JAMA Clinical Reviews
Episodes
Treating Lyme Disease in 2018, Part 2
18 Sep 2018
Contributed by Lukas
There are new findings about another form of Borrelia: Borrelia miyamotoi. This form of Borrelia causes a relapsing fever but is spread in the same wa...
Treating Lyme Disease in 2018, Part 1
11 Sep 2018
Contributed by Lukas
In this JAMA Clinical Reviews podcast, we talk to Eugene D. Shapiro, MD, from Yale University School of Medicine for an update on Lyme disease, includ...
What you need to know about syphilis in 2018
04 Sep 2018
Contributed by Lukas
Syphilis is on the rise despite prior successful efforts to control it. Why is it coming back and what needs to be done about it? Dr Charles Hicks fro...
Treating Alcohol Use Disorder
28 Aug 2018
Contributed by Lukas
Up to 7% of the entire US population has alcohol use disorder. It's important for every clinician to understand how to approach patients to question t...
Saving Lives by Stopping Bleeding
14 Aug 2018
Contributed by Lukas
Bleeding is one of the most common preventable causes of death. It is common, yet most people don't know what to do about it when they see it. The Sto...
Working on the Precipice: On the Frontlines of the AIDS Epidemic at the CDC, Part II
01 Aug 2018
Contributed by Lukas
As the AIDS crisis unfolded, each discovery seemed to lead to a new mystery. Who was at risk? Why was this disease of immune activation so hard for th...
Working on the Precipice: On the Frontlines of the AIDS Epidemic at the CDC, Part I
24 Jul 2018
Contributed by Lukas
When AIDS first appeared in the gay community in 1981, it was terrifying for patients and clinicians alike. Nobody knew exactly what was going on. But...
Return of the IUD: Long-acting Reversible Contraception Is Safe and Effective
06 Jul 2018
Contributed by Lukas
Misplaced fears about IUDs have caused them to be avoided by many women, despite the fact that they are very safe and among the most effective means f...
Health Care Spending Gone Wild: Using Expensive Insulin Analogs With Few Clinical Advantages
23 Jun 2018
Contributed by Lukas
Health care spending in the United States is out of control. The most significant aspect of medical care driving this spending is pharmaceuticals; wit...
A Goal Too Far: Rethinking HbA1c Targets for Diabetes Treatment
19 Jun 2018
Contributed by Lukas
The American College of Physicians just changed its guidance for how aggressively to treat type 2 diabetes, relaxing the HbA1c goal to something below...
When Will It Stop? Clinicians Are Still Ordering Routine ECGs Despite Recommendations to the Contrary
12 Jun 2018
Contributed by Lukas
For many years guidelines have recommended against obtaining ECGs for low-risk patients undergoing routine health examinations. Yet about a fifth of a...
Replacing the Trachea: An Exciting New Procedure; But How Do We Know It Really Works?
20 May 2018
Contributed by Lukas
Many attempts to replace the trachea have failed in the past. The most spectacular failure was fraudulent research done in Europe by a high-profile su...
Update: New Recommendations for Prostate Cancer Screening
08 May 2018
Contributed by Lukas
The controversy continues about the efficacy of PSA screening for prostate cancer. New recommendations were just issued from the USPSTF about who shou...
Peanut Allergy: The Recommendations Have Changed
06 Mar 2018
Contributed by Lukas
Peanut allergy is common. But it is more common in countries that delay the introduction of peanuts into the diets of infants. Guidelines in the Unite...
What Is New in Acute Respiratory Disease Syndrome?
20 Feb 2018
Contributed by Lukas
Acute respiratory disease syndrome is characterized by respiratory failure that occurs after someone is acutely ill, usually from a disease that does ...
Medical Findings In U.S. Government Personnel Reporting Symptoms After Exposure To Sensory Phenomena in Havana, Cuba
14 Feb 2018
Contributed by Lukas
Douglas H. Smith, MD, of the University of Pennsylvania's Department of Neurosurgery and Center for Brain Injury and Repair, and Randel Swanson II, DO...
