April 30th, 2012
Podcast 153: Type 2 diabetes in young people — tough going on the treatment front
About half of adolescents with type 2 diabetes fail treatment with metformin alone within a few years. Things go somewhat better with metformin plus an intensive lifestyle intervention, and better still with the addition of rosiglitazone to metformin — however even the addition of the second drug leads to treatment failure about 40% of the time. […]
September 26th, 2010
Podcast 102: Short compression stockings would seem to have no further role clinically.
Prof. Martin Dennis chats with us about his latest trial, comparing the utility of thigh- versus below-knee-length stockings for patients immobilized after stroke. The latest results show the superiority of thigh-length stockings, but at the further risk of skin breaks in these vulnerable patients. Taken together with the results of his earlier work, at the […]
July 30th, 2010
Podcast 96: Survivors of childhood cancer face manageable reproductive risks.
What becomes of children who survive cancer treatment and enter their reproductive years? Would their attempts to have children end in a higher-than-normal rate of stillbirths and miscarriages? Apparently not. It turns out the major concern is with women who’ve undergone pelvic irradiation before menarche. That treatment seems to hobble uterine development, but not irretrievably. For […]
July 1st, 2010
Podcast 94: What does a new meta-analysis tell us about statins and primary prevention?
A meta-analysis of 11 studies encompassing more than 60,000 subjects finds that statins don’t lower all-cause mortality in people without cardiovascular disease. One editorialist calls the study, just published in the Archives of Internal Medicine, “the cleanest and most complete meta-analysis of pharmacological lipid lowering for primary prevention.” One of the study’s principal authors, Kausik K. […]
June 5th, 2010
Podcast 90: Preventing type 2 diabetes with low-dose metformin and rosiglitazone seems possible, but clinical use has to await results of another study.
Here’s a question wrapped in mist: How to prevent diabetes? Well, lifestyle changes for sure, but that’s hard. Drug therapy? Easier, but side effects can take away that advantage pretty quickly. Rosiglitazone offers some benefits, but its side effects — most notably increased risks for heart failure and death — have some people wondering whether […]
February 27th, 2010
Podcast 76: On saying “No” to patients’ requests.
A conversation with the authors of an Archives of Internal Medicine study that examines the best tactics for saying “No” to inappropriate requests. Contact me at 1-617-440-4374 or at jelia@jwatch.org. Interview-related links: Archives of Internal Medicine abstract Atul Gawande’s New Yorker article News-related links: The rosiglitazone (Avandia) controversy Advisory on thiazolidinediones Physicians’ work hours 13-valent pneumococcal vaccine Influenza-vaccination expansion […]
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