Clinical Conversations

It’s the usual offering: the week’s news summarized, an interview, and a quick exit. This week we talk with Steven DeKosky about his JAMA paper on the (lack of) usefulness of ginkgo extract in preventing dementia. The links will point you to a good resource on these alternative therapies and what’s known about them. Don’t hesitate to leave us a comment at 617-440-4374.
News links:
Statins and cardiovascular risks
Journal Watch Cardiology
Physician’s First Watch
New England Journal of Medicine article
Guidelines on second-generation antidepressants
Physician’s First Watch
Annals of Internal Medicine article
Interview links:
National Center for Complementary and Alternative Medicine site
Journal Watch Psychiatry coverage
Physician’s First Watch coverage
JAMA article
The post Podcast 21: An interview with Dr. Steven T. DeKosky about his JAMA paper showing that ginkgo extract does not prevent dementia first appeared on Clinical Conversations.

We interviewed Steven Woloshin back in June about a method of showing patients the magnitude of the risks they face from habits like smoking. We reprise the interview while we take some time off to recharge our batteries.
Interview link:
First Watch coverage of Woloshin’s study in JNCI
The post Podcast 20: While we take a week off, we offer the reprise of an interview with Dr. Steven Woloshin of Dartmouth Medical School. first appeared on Clinical Conversations.

This week’s podcast features an interview with the Australian researcher Susan Davis. She’s just had a study in NEJM about the effect of testosterone on low libido in postmenopausal women.
We also have the usual news roundup. Enjoy! (If you don’t, let us know at 1-617-440-4374.)
Journal Watch links:
CDC: Most Americans with Prediabetes Don’t Know They Have It
Low Maternal Caffeine Intake Linked to Fetal Growth Restriction
FDA Approves Drug Treatment for Overactive Bladder
Testosterone Patch Improves Sexual Desire in Postmenopausal Women
Interview link:
New England Journal of Medicine abstract
Journal links:
MMWR article on prediabetes
BMJ article on maternal caffeine intake
FDA announcment on bladder drug
New England Journal of Medicine abstract on testosterone
Election links:
The 2008 election results
The post Podcast 19: An interview with Dr. Susan Davis about using testosterone in postmenopausal women who have low libido. Plus, the week’s news. first appeared on Clinical Conversations.

This week we look at why infective endocarditis among the elderly has characteristics very different from its manifestations in younger patients. Prof. Riccardo Utili of the Second University of Naples is our guest. And of course we start with a brief news roundup.
Journal Watch links:
Breast Cancer Less Likely to Recur in Women with Vasomotor, Joint Symptoms During Early Treatment
Comorbidities Associated with Delays in MS Diagnosis
Statin Use Associated with Drops in PSA Levels
Age Determines Clinical Characteristics of Infective Endocarditis
Journal links:
Breast cancer article from the Lancet Oncology
Multiple sclerosis article from Neurology
JNCI article on statins and PSA levels
Interview links:
Archives of Internal Medicine study on age and endocarditis
Voting links:
Federal Election Commission
Presidential voting history
The post Podcast 18: News plus an interview with Prof. Riccardo Utili about infective endocarditis in the elderly first appeared on Clinical Conversations.

This week Dr. Arto Strandberg, a general practitioner who does his research at the University of Helsinki, talks with us about the effects of midlife smoking on later-life living. Plus we have the usual news roundup.
Journal Watch links:
ACIP Recommends Pneumococcal Vaccine for Smokers
ADA Updates Algorithm for Management of Hyperglycemia in Type 2 Diabetes
Guidelines on GERD Management Issued
Hip Fracture Risk Elevated in Heart Failure Patients
Journal links:
Associated Press story
Diabetes Care guidelines
Gastroenterology guidelines
Circulation article
Interview links:
Archives of Internal Medicine article
X-ray story links:
Nature video
The post Podcast 17: News plus an interview with Dr. Arto Strandberg regarding midlife smoking first appeared on Clinical Conversations.

We had trouble reaching our intended interviewee in Finland. so we rescheduled that for next week. Instead, we’re bringing you an interview with Dr. John Douglas of the CDC that we recorded in March. He talks with us about the implications of a finding that one in four young women in the U.S. has a sexually transmitted disease. But first, news.
Journal Watch Links:
Aspirin, Antioxidants Offer No Primary Cardiovascular Protection in Diabetes
Homocysteine-Lowering with B Vitamins Doesn’t Slow Cognitive Decline in Alzheimer Disease
AAP Guidelines Recommend Doubling Children’s Vitamin D Intake
Smoking in Middle Age Confers Poor Quality of Life Years Later
Journal Links:
BMJ on aspirin and antioxidants in diabetics at risk for CVD
JAMA on B-vitamin supplementation in AD
Pediatrics guidelines on Vitamin D
Archives article on midlife smoking
Brian Eno and Will Wright discuss creativity and music and much else.
The post Podcast 16: This week’s news, plus an interview recorded earlier this year with Dr. John Douglas of the CDC’s Division of STD Prevention first appeared on Clinical Conversations.