The Health of Players of American Football
01 Feb 2018
Contributed by Lukas
The health risks associated with participation in American football have garnered increasing attention over the past several years. Particular focus h...
Gastric Sleeve Resection for Obesity: How good Is It?
16 Jan 2018
Contributed by Lukas
Why is two-thirds of the US population overweight or obese? Obesity began to increase in 1980, and its incidence is still rising. One reason for this ...
Surveillance for Thyroid Cancer
02 Jan 2018
Contributed by Lukas
The incidence of thyroid cancer is increasing. Like so many cancers, it is being diagnosed at earlier stages because of more aggressive screening and ...
Diagnosis and First-Line Treatment of Chronic Sinusitis
19 Dec 2017
Contributed by Lukas
Sinusitis is one of the most common conditions seen by clinicians. Despite its frequency, it is often misdiagnosed. In this podcast, we review the pro...
Managing Hypertension: Understanding the New AHA/ACC Hypertension Guideline, Part II
12 Dec 2017
Contributed by Lukas
In November 2017, new guidelines were issued for hypertension treatment. They are a comprehensive overhaul of recommendations for both the diagnosis a...
Matching Drugs to Genetic Abnormalities to Precisely Treat Cystic Fibrosis
05 Dec 2017
Contributed by Lukas
Cystic fibrosis is a common autosomal recessive disease. It is caused by any one of many discrete genetic abnormalities that affect chloride transport...
Managing Hypertension: Understanding the New AHA/ACC Hypertension Guideline
05 Dec 2017
Contributed by Lukas
In November 2017, new guidelines were issued for hypertension treatment. The new guideline is a comprehensive overhaul of recommendations for both the...
Mendelian Randomization: How the Natural Assortment of Genes Can Mimic Randomized Clinical Trials
21 Nov 2017
Contributed by Lukas
The best evidence for proving cause-and-effect comes from randomized clinical trials. However, they are expensive and difficult to perform. The natura...
Bacteriophage Treatment for Serious Infections Is Back!
14 Nov 2017
Contributed by Lukas
Bacteriophages are viruses that infect and kill bacteria. When they were first discovered in the early part of the 20th century, there was great enthu...
Incontinence in Women: How We Talk About It and What Can Be Done
24 Oct 2017
Contributed by Lukas
Urinary incontinence in women is common but not often discussed. Linda Brubaker, MD, and Emily S. Lukacz, MD, review the evaluation and management of ...
Managing Transgender Patients: Endocrine Society Guideline Update 2017
17 Oct 2017
Contributed by Lukas
An increasing number of transgender patients are being seen in all care settings. Their medical needs are not too different from those for any primary...
Replacing Tissue Biopsies With a Blood Test: The Technique of Liquid Biopsy
03 Oct 2017
Contributed by Lukas
Powerful new genetic technologies enable clinicians to detect and sequence tiny amounts of free DNA circulating in blood. DNA gets into blood when cel...
Delirium: Prevention, Diagnosis, and Treatment
26 Sep 2017
Contributed by Lukas
Delirium goes unrecognized in approximately 60% of cases. When it is recognized, it can be difficult to treat. Recognizing and treating, as well as pr...
Breast Cancer Surgery: Less Is More
12 Sep 2017
Contributed by Lukas
Every successive major clinical trial of less invasive breast cancer surgery seems to show that less is more--less because less surgery seems to not i...
How Couples With Genetic Disease Can Have Healthy Offspring
05 Sep 2017
Contributed by Lukas
Clinicians can now sample DNA from in vitro blastocysts to identify embryos with genetic abnormalities and avoid implanting them. This genetic screeni...
