NEJM Journal Watch Podcasts: Clinical Conversations

NEJM Journal Watch Podcasts: Clinical Conversations episodes:

• 09.02.2022

  Podcast 298: COPD exacerbations — 7 days of antibiotics versus 2

  A VIDEO RECORDING OF THIS INTERVIEW IS AVAILABLE AT THIS LINK. In treating most exacerbations of chronic obstructive pulmonary disease (COPD) the usual regimen consists of prednisone plus 5- to 7-days of antibiotics. But what if a shorter course of antibiotic...

  
• 08.19.2022

  Podcast 301: Monkeypox — what to look for, how to treat

  A VIDEO RECORDING OF THIS INTERVIEW IS AVAILABLE HERE. This time, we look to New York for guidance on recognizing and treating monkeypox. Dr. Eric Meyerowitz of Montefiore and Dr. Stephen Baum of Einstein will lead you through the monkeypox thicket in...

  
• 08.11.2022

  Podcast 300: NADIM II trial offers “quite exciting” results in lung cancer

  A VIDEO RECORDING OF THIS INTERVIEW IS AVAILABLE HERE. We’re back with another interview from this year’s IASLC conference. This time, Christine Sadlowski and Dr. Julia Rotow interview Dr. Mariano Provencio about the survival outcomes from the NADIM II trial. In that...

  
• 08.09.2022

  Podcast 299: Lung cancer and atezolizumab — results from the IMpower010 trial

  A VIDEO RECORDING OF THIS INTERVIEW IS AVAILABLE HERE. Interim results on overall survival in phase 3 of the IMpower010 trial were presented at this year’s meeting of the International Assosciation for the Study of Lung Cancer (IASLC). As part of...

  
• 07.28.2022

  Podcast 297: Forget about all that vitamin D testing!!

  A VIDEO RECORDING OF THIS INTERVIEW IS AVAILABLE HERE. THE USUAL AUDIO FILE IS AVAILABLE BELOW Steven Cummings has co-written a take-no-prisoners editorial in the New England Journal of Medicine. The topic? Vitamin D supplements. The conclusion? “…providers should stop screening for...

  
• 07.20.2022

  Podcast 296: A roundtable on the question, Why are young internists flocking to the hospitalist practice style?

  A VIDEO RECORDING OF THIS ROUNDTABLE IS AVAILABLE CLICK HERE. THE USUAL AUDIO FILE IS AVAILABLE BELOW Your host is old enough to remember when hospital corridors featured physicians with little black bags, scurrying around to see their patients. That’s no longer true,...

  
• 07.06.2022

  Podcast 295: How should clinicians manage severe (but asymptomatic) carotid artery stenosis while awaiting CREST-2’s results?

  CREST-2’s results are probably more than a year away. In the meantime, what to do about diagnosed severe (but asymptomatic) carotid stenosis? Recent results suggest that medical management compares favorably with the surgical approach. In this edition, we address the question...

  
• 06.29.2022

  Podcast 294: PD-1 blockade in locally advanced rectal cancer

  Locally advanced rectal cancer usually receives a three-part treatment: chemotherapy followed by radiotherapy and then surgery. In a small-cohort study presented at this year’s ASCO conference researchers used a PD-1 inhibitor — dostarlimab — every three weeks for 6 months against...

  
• 06.27.2022

  Podcast 293: HER2-“low” breast cancer and its reponse to an antibody-drug conjugate

  Patients with metastatic breast cancer whose tumors express low levels of HER2 are generally classified and treated as having HER2-negative disease. However, Dr. Shanu Modi of the Memorial Sloan Kettering Cancer Center and a group of international collaborators explored the use...

  
• 06.17.2022

  Podcast 292: Informed consent and apnea testing for death — or — What is death, anyway?

  Apnea testing is part of the protocol used to determine whether a patient is dead according to neurologic criteria. The question is, do clinicians need to obtain consent to proceed? In a fascinating 15-minute chat, two intensivists, Drs. Patricia Kritek and...

  
• 05.24.2022

  Podcast 291: Unionized nursing homes had lower mortality during Covid-19

  In the early waves of the Covid-19 pandemic why did patients in unionized nursing homes, have a roughly 10% lower rate of mortality than those in non-unionized ones? A report in Health Affairs tries to sort out the possible reasons. Listen...

