Pharmacist intervention for long-term blood pressure control, HPV and cancer, teenagers
with reduced cognitive ability at higher risk of developing Alzheimer’s, and chronic
pain and suicide.
1:05 Pharmacist telemonitoring to control blood pressure
1:40 Slightly reduced, but benefits not significant long-term
2:38 App to self-monitor may be beneficial
3:10 More medications involved with pharmacist intervention
3:44 HVP-associated cancers
4:19 Survival rates for single HPV-associated cancer improving
4:41 Persistent HPV infection leading to second cancer down the line
4:44 May be at the same site, but sometimes not
5:00 Importance of HPV vaccine
5:23 Continuous screening important
5:48 70-year Project Talent Medicare data set
6:25 Teenage boys with lowered mechanical reasoning, girls with lowered word recall,
higher risk for Alzheimer’s
7:12 Unclear whether association or causation
8:12 People with chronic pain at higher risk for suicide
8:30 Most studies on survivors and not decedents
9:00 9% had evidence of chronic pain: back pain, cancer pain, arthritis
10:05 Most suicides from firearms and not opioid overdose
The burden of firearm death worldwide, does aspirin or fish oil help people with diabetes,
and anticoagulation following hospitalization.
0:51 Global burden of firearm death
1:52 Very sobering data with certain countries prominent
2:52 Homicide death 19% of the time
3:10 Fish oil and aspirin in people with diabetes
4:10 Aspirin reduced risk
5:11 Didn’t increase serious bleeding
5:34 Second agent for diabetes management
6:35 Largely the same
7:33 A moving target
8:00 Rivaroxiban for VTE post-hospitalization
9:00 Treated for 45 days
This week’s topics include Parkinson’s disease and metabolic syndrome, lorcaserin
and heart problems, the global burden of alcohol related disease, and robotic surgery
0:40 Metabolic syndrome and Parkinson’s disease
1:40 Corrected for many confounders
2:40 Some biological reasons
3:30 Robotic surgery costs
4:31 Substantial costs for almost any procedure
5:26 Lorcaserin and heart problems
6:26 Downward trend with diabetes
7:30 Primary care doc intervention
7:48 Alcohol use and burden
8:47 Tuberculosis, road injuries and self harm
9:41 Cancer increase
Living a healthy life and dementia risk, how much combination medicines cost Medicare,
cervical cancer screening, and LDL cholesterol in those at low risk for a cardiovascular
0:40 Cardiovascular health in those older than 65 and dementia 1:40 Fasting glucose less than 100 2:42 Modifying in those 65+ 3:11 Cervical cancer screening update 4:11 Big group 29-65 5:11 Women need to choose 6:04 Combination pill cost 7:04 Way more expensive to use combinations 8:04 LDL cholesterol in those at low 10 year risk 9:05 Increased risk by 50-60% 10:14 End
This week’s topics include vaccination in pregnant women and ASD, treating stroke
outside the window, smoking, mortality and weight gain, and five risk factors for
death in type 2 diabetes.
0:53 TDAP in pregnancy and ASD
1:52 Somehow affects neurodevelopment
2:52 Lots of miscommunication
3:21 Risk factors, mortality in type 2 diabetes
4:30 Little or no excess mortality risk with control
5:31 Control especially in younger people
6:19 Stroke intervention outside the window
7:18 Give thrombolytic therapy
8:18 Expanding window for stroke treatment
8:31 Smoking cessation, weight change, type 2 diabetes, mortality
9:35 Attenuated over time
This week’s topics include secondhand smoke and adolescents, labor induction, screening
young athletes for cardiac problems and ADHD medicines.
0:36 Screening young athletes for cardiac problems 1:36 Spent over $8million to screen 2:36 Labor induction in low risk women 3:34 Sweet spot of delivery 4:32 Okay to induce at 39 weeks 5:12 Adolescent exposure to cigarette smoke 6:13 Much higher incidence of respiratory problems 7:18 Best ADHD medicines 8:18 Methylphenidate for adolescents and children 9:18 Tolerated better than placebo 10:21 End
This week’s topics include caliber of bullets and handgun deaths, a novel agent for
dilated cardiomyopathy, getting genomic screening into clinical practice, and new
diabetes subtypes based on continuous glucose monitoring.
0:52 Genomic screening in healthcare 1:54 Integration with consumer data 2:54 Far from routine clinical care right now 3:58 Deaths from firearms and caliber 4:57 Large caliber increased risk 4 or 5 times 5:50 Continuous glucose monitoring and diabetes subtypes 6:50 No previous diagnosis of diabetes 7:50 Able to categorize both pre diabetes and diabetes 8:53 Use of an anti-inflammatory for dilated cardiomyopathy 9:51 Inhibit interleukin-1 10:45 End
This week’s topics include head injury and CT, Medicare versus Walmart, use of osteoporosis
meds after hip fracture, and persistent Ebola infection.
