October 6th, 2015
Podcast 186: Stop supplementing calcium!
Podcast: Play in new window | Download
Subscribe: RSS
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]
September 27th, 2015
Podcast 185: A Spirited Discussion on Medicare’s ‘Doc Fix’ Fix for Reimbursement
Podcast: Play in new window | Download
Subscribe: RSS
A group of physicians, economists, and medical students gathered on Medstro to talk about Medicare’s solution to the decades-old “doc fix” problem — it’s how you get paid for caring for Medicare patients.
The chat was occasioned by an essay in the New England Journal of Medicine by Meredith Rosenthal, an economist and a close observer of Medicare policy and reimbursement in general. She joins the discussion and helps sort things out. You’ll want to listen, but we warn you: it’s contentious!
[Running time: 29 minutes]
NEJM essay (free)
September 22nd, 2015
Podcast 184: Ruling out pulmonary embolism in primary care
Podcast: Play in new window | Download
Subscribe: RSS
Pulmonary embolism is a vexing problem in primary care: Does this patient have it? Can I send them home with reassurance? Should I refer them for further testing?
A Dutch group has evaluated the tests most likely to be available in the primary care setting — the various flavors of the Wells rules and the Geneva scores — against a panel of some 600 patients with suspected PE and known outcomes after referral and three months’ follow-up. They come down in favor of the Wells rule and simple D-dimer testing, but an editorialist in the BMJ offers a note of dissent.
Our interview with one of the study authors, Dr. Geert-Jan Geersing, sorts this all out.
[Running time: 13 minutes]
BMJ study (free)
BMJ editorial (subscription required)
August 21st, 2015
Podcast 183: An Obesity ‘Switch’ in the Genome Described
Podcast: Play in new window | Download
Subscribe: RSS
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)
August 16th, 2015
Podcast 182: Dietary fat studies meta-analyzed — trans fat still a bad bet
Podcast: Play in new window | Download
Subscribe: RSS
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.
Physician’s First Watch coverage (free)
[Running time: 19 minutes]
About the Podcast
Comments, suggestions, and story ideas welcome. Learn more about Clinical Conversations.
Follow us:
