October 8th, 2011
Podcast 133: Over 50 years later, DES’s adverse effects continue
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A cluster of clear-cell adenocarcinomas of the vagina in young women led to the realization some 40 years ago that almost all their mothers had taken diethylstilbestrol during pregnancy — a drug in wide use in the early 1950s.
In a follow-up to that drug disaster, researchers (including one of the authors of the original reports in the early 1970s) have examined reproductive health in a large cohort of women exposed to DES in utero. Their results were published last week in the New England Journal of Medicine, and they show that the health effects apparently continue beyond the reproductive years. With that cohort — the baby boomers — now entering the stage of their lives when health visits start to increase, it’s worthwhile for clinicians to be briefed on these long-term effects.
This week, we talk with two authors of the new report.
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September 30th, 2011
Podcast 132: In discussing a child’s overweight with parents, words matter
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Words really do matter, and for clinicians discussing a child’s overweight with parents, words can hurt, stigmatize, and discourage parents from taking the right actions.
In a brief interview, the author of a Pediatrics study talks about the best approach to take in these discussions. There are no “magic words,” rather the approach should involve asking parents what words they feel most comfortable using in talking about how to address the problem.
Links:
- Physician’s First Watch summary (free)
- Pediatrics article (free)
September 23rd, 2011
Podcast 131: Measuring the effect of the rotavirus vaccine program on kids in the U.S.
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Vaccines work, and here’s more evidence. The quadrivalent rotavirus vaccine introduced in 2006 has dramatically lowered hospitalizations for rotavirus-related diarrhea among children under age 5, among other benefits. Its presence has produced a kind of herd immunity whereby even the unvaccinated are reaping benefits. It bears remembering, though, that vaccinees have about a 90% lower rate of hospitalization for the illness than the unvaccinated. And as to intussusception — a concern with an earlier rotavirus vaccine — that risk is an order-of-magnitude less, according to field data from outside the U.S.
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September 16th, 2011
Podcast 130: If you’re a clinician concerned about health costs, wash your hands — don’t just wring them
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Health Affairs has a study in which a few simple, but rigorously followed patient-care procedures in a pediatric ICU dropped infection rates, mortality, lengths of hospital stay, and total costs. Sound too good to be true? Well, it wasn’t exactly easy, but the results were real and measurable. Listen in and see whether this could work for you and your institution.
Links:
- Health Affairs article (free abstract)
- Physician’s First Watch summary (free)
- Psychological Science study of motivations for clinicians’ hand washing (news release)
September 10th, 2011
Podcast 129: Non-aspirin NSAIDs are associated, as a class, with spontaneous abortion in a Quebec study
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Last week the Canadian Medical Association Journal published an analysis of data from the Quebec Pregnancy Registry showing that the use of any non-aspirin NSAID during pregnancy was associated with an increased risk for spontaneous abortion before the 20th week of gestation. There was no apparent dose-response effect.
We discuss the research with the paper’s senior author, Dr. Anick Berard of the University of Montreal.
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August 12th, 2011
Podcast 128: Bleeding patients, inadvertently, into anemia happens more often than you might think
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An article in Archives of Internal Medicine examines what’s called “diagnostic blood loss” — the loss of blood through phlebotomy and not hemorrhage. The effect is the same, however.
According to a study conducted in 57 medical centers among some 18,000 patients with myocardial infarction, one in five became moderately or severely anemic (hemoglobin level under 11) from their hospital stay. That’s a 20% rate of iatrogenic anemia. Two of the study’s authors discuss the work and their proposed fixes to this problem, which most likely isn’t limited to patients with MIs.
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