks down the buzz around President Joe Biden's recent prostate cancer diagnosis—and uses the moment to teach, clarify, and contextualize what it really means to screen for prostate cancer in 2025.As a former Urology PA, Tracy brings her clinical experience and clear communication to an often-misunderstood topic. She walks through:What the prostate does and how PSA testing worksWhat elevates PSA levels (that isn't cancer)Why BPH complicates the pictureWhat Gleason scores tell us about cancer aggressivenessCurrent USPSTF and AUA guidelines for prostate cancer screeningHow shared decision-making, not headlines, should guide patient careThis episode is a reminder to return to nuance and individualize care—especially when the world is watching.

This week's topics include USPSTF on screening for syphilis in pregnancy, when to take blood pressure medicines, comparing weight loss drugs, and a narrative intervention for PTSD after an ICU stay.Program notes:0:40 NEJM publication of comparison of obesity medications1:40 Tirzepatide versus semaglutide for 72 weeks2:41 Also had reduction in blood pressure3:26 Rise in congenital syphilis and screening4:26 Disparities among various groups5:26 Highest incidence in the last 30 years6:26 In 2023 210,000 cases of syphilis7:00 When to take blood pressure meds8:00 Monitored blood pressure in a subset8:40 Intervention for PTSD after ICU stay9:40 Self reported PTSD symptoms​​10:40 Must learn to deliver intervention11:40 Physician needed to spend 45 minutes per visit12:42 End

In the latest episode of Ask Michelle, Michelle shared key compliance updates, including the upcoming April Supreme Court ruling on the U.S. Preventive Services Task Force's (USPSTF) authority over preventive care recommendations, the San Francisco Health Care Security Ordinance (HCSO) annual reporting deadline on May 2, 2025, and President Trump's recent Executive Order aimed at lowering drug costs. Michelle also highlighted the upcoming Fisher Phillips webinar on April 30, 2025, covering the latest in labor and employment law.Michelle addressed several listener questions, such as whether beneficiaries are taxed if an employer fails to impute income on excess group term life insurance, the requirement to issue a Summary of Material Modifications (SMM) after a plan and carrier change on January 1, 2025, and if fully insured group health plans must conduct a Non-Quantitative Treatment Limitation (NQTL) analysis for Mental Health Parity compliance.She also discussed the rise in class action lawsuits against employer wellness programs related to tobacco surcharges and reminded listeners about the BCBS Provider Settlement Fund claims deadline of July 29, 2025. Are you curious about a compliance issue? Please submit your questions to AskMichelle@imacorp.com, and Michelle will answer them in the next episode. 

This week on Faisel and Friends, we are discussing Connecting Back to Care: Reimagining Maternal Health. Faisel and Dan are talking with Dr. Esa Davis: Associate Vice President for Community Health at University of Maryland School of MedicineOur conversation explores navigating challenging medical situations, creating an environment where patient voices matter, and looking towards a psychologically safe future in healthcare.Dr. Esa Davis is a Vice Chair of the US Preventive Services Task Force (USPSTF) and the materials expressed in this podcast reflect her individual views only and do not represent the views or recommendations of the USPSTF.  The overall presentation should not be attributed to the USPSTF.

Today we are going over the basics of DEXA. This will help patients understand the test and what is being measured. It will also help clinical providers understand this test better. Let's dive in! The BasicsDEXA stands for Dual Energy X-Ray Absorptiometry-              Xray machine used for analyzing body composition-              Great at telling the difference between bone, fat, and lean tissue (mostly muscle)-              Uses 2 xray beams of different energies for this, hence Dual (via subtracting attenuation coefficients….or something like that)-              Most studied and widely used tool for looking at bone density-              USPSTF recommends all women over age 65 get one-              But 65 is way to late to get your first DEXA. The Cliff of old age is already luming at that point.-              I recommend getting one in your 20s or 30s to get a baseline and to help plan for the future. This will give you decades to improve things like bone density or get more muscled.Check out FullScope.org or Longetrics.org for the complete blog posts.