Are they safe? Drugs and devices receiving accelerated approval by the FDA
15 Aug 2017
Contributed by Lukas
Some drugs and devices receive accelerated approval from the FDA in order to provide potentially important treatments for patients when effective ther...
How Studying Familial Hypercholesterolemia Resulted in the Discovery of Statins as an Effective Treatment for High Cholesterol
25 Jul 2017
Contributed by Lukas
Scott Grundy, MD, PhD, is a professor of medicine at UT Southwestern in Dallas and is one of a small group of investigators who saved statins from bei...
How to Diagnose and Manage Adult Asthma
18 Jul 2017
Contributed by Lukas
Asthma often develops in childhood but also affects a significant number of adults. It can present in various ways and with varying degrees of severit...
Dual Antiplatelet Therapy: Balancing Ischemic and Bleeding Risk
11 Jul 2017
Contributed by Lukas
Following placement of cardiac stents, patients receive dual antiplatelet therapy (DAPT) to prevent stent thrombosis. Prevention of thrombosis is offs...
Penicillin Allergy – It's Less Common Than You Think
03 Jul 2017
Contributed by Lukas
Allergy to penicillin is one of the most commonly reported allergies by patients. In reality, true penicillin allergy is uncommon. Dr. Elizabeth Phill...
Diagnosing Congenital and Intellectual Abnormalities With Chromosomal Microarray Analysis
27 Jun 2017
Contributed by Lukas
Chromosomal microarray technology (CMA) facilitates the genetic diagnosis of intellectual disabilities, autism spectrum disorder, and congenital abnor...
High-Intensity Statin Therapy – The Controversy Continues
27 Jun 2017
Contributed by Lukas
Multiple guidelines have been issued regarding how aggressively cholesterol should be managed. These guidelines do not agree with one another and the ...
Treating Depression in Older Patients
23 May 2017
Contributed by Lukas
Depression is very common in old age. Because it is associated with many issues related to aging such as having diabetes, hypertension, and other dise...
Genomic Sequencing for the Healthy Individual?: Think Smaller
09 May 2017
Contributed by Lukas
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 h...
Diabetes in 2017: Focus Less On HbA1c and More On Cardiovascular Risk Reduction
03 Apr 2017
Contributed by Lukas
Much has changed recently in diabetes management. The treatment goal has shifted from rigorous glucose control with HbA1c as the primary target to car...
JAMA Performance Improvement: Retained Foreign Body From a Sheared Off Lumbar Drain
28 Mar 2017
Contributed by Lukas
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 ...
Alzheimer Disease Overview and the Possibility That It's Caused By Infections
20 Mar 2017
Contributed by Lukas
Alzheimer disease causes progressive neurologic deterioration and is reasonably common in elderly patients. It is characterized by specific patterns o...
Why the New Sepsis Guideline Changed
07 Mar 2017
Contributed by Lukas
Recent guidelines for how to best manage septic shock have changed. Gone are recommendations for central venous oxygen saturation monitoring and goal-...
Updated Guidelines for Sepsis Management
28 Feb 2017
Contributed by Lukas
In 2017 the Society for Critical Care Medicine updated its guidelines for sepsis management. These new guidelines differ significantly from ones in t...
JAMA Professionalism: What Should Students or Residents Do When Abused by Faculty
16 Feb 2017
Contributed by Lukas
Approximately one-third of all medical school graduates report having been abused as students. Medical student and resident abuse has long been consid...
Sarcopenia, Frailty and Risk Prediction in Geriatric Patients
09 Feb 2017
Contributed by Lukas
As people age, loss of muscle mass is inevitable, resulting in sarcopenia. Muscle loss contributes to overall weakness, which causes frailty. Frailty,...
Hypertension Management and Dealing With Polypharmacy in Elderly Patients—A Report From the 2016 European Union Geriatric Medical Society Meeting
02 Feb 2017
Contributed by Lukas
Managing hypertension in elderly patients is complicated. Recent studies have shown that elderly patients may benefit from aggressive hypertension man...
