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Johns Hopkins Medicine News Roundup

PodMed

Johns Hopkins Medicine's weekly news round-up

PodMed is a weekly podcast looking at the top medical stories of the week for people who want to become informed participants in their own health care. With Elizabeth Tracey, director of electronic media for Johns Hopkins Medicine, and Rick Lange M.D., professor of medicine at Johns Hopkins and vice chairman of medicine at the University of Texas Health Science Center at San Antonio.

Find out more details of each podcast on our PodMed Blog

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Week of April 14, 2014

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This week’s topics include new treatments for hepatitis C, paternal obesity and autism risk, aspirin and preeclampsia, and spironolactone for one form of congestive heart failure.
 
Program notes:
 
0:50 Obesity and autism spectrum disorders
1:50 Fathers’ obesity problematic
2:42 Aspirin for preeclampsia
3:42 Reduced risk 20%
4:42 Widely available and inexpensive
4:50 Spironolactone and one form of congestive heart failure
5:50 No help with all cause mortality or other outcomes
6:50 Worldwide studies
7:08 Oral therapy for hepatitis C
8:08 Single tablet regimen
9:05 Unaffordable for many
10:11 End
 

Week of April 7, 2014

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This week’s topics include kidney denervation, long term impact of bariatric surgery, the dangers of transfusions, and prevention of erectile dysfunction in men who have radiation for prostate cancer.
 
Program notes:
 
0:37 Kidney denervation and high blood pressure
1:37 Those who received procedure and those who didn’t no change
2:35 Haven’t pushed medications high enough
2:59 Impact of bariatric surgery at 3 years
4:01 Better outcome measures with surgery
5:00 Pay more attention to obesity in medicine
5:22 Medication for prevention of erectile dysfunction when radiation is used
6:20 Daily use did not help
7:12 Transfusion risk
8:15 Serious infection rate 17% with liberal transfusion
9:15 Resist transfusions
10:00 End
 

Week of Mar 31, 2014

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This week’s topics include Barrett’s esophagus and radiofrequency ablation, a screening and intervention tool for college drinkers, hemoglobin A1c and cardiovascular risk, and e-cigarettes, again.
 
Program notes:
 
0:42 e-cigarettes and cessation
1:40 Did not predict ability to quit
2:36 Dangerous levels of nicotine
3:29 Barrett’s esophagus and radiofrequency ablation
4:25 Low grade dysplasia intervention
5:30 How are subjects identified?
6:23 Hemoglobin A1c and cardiovascular events
7:23 Could be another factor?
8:20 Screening and web-based intervention for drinking in college students
9:20 Ineffective with the intervention
10:29 End
 

Week of Mar 24, 2014

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This week’s topics include adverse outcomes relative to a common infection during pregnancy, antiviral drug impact, statins and MS, and genetic profiles and fatty food consumption.
 
Program notes:
 
0:32 H. influenzae and adverse pregnancy outcomes
1:30 Much more likely to be infected if pregnant
2:35 Diagnosis only when looked for
3:10 Impact of antiviral medications in flu
4:12 Compared outcomes of no treatment or antiviral
5:16 Statins and MS
6:10 Anti-inflammatory effects
7:10 Genetic profile and diet impact
8:07 Clear interaction with genetic risk and fried food consumption
9:07 Medical advice needs to be tailored
10:21 End
 
 

Week of Mar 17, 2013

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This week’s topics include whole genome sequencing, the impact of surgical checklists, discontinuing randomized trials, and a blood test for Alzheimer’s disease.
 
Program notes:
 
0:30 Blood test for Alzheimer’s disease
1:32 Needs further testing in bigger population
2:30 May be important in membrane maintenance
2:43 Whole genome sequence
3:45 Our capabilities are advancing faster than we can interpret
4:44 Clinical trial cessation
5:47 Discontinued most likely to remain unpublished
6:30 Impact of surgical checklists
7:30 No difference in risk of death or complications
8:29 Observational studies may have bias
10:08 End
 

Week of March 10, 2014

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This week’s topics include genetic modification of HIV susceptibility, chronic hepatitis C in the US, moving at risk kids to more affluent neighborhoods, and the impact of casino opening on obesity in American Indian children.
 
