Clinical Conversations

By NEJM Group

From NEJM Journal Watch, this podcast features lively interviews, concise summaries, and expert commentary that busy clinicians need to stay current and improve patient care.... more

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FAQs about Clinical Conversations:

How many episodes does Clinical Conversations have?

The podcast currently has 304 episodes available.

Clinical Conversations episodes:

July 02, 2010Podcast 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. Ray, talked with us from London. I think you’ll find that listening in is worth your time.
Interview-related links:
Physician’s First Watch coverage of the Archives‘s statin papers
Ray et al.‘s meta-analysis
News-related links:
Starting dialysis early doesn’t improve mortality
Digoxin’s dangers in dialysis
Rosiglitazone’s bad week
Tight glucose control in diabetes brings some benefits, but at the cost of “imprudent” risks
PSA testing for prostate cancer lowers mortality, but mostly in low-screening regions
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14min
June 25, 2010Podcast 93: Is computed tomography safe? Yes, but …
That’s the question asked in an intriguing essay — by a radiologist — released online in the New England Journal of Medicine. We have her as our guest this week.
Feedback, please! You can comment here or by emailing me at [email protected] — or better still, call 1-617-440-4374.
Interview-related links:
Rebecca Smith-Bindman’s essay
Radiation doses from common CT exams
News-related links:
California’s pertussis epidemic
Life in utero near a cell tower doesn’t lead to childhood cancer
Homocysteine-lowering again fails as secondary CVD prevention
FDA approves test that can detect both HIV antibodies as well as antigen
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16min
June 18, 2010Podcast 92: Corticosteroids in COPD exacerbations — high-dose intravenous or low-dose oral?
A JAMA paper suggests that in all but the most severe exacerbations of COPD, it’s best to start off with low-dose oral corticosteroids rather than the higher-dose intravenous treatment that, contrary to guideline recommendations, almost everyone now gets. Our conversation this week is with the study’s first author, Dr. Peter Lindenauer.
Visit the Journal Watch website at http://jwatch.org for a comprehensive look at new medical research, with comments from our experts.
Interview-related links:
COPD guidelines from the Global Initiative for Chronic Obstructive Lung Disease
JAMA article abstract
News-related links:
Increased cancer risk with ARBs
Diabetes, its treatments, and cancer risks
FDA announces review of olmesartan
FDA’s MedWatch reporting site
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17min
June 11, 2010Podcast 91: What risks do NSAIDs hold for healthy people? They’re not trivial.
We talk with a Danish researcher, Emil Fosbøl, whose team estimated the risks of cardiovascular events caused by NSAID use in healthy people.
Your feedback is always welcomed and encouraged. Please drop me a note ([email protected]) or call in a comment to 1-617-440-4374. I’m eager to act on your suggestions.
The interview-related link:
First Watch coverage of the NSAIDs article
News-related links:
Distracted driving
Valproic acid
The post Podcast 91: What risks do NSAIDs hold for healthy people? They’re not trivial. first appeared on Clinical Conversations.
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12min
June 05, 2010 Podcast 90: Preventing type 2 diabetes with low-dose metformin and rosiglitazone seems possible, but clinical use has to await results of another stud...

