PODCAST

JAMA Clinical Reviews

JAMA Network

Author interviews that explore the latest clinical reviews.

health & fitness medicine

All Episodes

18:27

Diagnosing Congenital and Intellectual Abnormalities...

JAMA Clinical Reviews ·

2017/06/27

Chromosomal microarray technology (CMA) facilitates the genetic diagnosis of intellectual disabilities, autism spectrum disorder, and congenital abnormalities in children. Previously, G-band karyotyping was the test performed for this purpose but it could only identify very large chromosomal abnormalities and was not very sensitive. Being a molecular rather than microscopic technique, CMA is far more sensitive for identifying genetic abnormalities and is now the test of choice. We interview David H

34:45

Treating Depression in Older Patients

JAMA Clinical Reviews ·

2017/05/23

Depression is very common in old age. Because it is associated with many issues related to aging such as having diabetes, hypertension, and other diseases and also the general ability to do less than when a person was younger, it is often assumed that depression is just part of the aging process. Inadequate treatment is often given for depression, frustrating patients and clinicians. However, aggressive depression treatment in elderly individuals can be very successful and greatly improve an older

17:14

Genomic Sequencing for the Healthy Individual?: Think...

JAMA Clinical Reviews ·

2017/05/09

Whole-genome sequencing is now easily done for very little cost. It is not known how to interpret the results of this testing. It is inadvisable for healthy individuals to undergo routine whole-genome sequencing but if someone has a reason to suspect a particular disease known to be associated with a unique gene, then targeted genetic sequencing is reasonable. Interviewee: James P. Evans, MD, PhD, from the University of North Carolina at Chapel Hill.

29:47

Diabetes in 2017: Focus Less On HbA1c and More On...

JAMA Clinical Reviews ·

2017/04/03

Much has changed recently in diabetes management. The treatment goal has shifted from rigorous glucose control with HbA1c as the primary target to cardiovascular risk reduction. Risk reduction can be achieved in a variety of ways and does not necessarily depend on expensive new drugs that were shown to achieve this end point. Older, cheaper drugs may achieve the same goal but were never tested in this context. Interview with JoAnn E. Manson, MD, PhD, from Brigham and Women's Hospital in Boston and

19:33

JAMA Performance Improvement: Retained Foreign Body...

JAMA Clinical Reviews ·

2017/03/28

A resident is asked to remove a drain that was placed in the lumbar space during an operation. Having never seen this sort of drain before not having removed one, the resident proceeded to remove the catheter. Several days later, the patient complained of persistent drainage. An 11-cm segment of retained catheter was removed. This JAMA Performance Improvement article discusses how to avoid this sort of problem as well as how to ensure that resident physicians have sufficient skills to perform

27:37

Alzheimer Disease Overview and the Possibility That...

JAMA Clinical Reviews ·

2017/03/20

Alzheimer disease causes progressive neurologic deterioration and is reasonably common in elderly patients. It is characterized by specific patterns of memory loss, which progressively worsens and for which there is no treatment. Recent drug trials have been disappointing in that promising medications have failed to affect the disease. Interesting new hypotheses have emerged from basic science research suggesting that the neurofibrillary tangles characteristic of Alzheimer brain lesions form in

33:32

Why the New Sepsis Guideline Changed

JAMA Clinical Reviews ·

2017/03/07

Recent guidelines for how to best manage septic shock have changed. Gone are recommendations for central venous oxygen saturation monitoring and goal-directed therapy. In is the concept that septic shock be treated as an emergency with rapid administration of antibiotics and large amounts of fluids. Our discussants Derek C. Angus, MD, MPH, and Michael D. Howell, MD, MPH, discuss why these recommendations have changed. This is the second podcast in the Surviving Sepsis guideline series. The first

15:36

Updated Guidelines for Sepsis Management

JAMA Clinical Reviews ·

2017/02/28

In 2017 the Society for Critical Care Medicine updated its guidelines for sepsis management. These new guidelines differ significantly from ones in the past in that they no longer recommend protocolized resuscitation and emphasize early and aggressive fluid resuscitation when patients present with septic shock. This is the first podcast in the Surviving Sepsis guideline series. The next episode discusses why the new sepsis guideline changed. Article discussed in this episode: Management of Sepsis

30:41

JAMA Professionalism: What Should Students or...

JAMA Clinical Reviews ·

2017/02/16

Approximately one-third of all medical school graduates report having been abused as students. Medical student and resident abuse has long been considered unacceptable behavior but still persists in the teaching environment. In this podcast we discuss how students and residents might respond to these events. We interview Geoffrey Young, MD, from the Association of American Medical Colleges and Thomas J. Nasca, MD, from the Accreditation Council for Graduate Medical Education, who discuss how they

18:02

Sarcopenia, Frailty and Risk Prediction in Geriatric...

JAMA Clinical Reviews ·

2017/02/09

As people age, loss of muscle mass is inevitable, resulting in sarcopenia. Muscle loss contributes to overall weakness, which causes frailty. Frailty, in turn, is the generalized susceptibility to disease and injury, all of which causes loss of autonomy. Because of the potential for progressive decline in physical function in very elderly patients, accurate tools are needed to predict mortality risk to individualize treatments intended to improve longevity such as chemotherapy, management of chronic

28:41

Hypertension Management and Dealing With Polypharmacy...

