Recent Posts


November 21st, 2015

Podcast 191: The prostate screening conundrum

(1 votes, average: 5.00 out of 5)

[Running time: 13 minutes]

The 2008 and 2012 recommendations from the USPSTF regarding PSA-based prostate screening have been accompanied by drops in both the screening and detection rates of prostate cancer, two studies in JAMA find.

Our guest, Dr. David Penson, wrote an editorial accompanying those studies. It attempts to put these new findings into perspective and to help the patients and physicians caught in the middle of a continuing debate on the wisdom of screening.

Physician’s First Watch coverage of the JAMA studies and editorial (free)

November 19th, 2015

Podcast 190: Last line of antibiotic defense breached

(3 votes, average: 5.00 out of 5)

The Lancet Infectious Diseases has just published a worrying account from China about a dangerous antibiotic resistance factor carried on plasmids. The factor, called MCR-1, confers resistance to colistin — a last line of defense against multi-resistant Gram-negative bacilli.

The co-author of a helpful commentary in that journal, Dr. David L. Paterson of the University of Queensland in Brisbane, is our guest.

Lancet Infectious Diseases article (free abstract)

Lancet Infectious Diseases commentary (free abstract)

Physician’s First Watch coverage (free)

November 9th, 2015

Podcast 189: Blood Pressure Target Should Be 120, SPRINT Data Show

(3 votes, average: 3.67 out of 5)

The SPRINT study, suggesting that we aim for a systolic BP target of 120 mm Hg in high-risk hypertensive patients, has been published with much fanfare.

Dr. Paul Whelton — one of the SPRINT investigators — is our guest. He warns against setting 120 as a performance measure, observing that roughly half the patients in the aggressively treated group had levels above that.


NEJM article (free)


November 1st, 2015

Podcast 188: Should “deintensification” be a quality-of-care measure?

(No Ratings Yet)

The ACCORD trial found dangers in too-strict control of blood pressure and glucose in diabetes. Our guest has just published a study in JAMA Internal Medicine measuring the scope of the problem. Using Veterans Affairs data, his group found that “deintensification” of therapy after targets were met or exceeded was disappointingly rare.

JAMA Internal Medicine study (free abstract)

Physician’s First Watch summary (free)

October 25th, 2015

Podcast 187: Colorectal adenomas not prevented by calcium and/or vitamin D

(No Ratings Yet)

We interview John Baron about his recent New England Journal of Medicine study testing the ability of calcium or vitamin D (or both) to prevent recurrences of colorectal adenomas in a population who had lesions found during colonoscopy. On follow-up after three to five years, the effects of daily calcium and/or vitamin D supplements were the same as for placebo — that is, there was no significant reduction in risk.

The results were surprising, since the same author found a protective effect for calcium in a 1999 publication in NEJM. (In that study, vitamin D wasn’t tested.)


New England Journal of Medicine study (free abstract)

Physician’s First Watch coverage (free)

October 6th, 2015

Podcast 186: Stop supplementing calcium!

(9 votes, average: 3.22 out of 5)

Two analyses in the BMJ show little or no benefit from loading up older patients with calcium — indeed, the bad side effects of doing so (kidney stones and cardiovascular problems, to name two) outweigh the benefits.

Our conversation with Dr. Mark Bolland should offer reassurance to clinicians and their patients that a normal diet will provide enough of the stuff for good health.

BMJ studies (free)

Physician’s First Watch coverage (free)

[Running time: 18 minutes]

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