Program notes:0:40 Polygenic risk score for prostate cancer1:40 90th percentile or higher2:40 Genetic risk for cancer3:41 Avoid false positives4:00 Cervical artery dissection and subsequent stroke risk5:00 High in older people, Black and Hispanic people6:00 Nonspecific symptoms may predict7:00 Preventing clotting in patients with cancer8:00 Standard dose followed by half dose8:44 USPSTF on supporting breastfeeding9:45 Support systems not that good10:55 What is the best strategy to support?12:14 End

It has been more than a decade since lung cancer screening guidelines via low-dose CT, based on the USPSTF's B recommendations, have been put into place. To discuss the guidelines' ambitions and obstacles, we are joined by the University of Illinois Health System's Mary Pasquinelli, DNP, who specializes in lung cancer, lung cancer screening and pulmonary nodule management. While a lifesaving procedure for at-risk individuals, the uptake of screening on a population-level—though increasing—has been slower than expected. Want more Lungcast? Visit us at HCPLive.com/podcasts/lungcast or www.lung.org/professional-education/lungcast

This Day in Legal History: Maryland Toleration Act PassedOn April 21, 1649, the Maryland Assembly passed the Maryland Toleration Act, a landmark piece of colonial legislation that granted freedom of worship to all Christians in the colony. Also known as the Act Concerning Religion, it was one of the first legal efforts in the American colonies to protect religious liberty through statutory law. The act was enacted under the leadership of Cecil Calvert, the second Lord Baltimore, who sought to maintain peace in Maryland's religiously diverse population, which included both Catholics and Protestants.The law's preamble acknowledged the dangers of religious coercion, stating that "the inforceing of the conscience in matters of Religion hath frequently fallen out to be of dangerous Consequence." To preserve harmony, it declared that no Christian should be "troubled, Molested or discountenanced" for practicing their faith, provided they did not threaten the colony's civil government or the authority of the Lord Proprietor.While progressive for its time, the Act's protections were limited to those who professed belief in Jesus Christ, excluding Jews, atheists, and other non-Christians. Violators of the law's religious tolerance provisions faced harsh penalties, including fines, public whipping, or even death for blasphemy.The Act was repealed just five years later during a period of Protestant ascendancy, reflecting the fragile nature of religious tolerance in colonial America. Nonetheless, it remains significant as an early attempt to codify the principle that faith should not be a basis for persecution.A federal judge has ruled that the Office of Personnel Management (OPM) can no longer direct the termination of probationary federal workers based on performance-related justifications that were, according to the court, misleading. U.S. District Judge William Alsup called OPM's use of standardized termination letters citing performance as the reason for firing thousands of employees a “total sham.” He emphasized that falsely attributing the dismissals to performance could harm the affected workers' reputations and career prospects for years to come.The ruling affects employees at six federal agencies and prohibits further terminations under these pretenses. Judge Alsup's decision underscores that these workers were dismissed under false narratives while still in their probationary period—either newly hired or recently promoted—and should not have been labeled as underperformers without proper evaluation or process.Though Alsup's ruling offers protection against future actions, he declined to issue a preliminary injunction requested by the state of Washington, stating the state lacked standing because it could not show concrete harm from the federal firings, such as a clear loss of federal services.This legal challenge comes amid a broader judicial tug-of-war. In March, Alsup had initially ordered the reinstatement of 16,000 workers pending resolution of a lawsuit. However, the U.S. Supreme Court blocked that injunction on April 8, suggesting that nonprofit organizations representing federal workers may lack the legal standing to sue on their behalf. Following that, the Fourth Circuit Court of Appeals also halted a separate injunction from a Maryland judge that would have reinstated probationary employees in 19 states and Washington, D.C.Despite the limits imposed by the higher courts, Alsup's decision focuses on the reputational harm caused by labeling the dismissals as performance-based, rather than procedural or administrative. He signaled that the government must correct the record for those terminated workers.Performance-Based Federal Worker Layoffs a ‘Sham' Judge RulesThe U.S. Supreme Court is set to hear a major challenge to a provision of the Affordable Care Act (ACA), commonly known as Obamacare, that mandates insurers cover certain preventive medical services—like cancer screenings and diabetes testing—without cost-sharing by patients. The case centers on the constitutional validity of the U.S. Preventive Services Task Force (USPSTF), a panel of medical experts that identifies which services should be covered. The panel's 16 members are appointed by the Secretary of Health and Human Services (HHS) but are not confirmed by the Senate.A group of Texas-based Christian individuals and businesses filed the lawsuit in 2020, arguing that the USPSTF wields too much authority and must therefore comply with the U.S. Constitution's Appointments Clause. This clause requires that significant federal officers—known as "principal officers"—be nominated by the president and confirmed by the Senate. The plaintiffs claim the task force has evolved from a purely advisory body to one that effectively imposes binding legal obligations on insurers, all without proper accountability.In 2024, the conservative-leaning 5th U.S. Circuit Court of Appeals agreed with the plaintiffs, ruling the task force's structure unconstitutional. The federal government appealed that ruling to the Supreme Court. The Biden administration originally filed the appeal, and it was later continued by the Trump administration. Government lawyers argue that the task force should be classified as comprising "inferior officers," since their recommendations are only made binding when approved by the HHS Secretary, who can remove task force members at will.The plaintiffs, however, maintain that the Secretary lacks actual power to stop recommendations from taking effect, making the task force's authority effectively unchecked. They also argue that this lack of oversight elevates the members to principal officer status, necessitating Senate confirmation.Before narrowing the lawsuit to the appointments issue, the plaintiffs also challenged the ACA's requirement to cover HIV prevention medication on religious grounds, asserting it promoted behaviors they opposed. The appeals court declined to sever portions of the law that might otherwise save the provision, another aspect now before the Supreme Court.If the Supreme Court upholds the lower court's decision, key preventive healthcare services could become subject to out-of-pocket costs like deductibles and co-pays, potentially deterring millions from accessing early detection and prevention tools. The Court's decision, expected by the end of June, could reshape how health policy is implemented under the ACA and may further weaken one of its core patient protections.US Supreme Court to hear clash over Obamacare preventive care | ReutersIn a rapidly unfolding legal confrontation, the U.S. Supreme Court issued an emergency order halting the deportation of a group of Venezuelan migrants from Texas, sparking a strong dissent from Justice Samuel Alito. The court intervened early Saturday morning, acting on urgent filings by detainees' lawyers who said the migrants were already being loaded onto buses for imminent deportation to El Salvador. The migrants were accused of gang affiliation, but their legal team argued they hadn't been given fair notice or time to challenge their removal. The administration attempted to use the Alien Enemies Act of 1798, a wartime law, to justify these expulsions.Justice Alito, joined by Justice Clarence Thomas, sharply criticized the majority's decision, calling it "unprecedented and legally questionable." He argued that the Court acted without giving lower courts adequate time to review the claims and issued its order with limited evidence and no explanation. The justices' ruling paused deportations “until further order of this Court,” leaving room for future legal developments.The Trump administration quickly responded, filing a motion urging the Court to reverse its stay. U.S. Solicitor General D. John Sauer argued the detainees' lawyers bypassed proper procedure by going directly to the Supreme Court and that lower courts had not yet had a chance to establish key facts. He maintained that the migrants received legally sufficient notice, though reports suggested the notices were in English only and lacked clear instructions.The administration's use of the Alien Enemies Act to deport alleged gang members is highly controversial. Originally passed in 1798 during hostilities with France, the law has been used sparingly and almost exclusively during wartime. The Supreme Court has not yet ruled on whether its application in this immigration context is constitutional. Migrants' advocates, including the ACLU, maintain that many of the men deported or at risk of deportation are not gang members and were denied due process.The legal conflict reflects a broader tension between Trump's immigration enforcement efforts and judicial oversight. Last month, Trump ordered the deportation of more than 200 men to a Salvadoran maximum-security prison, reportedly ignoring a judge's oral order to halt at least two flights. The White House has not signaled any intent to defy the current Supreme Court stay but remains committed to its immigration crackdown.The case, A.A.R.P. v. Trump, now becomes a focal point in ongoing disputes about executive authority, due process rights for detainees, and the scope of immigration enforcement under rarely invoked legal provisions. As the Court weighs further action, the lives of dozens of migrants hang in the balance, caught between legal technicalities and broader political pressures.Supreme Court's Alito Calls Block of Deportations ‘Questionable' - BloombergAlito criticizes US Supreme Court's decision to 'hastily' block deportations | ReutersTrump Administration Asks Supreme Court to Lift Deportation Halt - BloombergA federal judge in Boston ruled that the Trump administration's passport policy targeting transgender and nonbinary individuals is likely unconstitutional. The policy, which followed an executive order signed by President Trump immediately after returning to office, required passport applicants to list their biological sex at birth and allowed only "male" or "female" markers. This reversed prior policies that permitted self-identification and, under the Biden administration, had allowed the use of a gender-neutral "X" option.U.S. District Judge Julia Kobick issued a preliminary injunction that bars enforcement of the policy against six of the seven plaintiffs who filed the lawsuit. She held that the policy discriminates based on sex and reflects a bias against transgender individuals, violating the Fifth Amendment's guarantee of equal protection. Kobick described the administration's approach as rooted in "irrational prejudice" and said it runs counter to the Constitution's promise of equality.Despite finding the policy likely unconstitutional, Kobick declined to issue a nationwide injunction, stating that the plaintiffs did not justify the need for broad relief. Still, the ruling marks a significant legal setback for the administration's broader effort to redefine federal gender recognition policies.The executive order at the center of the case mandated all federal agencies, including the State Department, to recognize only two sexes—male and female—based on biology at birth. The State Department then revised its passport application process to align with this directive.The case is part of a wave of legal challenges to Trump's rollback of gender recognition policies. Lawyers for the plaintiffs, represented by the ACLU, vowed to continue fighting to expand the ruling's protections to all affected individuals.Trump passport policy targeting transgender people likely unconstitutional, judge rules | Reuters This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.minimumcomp.com/subscribe