Program notes:
 
0:31 Chance HIV susceptibility
1:30 Gene editing in T cells and changed susceptibility
2:33 Clinically beneficial
3:01 Casino openings and childhood obesity
4:01 More slots reduced childhood weight
4:46 Moving kids out of low income areas
5:47 Those that moved boys did worse
6:47 Even authors did not propose a hypothesis
7:00 Hepatitis C infection declining
8:00 All people born between 1945 and 1965 should be tested
9:00 Could save 120,000 lives by screening
10:05 End
 
 

Week of Mar 3, 2014

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This week's topics include DNA testing for genetic fetal abnormalities, fever in African children, a vaccine for enterovirus, and selenium, vitamin E and prostate cancer.

Program notes:

1:03 Enterovirus vaccine
2:01 Developed in China
3:04 Prenatal testing for trisomies
4:04 Collected blood samples in low risk women
5:04 Better predictive value
5:25 Fever in African children
6:30 Testing alone misleading
7:30 Malaria drugs used anyway
8:10 Vitamin E, selenium, and prostate cancer
9:22 May increase risk
10:40 End
 

Week of Feb 24, 2014

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This week's topics include the best treatment for ear infections in kids with tubes, first line treatment for atrial fibrillation, how to manage asymptomatic AVMs, and citalopram for agitation in Alzheimer's disease.

Program notes:
0:51 Atrial fibrillation treatment
1:51 Perforation of heart possible
2:51 Patients often say let's try medicine
3:01 Citalopram in Alzheimer's disease
4:01 Psychosocial intervention with and without citalopram
5:01 Make sure to obtain EKG
6:01 Treatment of AVMs
7:01 Half on medical therapy and half intervention
8:08 Recurrent ear infections after tubes
9:02 Topical solution superior
10:28 End
 

Week of Feb 17, 2014

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This week's topics include genital warts and the HPV vaccine, economics of raising the price of alcohol, restless legs syndrome treatment, and risk of end stage renal disease in kidney donors.

Program notes:

0:31 HPV vaccine and genital warts
1:30 Vaccine dose and first occurrence of warts
2:30 Suboptimal dosing not okay
3:05 Restless legs treatment
4:05 Pregabalin effective
5:16 Minimal pricing of alcohol
6:16 Immediate reduction in alcohol use
7:16 Low income people get benefit
7:46 Risk of end stage renal disease in living kidney donors
8:46 Increased but very small increase
9:30 Needs vigilance for donors
10:20 End
 

Week of Feb 10, 2014

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This week's topics include a lack of benefit in slowing cognitive decline with tight control of risk factors in diabetics, a new type of medication for post-herpetic neuralgia, a new flu virus, and benefits of child restraining seats in motor vehicles.

Program notes:

0:56 Lack of benefit in control in slowing cognitive decline in diabetics
1:58 Intensive control over 40 months
2:52 Restraint use and motor vehicle crash deaths in children
3:52 Only two states requiring use through age 8
4:30 Angiotensin receptor blockers in pain relief
5:30 Could the antagonist decrease pain?
6:30 Expanded indications?
7:00 H10N8 flu virus
8:00 A second case reported
9:00 Global travels allows spread
9:44 End
 

Week of Feb 02, 2014

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This week's topics include an FDA report on OTC pain relievers, making sense of the new cholesterol guidelines, evaluating child abuse when injury occurs, and incidence of childhood obesity in the US.

Program notes:

0:30 FDA report on NSAIDs and cardiovascular events
1:28 3 excess major cardiovascular events
2:28 Naproxen or another agent at lowest dose
3:35 Cholesterol guidelines
4:35 When is risk high enough to justify statins?
5:10 Suspected child abuse and fractures
6:10 History important
7:06 Incidence of childhood obesity in US
8:06 Almost 8000 participants
9:06 Intervention must occur very early
10:20 End
   
 

Week of Jan 27, 2014

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This week's topics include mortality and timing of MI, new antibody treatments for Alzheimer's disease, handguns and homicide and suicide, and vitamin D levels and MS.