1:00 Persistent Ebola virus infection 2:00 Became viremic again 3:00 Even without known exposure 3:11 Use of osteoporosis meds in people who’ve had a hip fracture 4:11 Continuous decline in use 5:11 These medicines associated with a femur fracture 6:00 Medicare versus Walmart for some medicines 7:01 Other tier programs are more expensive 7:30 TBI, blood markers, and CT 8:32 2.5 million ED visits for TBI 9:31 Might be used to look at concussion recovery 10:41 End
This week’s topics include tick borne illness, late life blood pressure and stroke,
a simple ED intervention to reduce suicidality, and fecal occult blood and mortality.
1:05 Tick borne illness and citizen science 2:05 Limited broadcast of tick testing 3:05 Pathogens outside of where they were known 4:17 Late life blood pressure 5:17 Only some of the Alzheimer pathology 6:15 Intervention in ED to reduce suicidality 7:15 Strategies to reduce simple and followed up by telephone 8:15 Fecal occult blood and mortality 9:18 More data as these tests are used for screening 10:40 End
This week’s topics include USPSTF recommendations on nontraditional risk factors for
heart disease, the role of genetics in congestive heart failure, a patch to diagnose
atrial fibrillation, and multivitamins and heart disease.
0:57 Patch for diagnosing atrial fibrillation 2:00 More likely to receive care 3:01 These were all people at risk 3:14 USPSTF and nontraditional risk factors for cardiovascular disease 4:14 No evidence that therapy is altered 5:15 In individuals with no risk factors 5:50 Multivitamins and heart disease 6:50 Adjusted for physical activity no benefit 7:31 The genetics of heart failure 8:31 Does increase one’s risk if biological parent has it 9:31 A complex trait 10:18 End
This week’s topics include DOACs and warfarin, use of defibrillators after Department
of Justice involvement, HPV testing versus Pap smears, and interfering with RNA in
a genetic disease.
0:51 Department of Justice and use of cardiac devices 1:50 Ultimately fined $280 million 2:51 Aren’t paying attention to guidelines 3:35 Direct oral anticoagulants or DOACs compared to warfarin 4:35 Reduced risk of intracranial bleeding 5:35 Don’t know about compliance 6:35 Warfarin much less expensive 7:00 Oligonucleotides and amyloidosis 8:00 Novel use of interfering with RNA 9:00 Replacement of Pap smears with HPV testing? 10:01 HPV testing had lower risk of cervical cancer at 48 months 10:47 End
This week’s topics include hospital at home, using a virus to treat brain cancer,
updated osteoporosis guidelines, and an artificial pancreas in hospitalized pat45
0:45 Screening for osteoporosis 1:45 DEXA for women over 65 2:45 Don’t make a firm determination in men 3:50 Artificial pancreas use in hospitalized patients 4:50 Controlled 66% of the time 5:46 Hospital at home 6:45 Rated better by patients 7:45 Patients older and with impairment 8:25 Use of polio virus to treat glioblastoma 9:25 Way to predict who will respond? 10:29 End
This week’s topics include the emotional consequences of gun violence, a single test
to diagnose diabetes, use of medicines to help addiction after opioid overdose, and
screening for abdominal aortic aneurysm.
1:00 Kudos to listeners 1:45 Opioid overdose and use of medications to assist afterward 2:45 Methadone better 3:45 Almost a third received another opioid prescription 4:45 Transition from ED to treatment 5:00 A single blood test to diagnose diabetes 6:00 Postitive predictive value about 90% over 15 years 7:10 Survivors of gun crimes 8:10 All individuals victimized 9:00 Screening for abdominal aortic aneurysm 10:30 End
This week’s topics include utility of EKGs, autism and allergy, Mediterranean diet
and heart risk, and trends in suicide rates in the US.
0:34 Mediterranean diet and cardiovascular risk 1:35 Randomized to three groups 2:36 Supposed to be randomized 3:43 Suicide data in US 4:42 Need to extend treatment 5:28 Allergy and autism 6:28 No information on why 7:28 Historical data may help 7:50 Screening EKG 8:50 Does not add additional info 9:30 False positives 10:17 End
This week’s topics include fecal transplant for primary treatment of C.diff, new colorectal
cancer screening guidelines, giving chemo a miss in breast cancer, and attendings
and rates of medical errors.
0:50 Fecal transplant for primary treatment of Clostridium difficile infection 1:50 Only tried after failure of antibiotics 2:50 45% response with metronidazole 3:50 Needs to be confirmed into a larger trial 4:20 Intermediate risk breast cancer treatment 5:20 94% were alive after 10 years 5:52 increased attending presence and medical errors 6:52 Interns felt less efficient 7:52 Can it be translated to other institutions? 8:11 New colorectal cancer screening guidelines 9:13 Didn’t pick a particular test 10:35 End
This week’s topics include the state of bacterial and fungal resistance worldwide,
a nurse-led intervention in the ICU and outcomes for surrogates, cardiovascular outcomes
and walking or biking to work, and procalcitonin and antibiotic use.