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 it should stay on the market.
Canadian researchers took the approach of using low doses of rosiglitazone and metformin in combination. They compared that treatment with placebo in a small group of 200 patients with impaired glucose tolerance. Those receiving treatment had a much lower risk of developing type 2 diabetes over the ensuing 4 years of follow-up.
The results aren’t anywhere near ready for allowing clinical use, but they at least move us a bit through the fog. Our conversation this week is with Bernard Zinman, the principal author of the study, just published in the Lancet.
News-related link: First Watch coverage of BMJ study on hormone-replacement therapy
The post Podcast 90: Preventing type 2 diabetes with low-dose metformin and rosiglitazone seems possible, but clinical use has to await results of another study. first appeared on Clinical Conversations.
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12min
May 28, 2010Podcast 89: Glasses aren’t just for reading any more. Listen in to how they can help the elderly avoid falls.
Glasses — when did you start wearing them? They serve to help us do more than just read the newspaper, according to our conversational guest today. Prof. Stephen Lord of Sydney’s Prince of Wales Medical Research Institute and his coauthors write in BMJ this week about trying to encourage elderly wearers of multifocal lenses to use single-focus lenses when they walk outside, where the terrain is unfamiliar. The results are practical, and the discussion about them (Prof. Lord’s side of it, that is) enlightening.
Give us a call at 617-440-4374.
This week’s conversation-related link:
Physician’s First Watch coverage of the BMJ study
This week’s news-related links:
AAP statement on pool and swimming safety
Beta-blockers and COPD
CREST: carotid endarterectomy vs. stenting
HIV-1 transmission drops after start of antiretroviral therapy
The post Podcast 89: Glasses aren’t just for reading any more. Listen in to how they can help the elderly avoid falls. first appeared on Clinical Conversations.
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16min
May 21, 2010Podcast 88: Weighing the benefits of endovascular versus open repair in abdominal aortic aneurysm.
The New England Journal of Medicine carries several studies comparing the long-term outcomes of endovascular versus open repair of abdominal aortic aneurysms. Tying all those studies together is an editorial by Dr. K. Craig Kent of the University of Wisconsin. We’ve got him as our guest this week. Have a listen.
Interview-related links:
K. Craig Kent’s editorial
EVAR trial abstract
DREAM study abstract
News-related links
Swapping in a reassembled-from-scratch genome
Dengue now originates in Florida
Antibiotic use has consequences
The post Podcast 88: Weighing the benefits of endovascular versus open repair in abdominal aortic aneurysm. first appeared on Clinical Conversations.
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14min
May 16, 2010Podcast 87: After this week’s news, we reprise an interview from last December on pharyngitis in adolescents and young adults.
Dr. Robert Centor of the University of Alabama at Birmingham believes that the paradigm for treating pharyngitis in adolescents and young adults must change. Listen to our conversation and hear why.
Here are this week’s links:
Interview-related links:
Commentary Urges ‘Expanding the Diagnostic Paradigm of Pharyngitis’ in Young People
Robert Centor’s blog — “Medrants”
News-related links:
PPI article in Archives of Internal Medicine
FDA’s “Bad Ad” Program website
Annual doses of vitamin D lead to increased falls
Cord-blood pH article from BMJ
The post Podcast 87: After this week’s news, we reprise an interview from last December on pharyngitis in adolescents and young adults. first appeared on Clinical Conversations.
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15min
May 07, 2010Podcast 86: Prompt follow-up after discharge for heart failure reduces early-readmission rates.
Why wouldn’t you want your hospital to lower its rate of early readmissions for heart failure by 15%? We talk with Dr. Adrian Hernandez about his examination of Medicare data from over 200 hospitals, how the hospitals vary widely in the rates at which their patients are followed up within a week of discharge for heart failure, and what that means for readmission rates. Hint: hospitals with more efficient follow-up have lower readmission rates. Listen in to our conversation.
Interview-related link:
Physician’s First Watch summary of Hernandez’s JAMA article
News-related links:
ACIP guidelines on MMRV vaccine
Herpes zoster vaccine underuse
Breast-cancer screening’s numbers for women just under 40
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15min
May 02, 2010Podcast 85: B vitamins lower homocysteine levels, so why don’t they retard the progression of diabetic nephropathy?
A surprise finding: homocysteine is supposed to be a factor in vascular inflammation, but lowering hyperhomocysteinemia in patients with diabetic nephropathy actually accelerated the decline of their GFRs. What gives?
We have a conversation with Dr. J. David Spence, whose results were just published in JAMA.
Interview-related link:
JAMA paper on the effect of B vitamins on diabetic nephropathy
News-related links:
Clopidogrel suffers possible class-effect interference from PPIs
BMJ paper on hyperemesis gravidarum across generations
High-test flu vaccine guidance from ACIP
Brain games and the lack of data supporting their effectiveness
The post Podcast 85: B vitamins lower homocysteine levels, so why don’t they retard the progression of diabetic nephropathy? first appeared on Clinical Conversations.
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15min

FAQs about Clinical Conversations:

How many episodes does Clinical Conversations have?

The podcast currently has 304 episodes available.