The medical news gods were generous this week, providing a wealth of stories to choose from. Plus, the Nobel prizes were announced. We’re especially fortunate to have an interview with a researcher whose findings relate directly to your clinical work.
Journal Watch links:
Patients and Caregivers Benefit from End-of-Life Discussions
Tiotropium Alleviates Symptoms, Doesn’t Reduce Rates of FEV1 Decline in COPD
USPSTF Updates Colorectal Cancer Screening Guidelines
Carotid Stenting vs. Endarterectomy: Longer-Term Outcomes
News story links:
JAMA abstract on end-of-life discussions
NEJM article (free) on tiotropium
USPSTF recommendations (free) in Annals of Internal Medicine
Lancet Neurology abstract of first carotid study
Interview links:
JAMA abstract on end-of-life discussions
Nobel links:
Nature news article
The post Podcast 15: The week’s news, plus an interview with Dr. Alexi A. Wright about her article in JAMA on end-of-life conversations and their cascading benefits first appeared on Clinical Conversations.

The week ending Oct. 3, 2008, was relatively slow for medical news, but crammed with news of every other sort. This week’s interview features Michael Hochman, a third-year resident in internal medicine who has just published a paper on how the media cover research on new drugs. It seems they don’t make a habit of reporting funding sources.
Journal Watch links:
AHA Recommends Screening Patients with Coronary Heart Disease for Depression
News Media Coverage of Drug Trials Faulted
Journal links:
Circulation article on screening
Simple screening questionnaire
Interview links:
JAMA abstract
Science link:
Scientific illustration
The post Podcast 14: News roundup and interview with Dr. Michael Hochman about his JAMA paper on how the news media cover drug research. first appeared on Clinical Conversations.

This week’s podcast includes an interview with Stephen Hetz, co-editor of the recently published book “War Surgery in Afghanistan and Iraq.”
Journal Watch links
Thrombolysis for Stroke Within 4.5 Hours Is Safe and Effective
Extending the Time Frame for Alteplase: The ECASS III Trial
Continuous Glucose Monitoring in Diabetic Pregnant Women
Maternal Influenza Vaccination Reduces Infant Influenza, Febrile Respiratory Illness
Maternal Influenza Immunization Protects Infants
Novel Approach to Infant Influenza
Survival After MI Better with Drug-Eluting Than with Bare-Metal Stents
Story links
NEJM alteplase abstract
NEJM alteplase editorial
BMJ glucose monitoring article
NEJM on maternal influenza vaccination
NEJM stents abstract
Interview link
Ordering “War Surgery” through the Government Printing Office
New Yorker link
Finnegan article online
The post Podcast 13: News and interview with Dr. Stephen Hetz, co-editor of “War Surgery in Afghanistan and Iraq” and director of medical education at Beaumont Army Medical Center, El Paso. first appeared on Clinical Conversations.

This week’s podcast includes an interview with Anne Schuchat about U.S. childhood immunization rates, along with the usual news roundup.
Journal Watch links
Physical Activity May Boost Cognitive Function in Older Adults
Vytorin (Simvastatin + Ezetimibe) Shows Little Benefit for Aortic Stenosis
New Questions and a Few Answers on Vytorin and Cancer Risks
Vytorin: Navigating Uncharted Waters
Omega-3s Improve Outcomes in Heart Failure Patients, Rosuvastatin Does Not
Exercise and cognitive impairment
http://firstwatch.jwatch.org/cgi/content/full/2008/903/3
http://jama.ama-assn.org/cgi/content/full/300/9/1027
http://jama.ama-assn.org/cgi/content/extract/300/9/1077
Vytorin’s risks and efficacy
http://content.nejm.org/cgi/content/full/NEJMoa0804602
http://content.nejm.org/cgi/content/full/NEJMsa0806603
http://content.nejm.org/cgi/content/short/NEJMe0807200v1
http://firstwatch.jwatch.org/cgi/content/full/2008/902/1
http://firstwatch.jwatch.org/cgi/content/full/2008/902/2
http://cardiology.jwatch.org/cgi/content/full/2008/902/2
Omega-3 versus rosuvastatin in heart failure
http://www.thelancet.com/journals/lancet/article/PIIS0140673608612398/abstract
http://www.thelancet.com/journals/lancet/article/PIIS0140673608612404/abstract
http://firstwatch.jwatch.org/cgi/content/full/2008/903/1
Dr. Anne Schuchat interview links
http://www.cdc.gov/vaccines/
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5735a1.htm
The post Podcast 12: News and interview with Dr. Anne Schuchat, Director of CDC’s National Center for Immunization and Respiratory Diseases first appeared on Clinical Conversations.