0:58 Alternatives to the car and cardiovascular health 1:58 Confounders corrected 2:30 Nurse led interventions to help surrogate decision makers 3:30 Enrolled all patients in five ICUs 4:31 Did not change six month mortality 5:15 Procalcitonin and antibiotic prescribing 6:15 Didn’t decrease antibiotic use 7:15 Moving in the right direction? 7:38 Bacterial and fungal resistance to drugs 8:38 Can extend lifetime of antibiotic use 9:33 Resistance increasing to antifungals 10:38 End
This week’s topics include occluding the atrial appendage and stroke, a pragmatic
smoking trial, a relative rise in lung cancer among women, and the benefits of egg
0:37 Disturbing rise in lung cancer among women 1:37 Over the decades has decreased more in men 2:35 A pragmatic trial of smoking cessation interventions 3:28 Only 20% even wanted to try 4:28 Still remains the greatest preventable cause of death 5:10 Surgical occlusion of left atrial appendage 6:10 Seems to be clear to do it 7:10 They were more likely to develop ongoing a-fib 7:46 Egg consumption and cardiovascular outcomes 8:49 One egg per day had lower risk 9:35 Americans have more ischemic heart disease 10:35 End
This week’s topics include the Ebola vaccine, stroke risk and resolved a-fib, an antibody
for migraine prevention, and cannabis and tobacco smoking by parents.
0:36 Ebola vaccine 1:36 Persistent neutralizing antibodies 2:36 May not return for boosters 3:36 These are worldwide concerns 4:10 Cannabis and tobacco use in parents 5:10 More prevalent in men 6:06 Resolved a-fib and stroke 7:08 Give blood thinners and decrease risk 8:09 Migraine prevention 9:09 Decreased by 1.5 headaches per month 10:08 Clinical entity is tip of the iceberg 10:45 End
This week’s topics include crowdfunding for stem cell therapies, USPSTF recommendations
for prostate cancer screening, MRI guided biopsy of the prostate, and testing blood
for Zika virus.
0:31 Zika virus screening of blood donations 1:31 Cost of about $1 million to prevent one case 2:31 Traveled into the US and gave blood 3:15 PSA screening recommendations 4:15 Screening 1000 men 5:14 Appropriate strategy to follow 5:26 Utility of MRI for targeted biopsy of prostate 6:27 Have a sonogram 7:15 Crowdfunding for stem cell therapy 8:15 How many soliciting? 9:15 FDA now looking 10:20 End
This week’s topics include the best blood vessel for cardiac bypass grafts, rates
of autism, five healthy lifestyle factors and their impact on mortality, and managing
0:37 Autism rates nationally 1:38 Are there differences in sites? 2:36 Overall increased from 13 per 1000 to 29 per 1000 3:15 Five lifestyle factors and lifespan 4:15 For men and women longer life 5:15 Smoking makes the most difference 6:01 Managing COPD 7:01 Randomized to triple or dual therapy 8:01 Radial artery versus the saphenous vein for CABG 9:01 Internal mammary on the LAD 10:37 End
This week’s topics include best treatment of venous leg ulcers, cannabis and cognition,
anticlotting agents after bypass grafting, and caffeine and childhood obesity.
0:38 Cannabis and cognition in young people 1:38 Didn’t see an impact after 72 hours 2:38 Neurodevelopment ongoing in this age group 3:35 Aspirin and ticagrelor after bypass 4:32 End of a year 89% were open 5:31 Keep people on two agents? 5:49 Caffeine consumption during pregnancy and childhood obesity 6:47 Excess childhood weight persisted to eight years 7:45 Tell mothers to use the lowest caffeine 7:57 Leg ulcer treatment 8:57 Ablation in first two weeks 9:50 Different types of ablation 10:28 End
This week’s topics include preventing falls in the elderly, ambulatory versus clinic
blood pressures, benefits of statin use, and how much alcohol is okay to consume.
0:36 How much alcohol consumption is safe 1:36 Standard drink amount 2:36 Variations worldwide 3:33 Different types of death, linear increase 4:00 Who benefits from statins? 5:04 Newer trials with lower LDL at baseline 6:03 Ambulatory blood pressure versus clinical measurement 7:03 Different categories of high blood pressure 8:03 Masked hypertension had three times mortality 8:44 Falls in the elderly 9:44 Exercise most beneficial 10:38 End
This week’s topics include safety of smoking cessation medicines, a nationwide look
at health, predictors of COPD in childhood, and neuron growth and health in one part
of the brain.
