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September 22nd, 2017

Podcast 213: Continuous glucose monitoring in pregnancies with type 1 diabetes

(No Ratings Yet)

Pregnant women with type 1 diabetes can realize more than better control with continuous glucose monitoring: their babies are less likely to be large for gestational age and less likely to spend time in neonatal ICUs. Dr. Denice Feig, who authored a recent international study in The Lancet, talks about her findings and makes recommendations for the future.

Links:

Lancet study

Physician’s First Watch summary

September 14th, 2017

Podcast 212: BP in CKD — Where’s the Sweet Spot?

(1 votes, average: 5.00 out of 5)

There was an excellent commentary accompanying a recent JAMA Internal Medicine meta-analysis: “The Ideal Blood Pressure Target for Patients with Chronic Kidney Disease — Searching for the Sweet Spot” by Csaba Kovesdy. He offers a nice perspective on the problem and kindly agreed to talk with us.

Links:

August 20th, 2017

Podcast 211: On (not) staying the (antibiotic) course

(5 votes, average: 4.80 out of 5)

Sometimes — but not all the time — patients can be advised to stop a course of antibiotics if they feel better. Traditionally, the advice has been to complete the entire course, regardless. Why? Because it was thought that stopping early might lead to more antibiotic resistance. That’s changing now, as the WHO and the CDC advise that courses be taken as directed by (and in consultation with) the prescriber.

Prof. Martin Llewelyn and his colleagues wrote an intriguing analysis in The BMJ of the idea of stopping treatment under certain circumstances. They point out that it’s the longer duration of treatment (and thus longer exposure of commensals to antibiotics) that’s almost certainly causing most cases of resistance.

Links:

Article in The BMJ

NEJM Group Open Forum starting Wednesday, Aug. 23

August 16th, 2017

Podcast 210: Jerome Kassirer — an editor looks back

(1 votes, average: 4.00 out of 5)

Dr. Jerome P. Kassirer served as editor-in-chief of the New England Journal of Medicine from 1991 to 1999.

Almost 20 years later, Kassirer looks back on his life and his time as editor in a new autobiography, titled “Unanticipated Outcomes” — and in a conversation with us.

Links:

Kassirer editorial on managed care.

Kassirer on the digital transformation of medicine.

July 9th, 2017

Podcast 209: “The guidelines need to be rewritten” to encourage antibiotic use after incision and drainage of small skin abscesses

(2 votes, average: 5.00 out of 5)

The senior author of a paper examining the role of systemic antibiotics after incision-and-drainage in treating small skin abscesses says the results should prompt a rewriting of current guidelines.

Henry Chambers of UCSF found a 15-percentage-point advantage in short-term cure rates for antibiotics over placebo. The guidelines don’t encourage systemic antibiotics in these circumstances, but Chambers’ group found the advantage held both in the intention-to-treat results and among those patients who were full adherent to their regimens.

Clinical Conversations comes to you through the NEJM Group.
Executive producer, Kristin Kelley.

June 10th, 2017

Podcast 208: How inequality kills — David Ansell talks with us about his new book

(2 votes, average: 4.50 out of 5)

Dr. David Ansell, a professor of medicine at Rush University Medical Center in Chicago, discusses his new book, “The Death Gap: How inequality kills.”

What’s the death gap? Look at it this way: you’re getting on the Chicago Transit Authority’s Blue Line at “The Loop” in downtown, where the average life expectancy is 85 yrs. Go 7 stops south, and you’ll end up in a place whose inhabitants have a life expectancy of 69 — lower than that in Bangladesh. That’s a “death gap” of 16 years.

It’s worse in rural America. Drive from Connecticut to rural Mississippi and see some 35 years’ life expectancy evaporate.

How did the United States get here? And what are we going to do about it?

Clinical Conversations comes to you through the NEJM Group.
Executive producer, Kristin Kelley.
Clinical Conversations

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