Editor's Summary by Kirsten Bibbins-Domingo, PhD, MD, MAS, Editor in Chief, and Preeti Malani, MD, MSJ, Deputy Editor of JAMA, the Journal of the American Medical Association, for articles published from April 5-11, 2025.

This week Gary, Mark, Kate and Henry discuss: adverse effects from inhaled steroids in asthma, Italian dementia guideline, fezolinetant for treatment of vasomotor symptoms, and updated USPSTF recommendations for osteoporosis screening.Show notes and links:Asthma and risk of CV events: https://pubmed.ncbi.nlm.nih.gov/39088770/ GINA 2024 guidelines: https://ginasthma.org/2024-report/ Italian dementia guidelines: https://www.ncbi.nlm.nih.gov/pubmed/39544104 with link to full report in Inglese: https://www.iss.it/documents/d/guest/the-full-guideline-english-version Fezolinetant for vasomotor symptoms: https://pubmed.ncbi.nlm.nih.gov/39557487/USPSTF osteoporosis screening guideline: https://pubmed.ncbi.nlm.nih.gov/39808425/ Dietary assessment tool: https://epi.grants.cancer.gov/asa24/ Article on interval for next BMD screening based on initial result: https://pubmed.ncbi.nlm.nih.gov/22256806/

Editor's Summary by Kirsten Bibbins-Domingo, PhD, MD, MAS, Editor in Chief, and Preeti Malani, MD, MSJ, Deputy Editor of JAMA, the Journal of the American Medical Association, for articles published from March 8-14, 2025.

Interview with Tumaini Rucker Coker, MD, MBA, USPSTF member and coauthor of Screening for Food Insecurity: US Preventive Services Task Force Recommendation Statement. Hosted by JAMA Editor in Chief Kirsten Bibbins-Domingo, PhD, MD, MAS. Related Content: Preventive Services for Food Insecurity Food Insecurity, Health, and Health Care in the US Navigating the Complexity of Food Insecurity Screening Screening for Food Insecurity US Preventive Services Task Force Recommendations for Screening for Food Insecurity Screening for Food Insecurity