Managing Violent Patients in Health Care Settings
30 Jan 2017
Contributed by Lukas
Workplace violence–related injuries occur disproportionately in health care settings. In this podcast, we discuss how individual clinicians should m...
Systematic Approach to a New Onset Seizure
27 Dec 2016
Contributed by Lukas
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 loo...
Using Medicare Star Ratings to Select Hospitals
01 Nov 2016
Contributed by Lukas
Medicare recently developed a star rating system to help consumers determine the quality of care delivered at various hospitals. This rating system wa...
Treatments for Hyperemesis and Nausea and Vomiting in Pregnancy
04 Oct 2016
Contributed by Lukas
Nearly all women experience some element of nausea and vomiting during their pregnancies. In this podcast we review the entire spectrum of disease all...
Fluid Resuscitation for Patients in Septic Shock
27 Sep 2016
Contributed by Lukas
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 line...
The High Cost of Pharmaceuticals in the United States
26 Aug 2016
Contributed by Lukas
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 Ke...
Opioid Use Disorder
11 Aug 2016
Contributed by Lukas
Edward H. Livingston, MD, discusses the British Columbia Ministry of Health's 2015 guidelines on clinical management of opioid use disorder in adults ...
Treating Opioid Use Disorder Using Buprenorphine Implants
19 Jul 2016
Contributed by Lukas
Richard N. Rosenthal, MD discusses a randomized clinical trial demonstrating the efficacy of an implantable buprenorphine-releasing device for treati...
Review of Lyme Disease
12 Jul 2016
Contributed by Lukas
Lyme disease is very common in certain regions of the country and is caused by the spirochete Borrelia bergdorferi. Lyme disease is transmitted by tic...
Managing Persistent Diarrhea
28 Jun 2016
Contributed by Lukas
Persistent diarrhea is a poorly recognized syndrome in all populations that requires proper assessment and diagnosis to ensure that affected individua...
The Discovery of Lyme Disease with Dr Allen Steere
14 Jun 2016
Contributed by Lukas
Dr Allen Steere discovered Lyme disease and discusses what he saw and did when confronted early in his career with a previously undescribed disease. L...
GERD and Esophagitis
17 May 2016
Contributed by Lukas
Drs Stuart Spechler and Peter Kahrilis discuss GERD and esophagitis--how they occur and how they are treated. Dr Spechler also discusses a new hypothe...
Treating ADHD in Adolescents
10 May 2016
Contributed by Lukas
Attention-Deficit/Hyperactivity Disorder, or ADHD is a very common problem affecting about 10% of all adolescents. Children with ADHD have short atten...
Diagnosing Infectious Mononucleosis
12 Apr 2016
Contributed by Lukas
Mononucleosis is a common disease of young adults manifested by lethargy, fever, pharyngitis, lymphadenopathy and splenomegaly. In this podcast, we re...
Opioid Prescribing: Rising to the Challenge
15 Mar 2016
Contributed by Lukas
An opioid abuse epidemic now plagues US healthcare. It was caused, in part, by overzealous advocacy for controlling chronic pain resulting in overuse ...
Treating Geriatric Polypharmacy by Deintensifying Unnecessary Diabetes Treatment
08 Mar 2016
Contributed by Lukas
Polypharmacy is a rapidly worsening problem that hits elderly patients particularly hard. As patients grow older, they need more medications but at ...
2015 Breast Cancer Screening Recommendations for Women at Average Risk
23 Feb 2016
Contributed by Lukas
The American Cancer Society breast cancer screening guidelines have been changed to recommend annual screening for women older than 45 and every other...
Antibiotic Therapy for Community-Acquired Pneumonia in Adults
09 Feb 2016
Contributed by Lukas
Community acquired pneumonia accounts for 600,000 hospital admissions a year. Many patients with this disease are quite ill and have a very high morta...
