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In this episode of Curbside Consults, we examine the latest guidelines on the diagnosis and management of Barrett’s esophagus by the American College of Gastroenterology (ACG). We are joined by Dr. Nick Shaheen, a Professor of Medicine and Chief of Gastroenterology and Hepatology at UNC Chapel Hill, and one of the guideline authors.…
 
Featuring articles on childhood risk factors and adult cardiovascular events, results of two cases of pig-to-human kidney xenotransplantation, vaccine effectiveness against omicron in children and adolescents, the efficacy and safety of a BNT162b2 booster, catching up on REMs, and on NEJM Healer; a review article on brain tumors in children; a case…
 
The U.S. Preventive Services Task Force recently issued its sixth set of guidelines on using daily aspirin to prevent cardiovascular disease. The guidelines appeared in JAMA — whose editors asked our guest, Dr. Allan Brett, to write an editorial evaluation. This edition carries Brett’s advice on using the new guidelines in daily clinical practice. …
 
Featuring articles on the treatment of mild chronic hypertension during pregnancy, lenacapavir for HIV-1 treatment, booster vaccination against omicron in Qatar, and on reframing the quality question; a review article on preeclampsia; a case report of a man with chylous ascites; and Perspective articles on health care reform under the Biden adminis…
 
Saline or balanced crystalloids? The question of which resuscitation fluid to use in clinical practice seems to have been settled by recent research findings — or at least settled in favor of balanced crystalloids. But wait, our guests see slight differences that may affect your choice. Patricia Kritek practices critical care medicine at the Univer…
 
Featuring articles on baricitinib for alopecia areata, convalescent plasma for early SARS-CoV-2 infection, efficacy of a fourth mRNA vaccine dose in Israel, ivermectin for early Covid-19, a new image for cell sorting, and metric myopia; a review article on nonspecific low back pain; a Clinical Problem-Solving on looking back; and Perspective articl…
 
In this episode of Curbside Consults, we examine the latest guidelines on the diagnosis and management of pediatric osteomyelitis by the Infectious Diseases Society of America (IDSA) and Pediatric Infectious Diseases Society (PIDS). We are joined by Dr. Samir Shah, a Professor of Pediatrics at Cincinnati Children’s Hospital, Editor-in-Chief of...…
 
Featuring articles on CT or coronary angiography in stable chest pain, protection against omicron by a fourth vaccine dose, a vaccine for RSV in pregnancy, nasal high-flow therapy during neonatal intubation, and reassessing quality assessment; a review article on understanding vaccine safety; a case report of a man with myalgias, fever, and bradyca…
 
Spend 15 minutes with Dr. Natalia Shevchuk, whom we interviewed by candlelight last month. She is sheltering in the Odessa region now, having left the Donetsk area. This time, she relates how she lost a colleague in Russia’s attack on the Kramatorsk railway station and found another she’d feared lost in Mariupol. She told us that she’s impressed by…
 
Featuring articles on restricted calories and eating times in weight loss, asthma therapy in Black and Latinx adults, ivosidenib in IDH1-mutated acute myeloid leukemia, vaccine boost effects on protection against omicron, and fighting cardiac fibrosis with CAR T cells; a review article on early-onset colorectal cancer; a case report of a woman with…
 
Featuring articles on nirmatrelvir plus ritonavir for Covid-19, the treatment of acute Achilles’ tendon rupture, rilzabrutinib in immune thrombocytopenia, mitapivat for pyruvate kinase deficiency, and global health and the moral clarity of Paul Farmer; a review article on cancer-associated hypercalcemia; a case report of a woman with pancytopenia; …
 
During the American Academy of Neurology’s 2022 meeting in Seattle, Dr. Richard Lipton of Albert Einstein College of Medicine took questions from Dr. Teshamae Monteith (U. Miami) and Joe Elia. Lipton’s group sought to characterize the impact of patients’ monthly headache days on their quality of life, especially the role of depression, allodynia, a…
 
Featuring articles on endovascular therapy for large cerebral infarction, population immunity and Covid-19 severity with the omicron variant in South Africa, tebipenem for complicated urinary tract infection, an implanted stimulator in multiple-system atrophy, U.S. medical faculty diversity over four decades, and the origins of calcific aortic sten…
 
Featuring articles on Covid-19 after vaccination and previous infection, vaccination after recovery from SARS-CoV-2 infection, mini-slings for stress incontinence in women, higher-dose primaquine for P. vivax malaria, and on how medicine is not gender-neutral; a review article on decompression sickness and arterial gas embolism; a case report of a …
 
Featuring articles on a single-dose liposomal amphotericin B treatment for cryptococcal meningitis, hydrocortisone to prevent bronchopulmonary dysplasia, darolutamide in metastatic prostate cancer, trastuzumab deruxtecan for HER2-positive breast cancer, addressing vaccine inequity, and targeting gene therapy to muscle; a review article on managing …
 
Dr. Natalia Shevchuk (pictured above) treats substance use disorders in Ukraine’s Donetsk region. Her face is candlelit because her town is under curfew, and people aren’t allowed to put on their room lights (if they have electricity) in the hours of darkness, lest Russian bombardments use the lights as guides. She talked with Dr. Ali Raja and Joe …
 
