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August 21st, 2015

Podcast 183: An Obesity ‘Switch’ in the Genome Described

(3 votes, average: 4.00 out of 5)

There’s a kind of “wall switch” in the human genome that’s been newly described. It seems to be able to turn on and off genes controlling the efficiency with which we burn fat.

The study describing the finding in the New England Journal of Medicine reads like a genetic research tour-de-force, showing how the whole circuit is controlled by a single variation in a nucleotide sequence.

The study’s senior author, MIT’s Manolis Kellis, examines the switch and its implications.

[running time: 26 minutes]

NEJM study (free)

NEJM editorial (free)

Physician’s First Watch coverage

August 16th, 2015

Podcast 182: Dietary fat studies meta-analyzed — trans fat still a bad bet

(2 votes, average: 2.50 out of 5)

The BMJ’s meta-analysis of several large cohorts finds no association of saturated fat with all-cause and cardiovascular mortality or total coronary disease. Trans fat, on the other hand, increased risk in all those categories.

The first author on the paper, Dr. Russell de Sousza, isn’t ready to give a free pass to saturated fat, though. Listen in as he explains.

BMJ meta-analysis (free)

Physician’s First Watch coverage (free)

[Running time: 19 minutes]

 

August 7th, 2015

Podcast 181: Oral Contraceptives’ Role in Reducing Endometrial Cancers

(1 votes, average: 5.00 out of 5)

(Running time: 15 minutes)

A study in the Lancet Oncology gathered information from dozens of epidemiological studies to estimate that over 200,000 cases of endometrial cancer have been prevented in the past 10 years as a result of oral contraceptive use.

A commentary in the journal offers a remarkable look at weighing the benefits and harms of OCs. We talk with a co-author of that commentary, Dr. Nicolas Wentzensen of the National Cancer Institute.

Lancet Oncology study

Lancet Oncology comment

July 18th, 2015

Podcast 180: A sketch of community-acquired pneumonia

(5 votes, average: 4.00 out of 5)
How Webster defined it 90 years ago.

How Webster defined it 90 years ago.

The CDC’s Seema Jain is our guest, talking about a study she did with her team to characterize the causes of community-acquired pneumonia in U.S. adults. (They don’t mention finding Webster’s Micrococcus lanceolatus.) Medicine has come a long way since 1925, but Dr. Jain says that clinicians still need better diagnostic tools to pinpoint the causes of CAP in individual patients.

Using five hospitals in Chicago and Nashville, Jain’s team surveyed over 2000 adult patients admitted with radiographic evidence of CAP during a 30-month period. Also included is discussion of her February paper that sought to characterize CAP in children.

NEJM abstract of study in adults

NEJM abstract of study in children

 

July 11th, 2015

Podcast 179: Pradaxa (dabigatran) reversal near?

(2 votes, average: 3.00 out of 5)

Running time: 20 minutes

The anticoagulant dabigatran, marketed in the U.S. as Pradaxa, has always had the problem that, although it’s more convenient to use, there’s no sure way to stop its effect if the patient has a major bleed.

Now, a monoclonal antibody fragment called idarucizumab (pronounced i-DARE-you-scis-ooh-mab) shows promise as a reversal agent. In an interim analysis of the first 90 of a planned 300 patients, the fragment was quite effective in stopping bleeds.

The analysis was published in the New England Journal of Medicine, and we talk with the paper’s first author, Charles V. Pollack, Jr.

Link to NEJM article (free)

July 4th, 2015

Podcast 178: Why Should Clinicians’ Complicity in CIA Torture Matter to You?

(2 votes, average: 5.00 out of 5)

Dr. Scott Allen of Physicians for Human Rights talks about the lessons evident in the complicity of clinicians — physicians, PAs, and psychologists at the very least — in the torture of prisoners.

His group published an analysis under the title “Doing Harm: Health professionals’ central role in the CIA torture program,” and that’s the focus of this discussion. Allen says that the lesson for all clinicians is to remember the importance of their professions’ commitments to patients, which were badly eroded in these episodes.

Running time: 20 minutes

Doing Harm report from PHR

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