  
• 05.08.2022

  Podcast 290: USPSTF’s new take on aspirin and primary prevention of CVD

  The U.S. Preventive Services Task Force recently issued its sixth set of guidelines on using daily aspirin to prevent cardiovascular disease. The guidelines appeared in JAMA — whose editors asked our guest, Dr. Allan Brett, to write an editorial evaluation. This...

  
• 05.04.2022

  Podcast 289: Saline versus balanced crystalloids — what to choose

  Saline or balanced crystalloids? The question of which resuscitation fluid to use in clinical practice seems to have been settled by recent research findings — or at least settled in favor of balanced crystalloids. But wait, our guests see slight...

  
• 04.21.2022

  Podcast 288: Following up with a Ukrainian narcologist

  Spend 15 minutes with Dr. Natalia Shevchuk, whom we interviewed by candlelight last month. She is sheltering in the Odessa region now, having left the Donetsk area. This time, she relates how she lost a colleague in Russia’s attack on the...

  
• 04.10.2022

  Podcast 287: Thinking about quality-of-life in migraine

  During the American Academy of Neurology’s 2022 meeting in Seattle, Dr. Richard Lipton of Albert Einstein College of Medicine took questions from Dr. Teshamae Monteith (U. Miami) and Joe Elia. Lipton’s group sought to characterize the impact of patients’ monthly headache...

  
• 03.21.2022

  Podcast 286: Talking about addiction treatment by candlelight from Ukraine’s Donetsk region

  Dr. Natalia Shevchuk (pictured above) treats substance use disorders in Ukraine’s Donetsk region. Her face is candlelit because her town is under curfew, and people aren’t allowed to put on their room lights (if they have electricity) in the hours...

  
• 03.11.2022

  Podcast 285: GERD’s revised guidelines — an internist and a gastroenterologist discuss them.

  Gastroesophageal reflux, or GERD, was the focus of a revised set of guidelines issued in January in the American Journal of Gastroenterology. Given the frequency of that condition in primary care clinics, internist and NEJM Journal Watch editor-in-chief Allan Brett...

  
• 03.08.2022

  Podcast 284: The clinical situation in Ukraine

  Some 85 years ago Guernica was bombed, and after that came Dresden, Coventry, Hiroshima, Bach Mai, and the rest. This episode of Clinical Conversations asks how it might be possible to help clinicians under bombardment in Ukraine. As you will...

  
• 02.22.2022

  Podcast 283: More data — this time from the U.K. — about post-Covid vaccination

  You want more evidence that post-recovery vaccination against Covid-19 reinfection helps? Here is a careful study from the U.K. that followed some 35,000 health care workers — initially without symptoms — in over 100 institutions there. Starting in June 2020...

  
• 02.17.2022

  Podcast 282: Vaccination after Covid-19 recovery prolongs natural immunity to reinfection

  Governments’ directives about how and when to vaccinate people who’ve recovered from Covid-19 vary widely. But, according to this episode’s guest, Dr. Ronen Arbel, they all say they don’t have enough evidence to set firm policy. So, Arbel and his...

  
• 02.05.2022

  Podcast 281: Drug Costs — What’s “The Right Price” for prescription pharmaceuticals?

  Why can’t the U.S. control prescription drug pricing as they do in the U.K., where per-capita spending is less than half our level? In a capitalist democracy, many parties — the drug companies, medical associations, consumer groups — get to lobby...

  
• 01.14.2022

  Podcast 280: MIS-C after Covid-19 in adolescents — can vaccination prevent it?

  Multisystem inflammatory syndrome in children (or MIS-C) is a serious complication of Covid-19 infection, usually showing up about a month after infection. CDC worked with several hospitals around the U.S. to discern whether vaccination in adolescents would lessen the likelihood of...

  
• 09.27.2021

  Podcast 279: Age-specific data do better than age-adjusted data in revealing health inequities

  Kiarri Kershaw has written a simple letter in JACC — the Journal of the American College of Cardiology. The letter conveys a strong message: health inequities don’t act uniformly across one’s lifetime. Her examination of Black versus white mortality from...