Featuring articles on gene therapy for hemophilia A, prekallikrein and hereditary angioedema, a trial of a cereblon modulator in lupus, and the immune effects of Covid-19 vaccine boosters; a review article on cryptogenic organizing pneumonia; a case report of a woman with episodes of swelling; and Perspective articles on a malaria vaccine for Afric…
 
Gastroesophageal reflux, or GERD, was the focus of a revised set of guidelines issued in January in the American Journal of Gastroenterology. Given the frequency of that condition in primary care clinics, internist and NEJM Journal Watch editor-in-chief Allan Brett proposed a discussion about the practical application of these guidelines with David…
 
Featuring articles on shorter-course TB treatment in children, thyroidectomy without radioiodine, Covid-19 vaccine effectiveness in North Carolina, ribociclib in hormone receptor–positive breast cancer, the effects of boosters after Ad26.COV2.S vaccination, and on tumors and T cells; a review article on extracorporeal kidney-replacement therapy for…
 
Some 85 years ago Guernica was bombed, and after that came Dresden, Coventry, Hiroshima, Bach Mai, and the rest. This episode of Clinical Conversations asks how it might be possible to help clinicians under bombardment in Ukraine. As you will hear, one hospital in Chernihiv keeps all but essential staff away from its buildings when they are not on …
 
In this episode of Curbside Consults, we examine the latest guidelines on the evaluation and management of well-appearing febrile infants 8-60 days old by the American Academy of Pediatrics (AAP). We are joined by Dr. Benard Dreyer, a Professor of Pediatrics at NYU, the past president of the AAP, who is one of the guideline authors.…
 
Featuring articles on a balanced multielectrolyte solution versus saline in critically ill adults, troponin I after cardiac surgery and 30-day mortality, nirsevimab for prevention of RSV in infants, a final analysis of single-dose Ad26.COV2.S, and melioidosis and aromatherapy; a review article on chronic pancreatitis; a Clinical Problem-Solving on …
 
Featuring articles on the effectiveness of the BNT162B2 vaccine in adolescents, the treatment of epileptiform activity after cardiac arrest, mechanisms of resistance to noncovalent BTK inhibitors, Covid-19 vaccination and delta transmission, mortality from congenital Zika syndrome in Brazil, and wound healing and stem cells; a review article on rea…
 
You want more evidence that post-recovery vaccination against Covid-19 reinfection helps? Here is a careful study from the U.K. that followed some 35,000 health care workers — initially without symptoms — in over 100 institutions there. Starting in June 2020 the SIREN study tested these people regularly, with blood sampling every month and nasal sw…
 
Governments’ directives about how and when to vaccinate people who’ve recovered from Covid-19 vary widely. But, according to this episode’s guest, Dr. Ronen Arbel, they all say they don’t have enough evidence to set firm policy. So, Arbel and his colleagues set out to collect evidence from some 150,000 patients’ records in Israel who’d recovered fr…
 
In this episode of Curbside Consults, we discuss the recently published guidelines on the management of venous thromboembolic disease by the American College of Chest Physicians. We are joined by one of the guideline authors, Dr. Lisa Moores, Associate Dean for Assessment and Professor of Medicine at the Uniformed Services University of...…
 
Why can’t the U.S. control prescription drug pricing as they do in the U.K., where per-capita spending is less than half our level? In a capitalist democracy, many parties — the drug companies, medical associations, consumer groups — get to lobby their points of view. Is the problem intractable, or just an exercise in chaos? Our three guests have w…
 
Multisystem inflammatory syndrome in children (or MIS-C) is a serious complication of Covid-19 infection, usually showing up about a month after infection. CDC worked with several hospitals around the U.S. to discern whether vaccination in adolescents would lessen the likelihood of this outcome. A vaccine hadn’t yet been approved, as it now is, for…
 
In this episode of Curbside Consults, we examine the latest guidelines on reassessing the inclusion of race in eGFR equations from the National Kidney Foundation (NKF) and American Society of Nephrology (ASN). We are joined by one of the guideline authors -- Nwamaka Eneanya, Director of Health Equity, Anti-Racism and Community...…
 
In this episode of Curbside Consults, we examine the latest guidelines on the management of Clostridiodes difficile (C. difficile) infection. This year, updated guidelines were developed by the Infectious Diseases Society of America and Society for Healthcare Epidemiology of America, as well as the American College of Gastroenterology. Here, we...…
 
In this episode of Curbside Consults, we examine the latest guidelines on the management of ANCA-associated vasculitis by the American College of Rheumatology (ACR) and Vasculitis Foundation. In doing so, we review the major trials in vasculitis research published during the last 10 years with one of the guideline authors, Dr. Peter...…
 
The former CEO of Memorial Hermann Health System, who began his career in nursing, traces the history of the nursing shortage back to the 1970s and offers a selection of solutions for its current iteration, focusing on short-, medium-, and long-term tactics.Door NEJM Group
 
Kiarri Kershaw has written a simple letter in JACC — the Journal of the American College of Cardiology. The letter conveys a strong message: health inequities don’t act uniformly across one’s lifetime. Her examination of Black versus white mortality from all causes and from cardiovascular causes with the use of age-specific data shows places in […]…
 
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