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September 9th, 2014

Podcast 174: PARADIGM and heart failure

(4 votes, average: 3.50 out of 5)

The PARADIGM-HF trial of LCZ696 — a novel compound that both blocks the renin-angiotensin system with an ARB component and blocks neprilysin’s degradation of natriuretic peptides — increased survival in heart failure by some 20% relative to enalapril. It seems to be a big deal, and the trial’s two principal authors have agreed to talk about their work and its larger meaning.

Running time: 15 minutes

Other links:

The study in the New England Journal of Medicine (free)

NEJM Journal Watch coverage of the study (free)

August 29th, 2014

Podcast 173: Sensible Sodium Levels in View at Last

(4 votes, average: 3.50 out of 5)

Running time: 9 minutes

In the light of the New England Journal of Medicine‘s recent publication three papers on sodium intake and its implications for cardiovascular disease, blood pressure, and excess mortality, we thought we’d speak again with Dr. Jan Staessen, who surprised a lot of people 3 years ago with a paper in JAMA warning against population-wide sodium reductions. His research showed that cutting sodium intakes to levels recommended by the U.S. Dept. of Agriculture was associated in his cohort with an increase in cardiovascular risk.

Dr. Staessen kindly agreed to serve as our guide through the new NEJM research.

LINKS:

The 2011 Staessen interview

Physician’s First Watch coverage of the new NEJM studies

 

July 30th, 2014

Podcast 172: Listening for the diagnosis, a conversation with Danielle Ofri

(14 votes, average: 2.71 out of 5)

Running time: 15 minutes

Dr. Danielle Ofri, author and internist (as well as an aspiring cellist), is writing a book about how patients and clinicians hear each other. Our discussion centers on that, and on her request that you contact her if you can put her in touch with great diagnosticians (and maybe even their patients).

If you have any suggestions about this or other matters, please contact me here: jelia@nejm.org.

Dr. Ofri may be contacted at her website: http://danielleofri.com

 Here’s a link to our 2009 interview with Ofri.

June 25th, 2014

Podcast 171: PTSD treatment effects remain largely unmeasured by the military and the VA

(2 votes, average: 2.00 out of 5)

Running time: 10 minutes

The Institute of Medicine’s report on treatment for post-traumatic stress disorder finds that active military and veterans with PTSD aren’t always getting evidence-based treatments. And when those treatments are used, they’re too often not used according to protocols and the results aren’t measured. The upshot? The agencies with responsibility for treating PTSD don’t know whether they’re doing their patients any good.

Institute of Medicine report on PTSD (free)

 

June 5th, 2014

Podcast 170 — An emergency physician has the tables turned on her and returns with lessons for all clinicians

(13 votes, average: 3.38 out of 5)

Dr. Charlotte Yeh was crossing the street in Washington, D.C., on her way to dinner when a car hit her.

She ended up in a Level I trauma center, and the experience was sobering for its reminder that in our drive to measure quality indicators, the patient may end up ignored or forgotten.

Running Time: 10 minutes

A link to her essay in Health Affairs

November 12th, 2013

Podcast 169: New guidelines on cardiovascular disease prevention

(13 votes, average: 2.77 out of 5)

 Running time: 11 minutes

The American Heart Association/American College of Cardiology have released four sets of guidelines — all aimed at the lowering of risk for atherosclerotic cardiovascular disease. For perspective, we’ve asked Harlan Krumholz, editor-in-chief of NEJM Journal Watch Cardiology and CardioExchange to chat.

Links:

Risk calculator (free)

CardioExchange (free)

Circulation homepage

New York Times piece by Krumholz on the guidelines (free)

Clinical Conversations

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