JAMA Clinical Reviews ·

2017/02/02

Managing hypertension in elderly patients is complicated. Recent studies have shown that elderly patients may benefit from aggressive hypertension management, but other studies have shown that some are harmed by overly aggressive hypertension management. These issues were discussed in detail at the 2016 European Union Geriatric Medicine Society meeting. In this podcast we discuss how to best manage hypertension in elderly patients with Athanase Benetos, MD, PhD, a professor of internal medicine from

21:55

Managing Violent Patients in Health Care Settings

JAMA Clinical Reviews ·

2017/01/30

Workplace violence–related injuries occur disproportionately in health care settings. In this podcast, we discuss how individual clinicians should manage violent patients who might attack them. Article discussed in this episode: Ensuring Staff Safety When Treating Potentially Violent Patients

28:14

Systematic Approach to a New Onset Seizure

JAMA Clinical Reviews ·

2016/12/27

Between 8% and 10% of the population will have a seizure at one point in life. It's important to distinguish seizures from other entities that can look like them and, once a diagnosis of a seizure is established, know how to treat them. In this podcast we discuss seizures and epilepsy with Jay Gavvala, MD, author of New-Onset Seizure in Adults and Adolescents: A Review. Article discussed in this episode: New-Onset Seizure in Adults and Adolescents: A Review

26:54

Using Medicare Star Ratings to Select Hospitals

JAMA Clinical Reviews ·

2016/11/01

Medicare recently developed a star rating system to help consumers determine the quality of care delivered at various hospitals. This rating system was considered controversial by many. In this podcast we discuss the rating system with one of its critics, Karl Y. Bilimoria, MD, MS, and with Kate Goodrich, MD, the Director of the Center for Clinical Standards and Quality at Medicare. Article discussed in this episode: The New CMS Hospital Quality Star Ratings: The Stars Are Not Aligned

18:05

Treatments for Hyperemesis and Nausea and Vomiting in...

JAMA Clinical Reviews ·

2016/10/04

Nearly all women experience some element of nausea and vomiting during their pregnancies. In this podcast we review the entire spectrum of disease all the way up to hyperemesis gravidarum and how to provide care for women experiencing these problems. Article discussed in this episode: Treatments for Hyperemesis Gravidarum and Nausea and Vomiting in Pregnancy

30:40

Fluid Resuscitation for Patients in Septic Shock

JAMA Clinical Reviews ·

2016/09/27

When managing septic shock, passive leg raising is the best test to determine if a patient is likely to respond to a fluid bolus, better than CVP lines or even bedside ultrasound. Dr Najib Ayas, Associate professor of Critical Care Medicine at the University of British Columbia, discusses shock management from the context of his Rational Clinical examination article in the September 27, 2016 issue of JAMA, entitled “Will This Hemodynamically Unstable Patient Respond to a Bolus of Intravenous

32:46

The High Cost of Pharmaceuticals in the United States

JAMA Clinical Reviews ·

2016/08/26

Drug prices continue to rise in the US. Many solutions have been proposed but few have been implemented. Drs. Janet Woodcock from the FDA and Aaron Kesselheim, author of The High Cost of Prescription Drugs in the United States from the Harvard Medical School discuss the role of brand name drugs and generics and how they influence the cost of pharmaceuticals. Also see The Cost of US Pharmaceutical Price Reductions: A Financial Simulation Model of R&D Decisions by Thomas A. Abbott and John A. Vernon

34:55

Opioid Use Disorder

JAMA Clinical Reviews ·

2016/08/11

Edward H. Livingston, MD, discusses the British Columbia Ministry of Health’s 2015 guidelines on clinical management of opioid use disorder in adults with Keith Ahamad, MD, Evan Wood, MD, PhD, ABIM, FRCPC, Tony L. Yaksh, PhD, and Humayun J. Chaudhry, DO, MS, MACP, FACOI. Articles and resources discussed in this episode: Opioid Use and Addiction Microsite Clinical Management of Opioid Use Disorder (JAMA Clinical Guidelines Synopsis) The Vancouver Opioid Use Disorder Guideline Model Policy on

18:41

Treating Opioid Use Disorder Using Buprenorphine...

JAMA Clinical Reviews ·

2016/07/19

Richard N. Rosenthal, MD discusses a randomized clinical trial demonstrating the efficacy of an implantable buprenorphine-releasing device for treating opioid use disorder.

38:26

Review of Lyme Disease

JAMA Clinical Reviews ·

2016/07/12

Lyme disease is very common in certain regions of the country and is caused by the spirochete Borrelia bergdorferi. Lyme disease is transmitted by tick bites and in this podcast we review the discovery of Lyme disease, its major clinical features, and how to diagnose and treat it, as told by Dr Alan Steere, Dr Lyndon Hu, and Dr Paul Auerwerter. Related article: Review of Lyme Disease, Human Granulocytic Anaplasmosis, and Babesiosis

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JAMA Clinical Reviews

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