  
• 04.27.2021

  Podcast 278: Where equity and community health intersect — a conversation with Joseph Betancourt

  An internist at Massachusetts General Hospital, Dr. Joseph Betancourt also runs their program on equity and community health. In this, the final entry in our four-interview exploration of race and clinical equity, Betancourt talks about the need for medical institutions to...

  
• 04.26.2021

  Podcast 277: Race and clinical equity — know your patients — a conversation with Karen Dorsey Sheares

  Dr. Sheares talks about her experience with inequities. She believes that clinicians should aspire to be students of their patients as well as of the pathophysiology of the diseases their patients present with. Listen in. Running time: 20 minutes

  
• 04.18.2021

  Podcast 276: Pay attention to the structural barriers that contribute to clinical inequity — Karol Watson

  In this, our second conversation on race and clinical equity, Dr. Karol Watson of UCLA offers her observations on what she’s observed as a cardiologist trying to deal with treatment plans for patients who’ve lost their health insurance or have...

  
• 04.11.2021

  Podcast 275: Race and Clinical Equity — a Conversation with Dr. Kimberly Manning

  We’ve conducted a set of four interviews with physicians on the topic of race and clinical equity. The conversations center not so much on their published research, but on the roles that these physicians take in their organizations and, in addition,...

  
• 01.18.2021

  Podcast 274: Preliminary Thoughts on the 2021 ASCO Gastrointestinal Cancer Conference

  Apologies for the long silence. We have been off doing other things — one of which has been figuring out how to cover conferences. Last month, after much preparation, we covered the American Society of Hematology (ASH) annual conference; our...

  
• 08.29.2020

  Podcast 273: The journals and the pandemic — NEJM

  Eric Rubin is editor-in-chief of the New England Journal of Medicine. I asked him how COVID-19 has affected that journal, which has been around since the War of 1812 and seen its share of pandemics. Listen in — it’s the first in...

  
• 08.08.2020

  Podcast 272: And now for something completely different… almost

  Dr. Paul Sax writes the closest thing that the NEJM Group has to humor. He’s serious, of course, since his blog “HIV and ID Observations” concerns all things infectious . But he sprinkles in the odd cartoon or links to...

  
• 08.05.2020

  Podcast 271: Checking back in with Florida — 4 months later

  Back in late March (people often tell me that, these days, 4 months ago might as well be 4 years ago) we talked with emergency physician Julian Flores, who was working out of Broward County. Covid-19 cases were modest in...

  
• 07.14.2020

  Podcast 270: Is healthcare privacy possible if “all data are health data”?

  Don’t expect HIPAA regulations to protect your “digital health footprint” from prying eyes. Every time you swipe your card to buy goodies at the supermarket (are you risking diabetes with all that ice cream?), or binge-watch that kinky series (how’s your...

  
• 07.06.2020

  Podcast 269: The pandemic in Texas is like a “slow-rolling level 6 hurricane”

  We interview Dr. Michael Gonzalez, a Houston-based emergency physician, who describes the situation there as “an ongoing, slow-rolling, level 6 hurricane that just isn’t gonna go away and, more importantly, isn’t gonna tell us when landfall is coming and when...

  
• 06.29.2020

  Podcast 268: Cannabis and road accidents — is there an association?

  This time Dr. Ali Raja and Joe Elia talk with two authors of a study that found disparate effects on traffic deaths from the legalization of recreational cannabis. The two states under study, Colorado and Washington, were compared, not with...

  
• 05.19.2020

  Podcast 267: Acute kidney injury in COVID-19 — how one New York system dealt with it

  The novel coronavirus obviously has devastating effects on the lungs, but other, less immediately visible attacks occur — notably to the kidneys. Dr. Steven Fishbane (a nephrologist) and his colleagues have just published their findings based on a survey of some...

  
• 05.10.2020

  Podcast 266: Interferon and early treatment in COVID-19 bring good outcomes

  A combination of three antivirals — Kaletra (which is lopinavir plus ritonavir) and ribavirin — when given early and with interferon significantly reduces viral shedding, disease symptoms, and hospital stay in  patients with COVID-19 when compared with a control regimen...

  
• 05.01.2020

  Podcast 265: COVID-19 in skilled nursing facilities

  We (Dr. Danielle Bowen Scheurer and Joe Elia) talk with Dr. John Jernigan of the CDC COVID-19 Investigation Team, which recently published its findings on the spread of COVID-19 in a Seattle-area skilled nursing facility. Most intriguingly, over half the patients...