0:41 A state by state look at health 1:41 Huge geographic difference in life expectancy 2:41 Have control over many factors 3:40 Can intervene with policy 4:01 New neurons in the hippocampus 5:02 Fairly small autopsy study 5:35 Safety of smoking cessation medicines 6:35 Extended study for full year 7:35 Effective in at least a third of individuals 7:52 Antecedents of COPD in childhood 8:50 Factors can be modified 9:52 Parental history of asthma 10:52 End
This week’s topics include diagnosing cellulitis, managing pleural effusion, antibiotics
and antacids in children and allergy, and loss of wealth and mortality.
0:38 Managing pleural effusion in people with cancer 1:39 Worked well on outpatient basis 2:33 Could be done in US? 3:08 Antibiotics and acid suppression in infants and allergy 4:08 Twice as likely to develop allergic reactions 5:08 Biologically plausible 5:44 Health and wealth 6:43 Increased mortality to same level as poverty 7:33 Cellulitis diagnosis 8:33 Don’t recommend routine imaging 9:32 Avoid these tests 10:18 End
This week’s topics include sinusitis treatment, low back pain management, waning mumps
immunity, and e-cigarettes and quitting attempts.
0:37 Mumps immunity waning 1:32 A booster should be assessed 2:33 Sequelae of mumps in adults 3:10 Use of e-cigarettes to assist in quitting smoking 4:12 Those using e-cigs were 50% or more less likely to quit 5:12 Damning evidence on e-cigs 5:46 Low back pain management 6:46 Call out to global health community 7:45 First line of therapy is nonpharmacologic 8:28 Sinusitis and antibiotic use 9:28 How should a patient approach this? 10:24 End
This week’s topics include treating infants with bronchiolitis, orthotics for heel
pain, medications for behavioral issues in people with dementia, and treating Helicobacter
pylori infection in people with early gastric cancer.
0:40 Orthotics for plantar heel pain 1:40 Not really helpful 2:41 Risk factors include low arch 3:01 CMS and use of medicines in people with dementia 4:01 Increased use of mood-altering drugs 5:01 Increases risk of death 5:45 Infection with H.pylori and gastric cancers 6:45 Chronic inflammation and cell change 7:45 Don’t know if screening helps in low and intermediate risk 8:23 High flow oxygen in infant bronchiolitis 9:23 Stabilized condition 10:51 End
This week’s topics include mortality statistics since 1980 across the US, domestic
healthcare costs, an iPad intervention for colorectal cancer screening, and real world
experience with clot retrieval in stroke.
0:40 An iPad intervention for colorectal ca screening 1:40 I need colorectal cancer screening 2:42 Hopefully hooked into having screening 3:02 Real world experience with clot retrieval after stroke 4:03 Lower complication rate 5:05 Patterns of mortality relative to substance abuse and self harm 6:08 This data helpful, county by county 7:03 Rural area more problematic 7:15 Medical costs in the US 8:15 Why costs so high? 9:15 Just prolong a few months 10:11 End
This week’s topics include the dangers of e-cigarettes, steroids and asthma, five
types of diabetes, and a single PSA measurement and outcomes.
0:41 Looking at metabolites of e-cigarettes 1:41 Increased organic compounds in blood 2:43 Targeting to this population 3:00 One time screening for prostate cancer 4:00 Did not decrease prostate cancer mortality at all 5:00 New tests will become available 5:17 Five subtypes of diabetes 6:17 Severe insulin deficient 7:16 Previously only classified by HbA1c 8:19 Metabolic measures 8:39 300 million people worldwide with asthma 9:45 Make sure they are optimally managed 10:33 End
This week’s topics include fluids best for resuscitation, a blood test for 8 cancers,
managing chronic pain for disadvantaged folks, and varicose veins and other circulatory
0:43 CancerSEEK, a blood test for cancer 1:44 For some of the cancers no screening test exists 2:44 Compared to a normal population 3:45 Specificity in a healthy population may not apply 4:33 Managing chronic pain in a disadvantaged population 5:33 Tough population with tailored CBT 6:33 Varicose veins and DVT 7:33 An association perhaps with common risk factors 8:22 Critically ill patients and fluid use 9:23 Helps kidneys but no difference in mortality 10:48 End
This week’s topics include anticoagulation after knee or hip surgery, proper treatment
of ARDS, dermatology consults for cellulitis in the hospital, and avoiding delirium
in the ICU.
0:39 Management of ARDS 1:37 Mechanical ventilation is important 2:34 Volume of air with each breath 3:21 Anticoagulation after hip or knee replacement 4:22 Aspirin versus NOAC 5:23 No studies of only aspirin 5:35 Benefits of in hospital dermatologists 6:35 Got correct diagnosis in cellulitis 7:31 Prevention of delirium in the ICU 8:31 Treatment with haloperidol did not improve outcomes 10:14 End