Episode 183: Colorectal Cancer in Young AdultsFuture Dr. Avila and Dr. Arreaza present evidence-based information about the screening and diagnosis of colorectal cancer and explain the increasing incidence among young adult and the importance to screen early in high risk groups.  Written by Jessica Avila, MS4, American University of the Caribbean School of Medicine. Edits and comments by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.IntroductionJessica: Although traditionally considered a disease only affecting older adults, colorectal cancer (CRC) has increasingly impacted younger adults (defined as those under 50) at an alarming rate. According to the American Cancer Society, CRC is now the leading cause of cancer-related death in men under 50 and the second leading cause in women under 50 (American Cancer Society, 2024). Arreaza: Why were you motivated to talk about CRC in younger patients?Jessica: Because despite advancements in early detection and treatment, younger patients are often diagnosed at later stages, resulting in poorer outcomes. We will discuss possible causes, risk factors, common symptoms, and why early screening and prevention are important. Arreaza: This will be a good reminder for everyone to screen for colorectal cancer because 1 out of every 5 cases of colorectal cancer occur in adults between the ages of 20 and 54. The Case of Chadwick BosemanJessica: Many people know Chadwick Boseman from his role as T'Challa in Black Panther. His story highlights the worrying trend of increasing CRC in young adults. He was diagnosed with stage III colorectal cancer at age 39. This diagnosis was not widely known until he passed away at 43. His case shows how silent and aggressive young-onset CRC can be. Like many young adults with CRC, his symptoms may have been missed or thought to be less serious issues. His death drew widespread attention to the rising burden of CRC among young adults and emphasized the critical need for increased awareness and early screening efforts.Arreaza: Black Panther became a hero not only in the movie, but also in real life, because he raised awareness of the problem in young AND in Black adults. EpidemiologyJessica: While rates of CRC in older populations have decreased since the 1990s, adults under 50 have seen an increase in CRC rates of nearly 50%. (Siegel et al., 2023). Currently, one in five new CRC diagnoses occurs in individuals younger than 55 (American Cancer Society, 2024).Arreaza: What did you learn about the incidence by ethnic groups? Are there any trends? Jessica: Yes, certain ethnic groups are shown to have higher rates of CRC. Black Americans, Native Americans, and Alaskan Natives have the highest incidence and mortality rates from CRC (American Cancer Society, 2024). Black Americans have a 20% higher incidence and a 40% higher mortality rate from CRC compared to White Americans, primarily due to disparities in access to screening, healthcare resources, and early diagnosis. Hispanic and Asian American populations are also experiencing increasing CRC rates, though to a lesser extent.Arreaza: It is important to highlight that Black Americans have the highest rate of both diagnoses and deaths of all groups in the United States. Who gets colorectal cancer?Risk FactorsJessica: Anyone can get colorectal cancer, but some are at higher risk. In most cases, environmental and lifestyle factors are to blame, but early-onset CRC are linked to hereditary conditions. Arreaza: There is so much to learn about colorectal cancer risk factors. Tell us more.Jessica: The following are key risk factors:Modifiable risk factors:Diet and processed foods: A diet high in processed meats, red meat, refined sugars, and low fiber is strongly associated with an increased risk of CRC. Fiber is essential for gut health, and its deficiency has been linked to increased colorectal cancer risk (Dekker et al., 2023).Obesity and sedentary lifestyle: Obesity and physical inactivity contribute to CRC risk by promoting chronic inflammation, insulin resistance, and metabolic disturbances that promote tumor growth (Stoffel & Murphy, 2023).Gut microbiome imbalance: Disruptions in gut microbiota, especially an overgrowth of Fusobacterium nucleatum, have been noted in CRC pathogenesis, potentially causing tumor development and progression (Brennan & Garrett, 2023).Arreaza: As a recap, processed foods, obesity, sedentarism, and gut microbiome. We also have to mention smoking and high alcohol consumption as major risks factors, but the strongest risk factor is a family history of the disease.Non-modifiable risk factors:Genetic predisposition: Although only 20% of early-onset CRC cases are linked to hereditary syndromes such as Lynch syndrome and familial adenomatous polyposis (FAP), individuals with a first-degree relative with CRC are at a significantly higher risk and should undergo earlier and more frequent screening (Stoffel & Murphy, 2023).Arreaza: Also, there is a difference in incidence per gender assigned at birth, which is also not modifiable. The rate in the US was 33% higher in men (41.5 per 100,000) than in women (31.2 per 100,000) during 2015-2019. So, if you are a man, your risk for CRC is slightly higher. Protective factors, according to the ACS, are physical activity (no specification about how much and how often) and dairy consumption (400g/day). Jessica, let's talk about how colon cancer presents in our younger patients.Clinical Presentation and Challenges in DiagnosisJessica: Young-onset CRC is often diagnosed at advanced stages due to delayed recognition of symptoms. Common symptoms include:Rectal bleeding (often mistaken for hemorrhoids)Young individuals may ignore it, believe they do not have time to address it, or lack insurance to cover a comprehensive evaluation.Unexplained weight lossFatigue or weaknessChanges in bowel habits (persistent diarrhea or constipation)This may also be rationalized by dietary habits.Abdominal pain or bloatingIron deficiency anemia.Arreaza: All those symptoms can also be explained by benign conditions, and colorectal cancer can often be present without clear symptoms in its early stages. Jessica: Yes, in young adults, symptoms may be dismissed by healthcare providers as benign conditions such as irritable bowel syndrome (IBS), hemorrhoids, or dietary intolerance, leading to significant diagnostic delays. Arreaza: We must keep a low threshold for ordering a colonoscopy, especially in patients with the risks we mentioned previously. Jessica: We may also be concerned about the risk/benefit of colonoscopy or diagnostic methods in younger adults, given the traditional low likelihood of CRC. Approximately 58% of young CRC patients are diagnosed at stage III or IV, compared to 43% of older adults (American Gastroenterological Association, 2024). Early recognition and prompt evaluation of persistent symptoms are crucial for improving outcomes. Empowering and informing young adults about concerning symptoms is the first step in better recognition and better outcomes for these individuals.Arreaza: This is when the word “follow up” becomes relevant. I recommend you leave the door open for patients to return if their common symptoms worsen or persist. Let's talk about screening. Screening and PreventionJessica: Due to the trend of CRC being identified in younger populations, the U.S. Preventive Services Task Force (USPSTF) lowered the recommended screening age for CRC from 50 to 45 in 2021 (USPSTF, 2021). Off the record, some Gastroenterologists also foresee the USPSTF lowering the age to 40. Arreaza: That is correct, it seems like everyone agrees now that the age to start screening for average-risk adults is 45. It took a while until everyone came to an agreement, but since 2017, the US Multi-Society Task Force had recommended screening at age 45, the American Cancer Society recommended the same age (45) in 2018, and the USPSTF recommended the same age in 2021. This podcast is a reminder that the age of onset has been decreased from 50 to 45, for average-risk patients, according to major medical associations.Jessica: For individuals with additional risk factors, including a family history of CRC or chronic gastrointestinal symptoms, screening starts at age 40 or 10 years before the diagnosis of colon cancer in a first-degree relative. Dr. Arreaza, who has the lowest and the highest rate of screening for CRC in the US? Arreaza: The best rate is in Massachusetts (70%) and the lowest is California (53%). Let's review how to screen:Jessica: Recommended Screening Methods:Colonoscopy: Considered the gold standard for CRC detection and prevention, colonoscopy allows for identifying and removing precancerous polyps.Fecal Immunochemical Test (FIT): A non-invasive stool test that detects hidden blood, recommended annually.Stool DNA Testing (e.g., Cologuard): This test detects genetic mutations associated with CRC and is recommended every three years.Arreaza: Computed tomographic colonography (CTC) is another option, it is less common because it is not covered by all insurance plans, it examines the whole colon, it is quick, with no complications. Conclusion:Colorectal cancer is rapidly emerging as a serious health threat for young adults. The increase in cases over the past three decades highlights the urgent need for increased awareness, early symptom detection, and proactive screening. While healthcare providers must weigh the risk/benefit of testing for CRC in younger adults, patients must also be equipped with knowledge of concerning signs so that they may also advocate for themselves. Early detection remains the most effective tool in preventing and treating CRC, emphasizing the importance of screening and risk factor modification.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:American Cancer Society. (2024). Colorectal Cancer Statistics, 2024. Retrieved fromhttps://www.cancer.orgAmerican Gastroenterological Association. (2024). Delays in Diagnosis of Young-Onset Colorectal Cancer: A Systemic Issue. Gastroenterology Today.Brennan, C. A., & Garrett, W. S. (2023). Gut Microbiota and Colorectal Cancer: Advances and Future Directions. Gastroenterology.Dekker, E., et al. (2023). Colorectal Cancer in Adolescents and Young Adults: A Growing Concern. The Lancet Gastroenterology & Hepatology.Siegel, R. L., et al. (2023). Colorectal Cancer Statistics, 2023. CA: A Cancer Journal for Clinicians.Stoffel, E. M., & Murphy, C. C. (2023). Genetic and Environmental Risk Factors in Young-Onset Colorectal Cancer. JAMA Oncology.U.S. Preventive Services Task Force. (2021). Colorectal Cancer Screening Guidelines.Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/.