New Dietary Guidelines
02 Feb 2016
Contributed by Lukas
The 2015-2020 US Dietary Guidelines for Americans were recently released. They are intended to provide guidance for health policy officials and clinic...
Peripheral Neuropathy
19 Jan 2016
Contributed by Lukas
Peripheral neuropathy is a highly prevalent and morbid condition affecting 2% to 7% of the population. Patients frequently experience pain and are at ...
Advances in Diagnosis and Treatment of Constipation
12 Jan 2016
Contributed by Lukas
Constipation is one of the most frequent problems clinicians are asked to deal with. Despite how common it is, constipation is frequently not treated ...
Antibiotics vs Appendectomy for Uncomplicated Appendicitis Treatment
29 Dec 2015
Contributed by Lukas
Appendicitis is one of the most common reasons people undergo abdominal surgery. Lost in history are the reasons why appendectomy was performed in the...
Head Trauma
22 Dec 2015
Contributed by Lukas
Minor head trauma usually does not cause significant brain injury. To be safe, clinicians often obtain head CT scans to ensure no major injury is pres...
Graves Disease
15 Dec 2015
Contributed by Lukas
Edward H. Livingston, MD discusses Graves disease with David Cooper, MD, author of Management of Graves Disease: A Review
Prostate Cancer Screening
17 Nov 2015
Contributed by Lukas
Edward H. Livingston MD, explores the topic of prostate cancer screening in author interviews with: Dan Merenstein about losing a malpractice case ...
Ruling Out Acute Coronary Syndrome in Patients With Chest Pain
08 Nov 2015
Contributed by Lukas
ACS is a common and potentially lethal problem. However, only about 10% of patients who present to an emergency department with chest pain actually ha...
Using Likelihood Ratios to Understand How Chest Pain Predicts Acute Coronary Syndrome
08 Nov 2015
Contributed by Lukas
Interview with David Simel, MD, author of Does This Patient With Chest Pain Have Acute Coronary Syndrome? The Rational Clinical Examination Systematic...
Explaining the Improved Health of the US: Mortality Trends 1969-2013
27 Oct 2015
Contributed by Lukas
Interview with Ahmedin Jemal, DVM, PhD, author of Temporal Trends in Mortality in the United States, 1969-2013, and J. Michael McGinnis, MD, MPP, aut...
Treating Chronic Sinusitis in Adults
01 Sep 2015
Contributed by Lukas
Interview with Luke Rudmik, MD, MSc, author of Medical Therapies for Adult Chronic Sinusitis: A Systematic Review. This systematic review summarizes ...
Posttraumatic Stress Disorder
04 Aug 2015
Contributed by Lukas
Edward H. Livingston, MD, interviews a war veteran and discusses PTSD with Maria Steenkamp, PhD, author of Psychotherapy for Military-Related PTSD, an...
Managing Atrial Fibrillation
21 Jul 2015
Contributed by Lukas
Edward H. Livingston, MD discusses atrial fibrillation with Eric N. Prystowsky, MD, author of Treatment of Atrial Fibrillation, and talks about new te...
Medical Marijuana for Treatment of Chronic Pain and Other Problems
23 Jun 2015
Contributed by Lukas
Interview with Kevin P. Hill, MD, MHS, author of Medical Marijuana for Treatment of Chronic Pain and Other Medical and Psychiatric Problems: A Clinica...
Stroke Prevention in Atrial Fibrillation
19 May 2015
Contributed by Lukas
Edward H. Livingston, MD discusses stroke prevention in atrial fibrillation with Gregory Lip, MD, author of Stroke Prevention in Atrial Fibrillation: ...
Achalasia
12 May 2015
Contributed by Lukas
Read the article and earn CME: bit.ly/1T3EpB1 Patient Page: bit.ly/1T3Exk0 Spanish Patient Page (Acalasia): bit.ly/1T3EHrr Understanding the swal...