  
• 04.20.2020

  Podcast 264: Is COVID-19 pushing MIs out of emergency departments?

  Cardiovascular consults are way down. Is the threat of COVID-19 infection scaring people away from EDs? We caught up with Dr. Comilla Sasson, the American Heart Association’s VP for science and innovation. She’s an emergency physician who teaches at the University...

  
• 04.15.2020

  Podcast 263: Checking in with Connecticut and Michigan on medicine after COVID-19

  This week’s guests, Dr. Andre Sofair and Dr. William (“Rusty”) Chavey are physician-editors on the daily clinical news alert called Physician’s First Watch. I went back through the recent issues and found this January 10 entry, which began “The CDC is...

  
• 04.06.2020

  Podcast 257: Here comes the summer after COVID-19

  Four weeks ago — in early March — I interviewed Dr. Renee Salas about climate change and clinical medicine. Back in those halcyon days, COVID-19 was very much a gathering storm, but it had not yet slammed into the United States. Here...

  
• 04.01.2020

  Podcast 262: COVID-19’s larger lessons

  We talk with Colleen Farrell who’s doing her third year of an internal medicine residency in New York City. Fortunately, we caught her during a one-week vacation (she was supposed to be taking two), and she chatted with us about how...

  
• 03.29.2020

  Podcast 261: COVID-19 as a medical disaster

  San Diego County has Dr. Kristi Koenig as medical director of its emergency medical services. That’s fortunate for the county, because she’s co-edited a definitive textbook, “Koenig and Schultz’s Disaster Medicine: Comprehensive principles and practices.” We’re fortunate to have her as...

  
• 03.27.2020

  Podcast 260: Interview with a Broward County, Florida, emergency room physician

  This time we talk with Dr. Julian Flores, who works in a Broward County, Florida, emergency room. When he was interviewed, the count of Covid-19 cases stood at 412, less than 12 hours later, the new number was 505, as of...

  
• 03.25.2020

  Podcast 259: A first-year resident tells us what he sees in the Covid-19 pandemic

  Dr. Matt Young is a first-year resident in obstetrics and gynecology in suburban Delaware. Between the day I invited him to be interviewed and the interview itself (a 36-hour span) things had changed a lot for him. Anxiety levels are...

  
• 03.19.2020

  Podcast 258 — One clinician’s experience of the early days of the COVID-19 epidemic in the U.S.

  We talk with Susan Sadoughi, an internist at Brigham & Women’s Hospital in Boston, about how quickly things have changed over the past week. Last week, I introduced the Fauci interview by saying that I’d heard a clinician complain that she’d...

  
• 03.10.2020

  Podcast 256 — Anthony Fauci: Talking with patients about COVID-19

  We have Dr. Anthony Fauci of NIAID to talk with us about COVID-19, the disease caused by the 2019 novel coronavirus (also known as SARS-CoV-2). He’s full of sound advice in the midst of a rapidly changing epidemic. We wanted to...

  
• 03.06.2020

  Podcast 255: Salt talks — transcript included

  Here we have an interview with Prof. Feng He, whose English is much better than my Mandarin. Thus, I’ve attached a transcript to make her ideas on salt intake (no level is too low) and blood pressure (there’s a dose-response...

  
• 02.28.2020

  Podcast 254: Old malpractice liability strategies need rethinking

  JAMA recently published a review of some 40 papers examining the relation between malpractice liability strategies — tort reform, increased insurance premiums, etc. — and the quality of care. Apparently the efforts had no discernible effect on mortality rates, length...

  
• 02.21.2020

  Podcast 253: Is a single-dose HPV vaccination effective?

  With human papillomavirus vaccine in short supply around, moving from a three- or two-dose regimen to one dose would immediately double or treble supplies, cut costs, and simplify logistics. A careful study in Cancer by this week’s guest, Ana Rodriguez, and...

  
• 02.13.2020

  Podcast 252: We revisit our chat about chatting about guns

  Back in November, Ali Raja and Joe Elia talked with Garen Wintemute about his Health Affairs paper regarding addressing the topic of guns with patients. Having encountered another of those weeks in which interviewees were either on vacation (richly deserved, we’re...