is

Advances in Diagnosis and Treatment of Constipation

Constipation is one of the most frequent problems clinicians are asked to deal with. Despite how common it is, constipation is frequently not treated adequately. In this podcast, Arnold Wald, MD, explains a stepwise approach to the management of constipation ranging from very simple measures to the most novel and complicated new medical therapies.









is

Opioid Prescribing: Rising to the Challenge

An opioid abuse epidemic now plagues US healthcare. It was caused, in part, by overzealous advocacy for controlling chronic pain resulting in overuse of narcotics. There are now 2 million Americans addicted to opioids. The approach for treating chronic pain must change. In this podcast, we summarize recent CDC guidelines for the proper use of opioids for treating chronic pain.

Articles discussed in this episode:





is

Diagnosing Infectious Mononucleosis

Mononucleosis is a common disease of young adults manifested by lethargy, fever, pharyngitis, lymphadenopathy and splenomegaly. In this podcast, we review the clinical features of the disease and how good each of them is at establishing a diagnosis of mononucleosis. We also review how Epstein Barr virus was discovered as the cause of mononucleosis and talk to Mark H. Ebell, MD, MS, author of Does This Patient Have Infectious Mononucleosis? The Rational Clinical Examination Systematic Review.

Articles discussed in this episode:






is

Histologic Changes in the Esophagus in Patients With GERD

Drs Stuart Spechler and Peter Kahrilis discuss GERD and esophagitis--how they occur and how they are treated. Dr Spechler also discusses a new hypothesis regarding how reflux esophagitis is caused that differs from the traditional teaching that acid and pepsin reflux into the esophagus and burn the mucosa layers.

Related articles:
Association of Acute Gastroesophageal Reflux Disease With Esophageal Histologic Changes
Turning the Pathogenesis of Acute Peptic Esophagitis Inside Out





is

Managing Persistent Diarrhea

Persistent diarrhea is a poorly recognized syndrome in all populations that requires proper assessment and diagnosis to ensure that affected individuals receive the treatment needed to experience improvement of clinical symptoms. Listen to Drs Herbert DuPont and Annie Feagins discuss how to diagnose and treat diarrhea. Related article: Persistent Diarrhea





is

Review of Lyme Disease

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

 







is

Opioid Use Disorder

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: 

 




is

JAMA Professionalism: Best Practice--Disclosure of Medical Error

Introducing a new series of JAMA articles on professionalism, discussed from the perspective of how clinicians should address challenging clinical situations and adverse events in their medical practice. In the first episode of the accompanying podcast, JAMA Professionalism: Best Practice, we interview Wendy Levinson, MD, and Jensen Yeung, MD, authors of Disclosure of Medical Error, which appeared in the August 16, 2016 issue of JAMA, as well as Thomas H. Gallagher, MD.





is

A Surgeon-scientist and Entrepreneur Fights Against Cancer

Patrick Soon-Shiong, MD, physician-scientist and entrepreneur, talks about the National MoonShot Initiative, his MoonShot 2020 Program, as well as promising approaches in cancer immunotherapy. This podcast was originally recorded on June 3, 2016





is

Treatments for Hyperemesis and Nausea and Vomiting in Pregnancy

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

 




is

Pioneering Geneticist Explains Ambitious Plan to “Write” the Human Genome

This Medical News podcast discusses the Human Genome Project-write with Harvard geneticist, George Church, PhD.






is

Updated Guidelines for Sepsis Management

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 and Septic Shock

Speakers:

Laura Evans, MD, MSc, of Bellevue Hospital and NYU Medical Center

Andrew Rhodes, MBBS, MD, of St George’s University Hospitals NHS Trust and co-chair of the Surviving Sepsis guideline panel

Mitchell M. Levy, MD, of the Alpert Medical School of Brown University and Rhode Island Hospital

 




is

Why the New Sepsis Guideline Changed

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 podcast reviewed what recommendations are in the guideline itself.

Article discussed in this episode: Management of Sepsis and Septic Shock

Speakers: JAMA Associate Editor Derek C. Angus, MD, MPH, University of Pittsburgh, and Michael D. Howell, MD, MPH, University of Chicago.





is

Genomics and Precision Health

Whole-genome sequencing is now easily done for very little cost. It is not known how to interpret the results of this testing. Healthy individuals should not have this performed. If someone has a reason to suspect a particular disease with a known genetic association, then whole-genome or targeted sequencing is reasonable to pursue.