How can breast cancer screening guidelines affect women's healthcare access? Dorothy Gibbons discusses recent changes in breast cancer screening recommendations. JAMA confirmed that starting screenings at age 40 improves outcomes. Previously, the USPSTF advised screening starting at age 50, but now they recommend it for women aged 40 to 74, every other year. Dorothy advocates for annual screenings for more effective detection. She differentiates between routine and diagnostic mammograms, emphasizing their importance. USPSTF’s stance on breast density informs whether further tests like MRIs or ultrasounds are necessary. Insurance coverage hinges on these recommendations. The Affordable Care Act mandates insurance to cover preventive services, but legal challenges could affect this provision. Dorothy recalls a case where a woman had to pay out of pocket for an ultrasound, which ultimately saved her life. She urges listeners to understand these issues and their potential impact on women's health. Subscribe to Let's Talk About Your Breasts and consider supporting The Rose at therose.org. Key Questions Answered 1. Why is it important to start breast cancer screening at age 40? 2. What are the differences between screening mammograms and diagnostic mammograms? 3. What were the previous recommendations for the starting age of breast cancer screenings by the USPSTF? 4. What did the recent update from the USPSTF recommend regarding breast cancer screenings? 5. What is the importance of breast density information for women? 6. What does the USPSTF say about supplemental screening for women with dense breasts? 7. How does health insurance typically respond to the USPSTF recommendations? 8. What is the role of the Affordable Care Act (ACA) in preventive services like mammograms? Timestamped Overview 00:00 "Breast Cancer Screening: Start at 40" 03:16 Affordable Care Act: Legal ChallengesSee omnystudio.com/listener for privacy information.

