Clinical Conversations

Latest Episodes:

Podcast 61: A conversation about end-stage dementia. Oct 16, 2009

Show notes

We talk with Susan Mitchell, a Harvard researcher who set out to characterize the final clinical stages of advanced dementia. There are some surprises — namely, the benefit of clear communications with patients and their families (which, come to think of it, shouldn’t come as much of a surprise at all). Talk with us at 1-617-440-4374 or write to jelia@nejm.org. This week’s links: Interview:

Advanced Dementia’s Course

News summaries:

Prophylactic Acetaminophen Reduces Immunogenicity of Childhood Vaccines

Nursing Home Residents See Marked Declines in Functional Status After Starting Dialysis

Minimally Invasive vs. Open Radical Prostatectomy

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Podcast 60: Weight loss in type 2 diabetes benefits obstructive sleep apnea — a conversation with Prof. Gary Foster Oct 10, 2009

Show notes

It’s been treated as fact for a long time, but now there are data to prove it: weight loss in type 2 diabetes does ameliorate obstructive sleep apnea. Gary Foster of Temple University has an ongoing study of some 250 patients, and he’s just presented data on the first year of an anticipated 4-year follow-up. Listen in. The gift deadline for our survey has been extended. The analysts want more data (don’t they always?), and so if you take the survey you’ll get a $5 gift certificate from Amazon. See the notice just above (or below) this text on the website for information. I don’t imagine they will extend the deadline much past the end of October, so please unload all your opinions upon us soonest. If you’d rather do that informally and directly, you can always dial 1-617-440-4374 or contact me at jelia@nejm.org.

This week’s links:

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Podcast 59: A conversation about bacterial coinfection in 2009 H1N1 flu deaths with Dianna Blau of the CDC Oct 02, 2009

Show notes

Early in the 2009 H1N1 pandemic, it was thought that bacterial coinfection was rare, but now that’s been shown to be untrue. Dr. Dianna Blau, one of the principal contributors to a study of coinfections in 77 fatal cases of 2009 H1N, is our guest. This week’s interview links:

This week’s news links:

The post Podcast 59: A conversation about bacterial coinfection in 2009 H1N1 flu deaths with Dianna Blau of the CDC first appeared on Clinical Conversations.

Podcast 58: A repeat of the July 31 interview with the CDC’s Denise Jamieson on treating pregnant women who have suspected 2009 H1N1. Sep 29, 2009

Show notes

Pregnant women are at greater risk for flu complications. This week, we repeat a conversation with a CDC researcher who’d just published a paper in Lancet urging prompt treatment with antivirals, even in the face of pending lab results. Contact us at 1-617-440-4374. This week’s links:

The post Podcast 58: A repeat of the July 31 interview with the CDC’s Denise Jamieson on treating pregnant women who have suspected 2009 H1N1. first appeared on Clinical Conversations.

Podcast 57: Treating community-acquired pneumonia according to the guidelines Sep 21, 2009

Show notes

When treated according to 2007 IDSA/ATS guidelines, community-acquired pneumonia is a less dangerous disease. You need to administer only 10 guideline-compliant treatments to elderly people, according to one estimate, in order to save a life. A good deal, no? We have the authors of two papers on the benefits of compliance as our guests this week. Their studies were published in the September 14 edition of Archives of Internal Medicine.
(A reminder to take the survey, please, if you haven’t already.) This week’s interview links:

This week’s news links:

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Podcast 56: A conversation with two JAMA staffers on their research into “ghost” authorship and “honorary” authorship in the principal medical journal... Sep 12, 2009

Show notes

We’ve seen research into this area before — 18 months ago, in fact. (We interviewed Joseph Ross back then in Podcast #2.) This time we interview Joseph Wislar, a survey-research specialist at JAMA, and Annette Flanagin, its managing deputy editor. They’ve just presented the abstracted results of a survey on ghost and honorary authorship that encompasses hundreds of articles from the principal medical journals. If you would like to comment, give us a call and leave a message at 1-617-440-4374 or drop me a note at jelia@nejm.org. This week’s links:

The post Podcast 56: A conversation with two JAMA staffers on their research into “ghost” authorship and “honorary” authorship in the principal medical journals. first appeared on Clinical Conversations.

Podcast 55: A conversation with Prof. Gilles Montalescot about his JAMA paper on immediate versus delayed intervention in non-ST-segment elevation acu... Sep 04, 2009

Show notes

French researchers find that in non-ST-elevation acute coronary syndrome, delaying intervention until the next day does not affect the occurrence of death, MI, or the need for urgent revascularization by the one-month mark. We caught up with the study’s first author in Paris. If you want access to earlier podcasts, you’ve come to the right place if you’re reading this at http://podcasts.jwatch.org. If you’d like to leave a note of delight or dismay, 1-617-440-4374 is the place to do so — or via email to me at jelia@nejm.org. This week’s news and interview links:

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Podcast 54: A conversation with Aaron Caughey, whose analysis of the literature shows that elective induction of labor does not, contrary to dogma, in... Aug 21, 2009

Show notes

Well, the headline says it all. UCSF’s Aaron Caughey has just published a meta-analysis in Annals of Internal Medicine that shatters the dogma of elective induction’s being associated with cesarean delivery. I hope you’ll enjoy the conversation. There won’t be a Clinical Conversation next week — I’m taking a week off — but the chit-chat returns in two weeks. Older conversations are all archived here at podcasts.jwatch.org, and you can leave me a note at 1-617-440-4374 or at jelia@nejm.org. This week’s links:

The Interview’s story link:

Elective Labor Induction Associated with Lower Cesarean Delivery Rates

The post Podcast 54: A conversation with Aaron Caughey, whose analysis of the literature shows that elective induction of labor does not, contrary to dogma, increase the risk of cesarean delivery. first appeared on Clinical Conversations.

Podcast 53: Patients extubated with hypercapnia can be managed better with noninvasive ventilation, a new study shows. Aug 14, 2009

Show notes

Dr. Miquel Ferrer of the University of Barcelona took some time away from his holiday to talk with us about an article he’s just published in Lancet. His research shows that in a subgroup of patients with chronic respiratory diseases (mostly COPD) who are undergoing extubation but who remain in hypercapnia, noninvasive ventilation support is the way to go. This week’s links:

The post Podcast 53: Patients extubated with hypercapnia can be managed better with noninvasive ventilation, a new study shows. first appeared on Clinical Conversations.

Podcast 52: Screening for intimate-partner violence doesn’t seem productive or very protective. What’s a concerned clinician to do? Aug 09, 2009

Show notes

We talk with two authors of a JAMA study that indicates that such screening doesn’t accomplish the ultimate goal: protecting the patient from further abuse. Our guests have some advice.

This week’s news links:

Interview links:

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