Editor's Summary by Kirsten Bibbins-Domingo, PhD, MD, MAS, Editor in Chief, and Preeti Malani, MD, MSJ, Deputy Editor of JAMA, the Journal of the American Medical Association, for articles published from January 11-17, 2025.

Interview with Esa M. Davis, MD, MPH, USPSTF member and coauthor of Screening for Osteoporosis to Prevent Fractures: US Preventive Services Task Force Recommendation Statement. Hosted by JAMA Editor in Chief Kirsten Bibbins-Domingo, PhD, MD, MAS. Related Content: Screening for Osteoporosis to Prevent Fractures Screening for Osteoporosis to Prevent Fractures Fracture Risk Assessment as a Component of Osteoporosis Screening—Easier Said Than Done Screening for Osteoporosis to Prevent Fractures

EVERYTHING CHANGES! So true. And now, the USPSTF has changed (UPDATED) their recommendations for cervical cancer screening in regards to HPV primary screening. This is BRAND NEW, within the last 24 hours. Primary HPV screening for cervical cancer has gained a lot of steam and is progressing quickly. The FDA approval of “dual stain” testing of hrHPV positive results, the recent FDA approval for patient self-collection for HPV vaginal samples in a clinical setting, and now this new draft recommendation from the USPSTF. What did they update? How is that controversial? Listen in for details!

In November 2013, ACOG issued the Hypertension in Pregnancy Task Force Report recommending daily low-dose aspirin (81mg) beginning in the late 1st trimester for women with a history of early-onset preeclampsia and preterm delivery at less than 34 0/7 weeks, or for women with more than one prior pregnancy complicated by preeclampsia. The following year, the USPSTF published a similar guideline, although the list of indications for low-dose aspirin use was more expansive. Since then, the ACOG has issued new guidance on low-dose aspirin, in 2018 and 2021. Nonetheless, while criteria for use has evolved, the dosage recommended has remained as 81 mg. But MEDICINE MOVES FAST, and a new Expert Review in the AJOG MFM is making a case for 162mg. Are we underdosing low-dose aspirin for prevention of preeclampsia? A litany of data says YES. Listen in for details.

Interview with Esa M. Davis, MD, MPH, USPSTF member and coauthor of Screening and Supplementation for Iron Deficiency and Iron Deficiency Anemia During Pregnancy: US Preventive Services Task Force Recommendation Statement. Hosted by JAMA Editor in Chief Kirsten Bibbins-Domingo, PhD, MD, MAS. Related Content: Screening and Supplementation for Iron Deficiency and Iron Deficiency Anemia During Pregnancy Screening and Supplementation for Iron Deficiency and Iron Deficiency Anemia During Pregnancy Anemic Data for Preventive Screening and Supplementation to Address Iron Deficiency Anemia in Pregnancy Screening for Iron Deficiency and Iron Deficiency Anemia During Pregnancy Iron Deficiency and Iron Deficiency Anemia During Pregnancy—Opportunities to Optimize Perinatal Health and Health Equity

In this episode of The Curbsiders Podcast, the team delves into the recently updated breast cancer screening recommendations from the U.S. Preventive Services Task Force (USPSTF) with Dr. Wanda Nicholson (@wnicholsonobgyn), an expert in preventive medicine, diversity, equity and inclusion, and women's health and the Chair of the Task Force.  Join us as we review the newest screening mammography recommendations, evidence for earlier screening for all women, the challenge of dense breast findings, and more. Importantly, we discuss disparities in breast cancer outcomes and the need to better understand and address them. Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro and Guest Background Case Updated Breast Cancer Screening Recommendations Rationale for screening age Considerations for findings of dense breasts Balancing benefits and harms Racial disparities Research Gaps Outro Credits Producer, writer, show notes, infographic, and cover art: Fatima Syed MD Hosts: Paul Williams MD, FACP and Fatima Syed MD    Reviewer: Emi Okamoto MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Wanda Nicholson MD, MBA, MPH

Happy 4th of July! This week Kate, Gary, Henry and Mark celebrate by talking about dequalinium for bacterial vaginosis, the comparative effectiveness of weight loss drugs, the new USPSTF mammography recommendation, and tirzepatide for adults with sleep apnea.

Interview with John M. Ruiz, PhD, USPSTF member and coauthor of Management of BMI in Children: US Preventive Services Task Force Recommendation Statement. Hosted by JAMA Editor in Chief Kirsten Bibbins-Domingo, PhD, MD, MAS. Related Content: Interventions for Weight Management in Children and Adolescents Interventions for High Body Mass Index in Children and Adolescents Interventions for High BMI in Children and Teenagers Treatment Interventions for Child and Adolescent Obesity

Interview with Li Li, MD, PhD, MPH, USPSTF member and coauthor of Interventions to Prevent Falls in Community-Dwelling Older Adults: US Preventive Services Task Force Recommendation Statement. Hosted by JAMA Editor in Chief Kirsten Bibbins-Domingo, PhD, MD, MAS. Related Content: Interventions to Prevent Falls in Community-Dwelling Older Adults Interventions to Prevent Falls in Older Adults Preventing Falls in Older Persons Prevention of Falls in Older Adults

Interview with Wanda K. Nicholson, MD, MPH, MBA, USPSTF Chair and coauthor of Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement. Hosted by JAMA Editor in Chief Kirsten Bibbins-Domingo, PhD, MD, MAS. Related Content: Collaborative Modeling to Compare Different Breast Cancer Screening Strategies Screening for Breast Cancer Screening for Breast Cancer Screening for Breast Cancer Toward More Equitable Breast Cancer Outcomes

Well, once again… Late breaking news! Today, April 30, 2024, the USPSTF released its updated recommendations for breast cancer screening (mammography) in average risk patients. This follows a firestorm of controversy and backlash over the last 1 to 2 years as the USPSTF continued to recommend initiation of mammogram at age 50, despite the increased incidence of breast cancer in women in their 40s. In this episode, we will review this brand new recommendation and summarize the ACOG response from ACOG President, Dr. Hicks.

Become a pro on pre-exposure prophylaxis! Review the updated 2023 United States Preventive Task Force (USPSTF) guidelines on PrEP for HIV Prevention with Dr. John Wong. Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro What is PrEP? USPSTF PrEP for HIV Prophylaxis recommendations Defining Increased Risk for HIV Counseling pearls Types of PrEP, considerations about choice of PrEP Talking about Safer Sex practices, HIV and STI screening on PrEP Recap; outro Credits Producer, Writer, Show Notes, Infographic/Cover Art: Beth Garbitelli MD Hosts: Paul Williams MD, FACP, Beth Garbitelli MD Reviewer:Leah Witt MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: John Wong MD