Program notes:

https://itunes.apple.com/us/podcast/johns-hopkins-medicine-media/id792911349?mt=2
New link for iTunes

0:31 We have an updated link to iTunes
1:35 MS and vitamin D levels
2:37 MRI look at brain lesions
3:32 Vitamin D disappointing elsewhere
4:07 Access to firearms and suicide
5:07 All old data because of federal funding ban
6:09 Timing of myocardial infarction and death
7:06 Longer balloon time and increased risk
8:00 Amyloid antibody
9:03 Is amyloid really the culprit?
10:32 End
 

Week of Jan 20, 2014

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Aortic repair, new herpes medication, effects of SSRIs in pregnancy, and screening for gestational diabetes.

Program notes:

0:50 Endovascular versus open repair in ruptured aortic aneurysm
1:50 Mortality 35-37%
2:49 Use of SSRIs in pregnancy and neonatal pulmonary hypertension
3:50 Risk was increased but overall very low
4:50 Avoidance of use carries high risk
5:00 New medication for herpes simplex
6:00 Targets an entirely different pathway
7:00 New recommendations for gestational diabetes
8:00 Screening after 24 weeks
9:00 Often referred to as diabetes unmasked
10:00 End
 

Week of Jan 13, 2014

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This week's topics include cigarette smoking stats (2), an implant for obstructive sleep apnea and diabetes and the Mediterranean diet.

Program notes:

0:55 Mediterranean diet and diabetes
1:50 Most involve energy restricted diets and increased activity
2:52 What is the role of weight in diabetes?
3:25 Obstructive sleep apnea and stimulation
4:25 Stimulation of a nerve in the tongue
5:24 Out of hospital in 24 hours
6:00 JAMA issue on smoking
7:01 Varenicline and combination most helped
8:01 Cites anniversary of first surgeon general's report
9:01 Smoking rates remain at one in five
10:20 End
 

Week of Jan 06, 2014

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This week's topics include vitamin E and Alzheimer's, driving distracted, mammography statistics, and global effects of smoking.

Program notes:

0:47 Mammography statistics
1:37 Hundreds have false alarm
2:35 Do these ranges help women?
3:32 Changing numbers
3:52 Distracted driving
4:52 Experienced drivers increased only with dialing
5:52 What does MRI reveal?
6:45 Vitamin E and dementia progression
7:45 Randomized to vitamin E, memantine, both or neither
8:44 Can't recommend in prevention
9:00 Global impact of cigarette smoking
10:00 Tax increases help
10:53 End
  
 

Week of Dec 30, 2013

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This week's topics include nuts in pregnancy, meniscal tears, testing for BRCA mutations, and dangers of supplements to your liver.

Program notes:

0:50 Nut consumption in pregnancy
1:50 Two studies showing that when mothers ate nuts allergies were reduced
2:20 BRCA testing
3:20 Women at risk only
4:20 Risk reduction surgery
5:00 Knee arthroscopy
6:00 Sham operation versus partial meniscus removal
7:00 Convinced that interventions aren't helpful?
8:00 Advance to osteoarthritis
8:13 Supplements and liver injury
9:13 Was uncommon but now 20-30%
10:32 End
 

Week of Dec 23, 2013

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This week's topics include the controversy surrounding antibacterial soaps, new high blood pressure guidelines, an interaction between calcium channel blockers and clarithromycin, and no benefits to multivitamins.

Program notes:

0:33 FDA looks at antibacterial soap
1:32 This is just consumer soaps
2:30 A year to obtain data
3:30 Multivitamins panned again
4:30 No help with cognition
5:32 Eighth joint national committee on hypertension
6:33 First line choices among medications
7:35 Aging does impact blood vessels
8:11 Interaction between clarithromycin and calcium channel blockers
9:14 Lots of acute kidney injury and other harms
10:11 End
 

Week of Dec 16, 2013

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This week's topics include the risk of overdiagnosis of lung cancers with low dose CT, genotype impact on Coumadin dosing, diabetes and hypoglycemia risk, and cholesterol management in folks with chronic kidney disease.

Program notes:

0:33 Overdiagnosis of lung cancer with low dose CT
1:30 Data from National Lung Screening Trial
2:33 How to discern which lung cancers are problematic?
3:00 Genotype analysis and Coumadin dosing
4:00 Did not improve dosing
4:49 Hypoglycemia in people with diabetes
5:49 How tightly HbA1c is controlled
6:50 Don't control too tightly
7:35 Lipid management in people with chronic kidney disease
8:35 LDL doesn't matter
9:35 Drug drug interactions important
10:35 End
 

Week of Dec 9, 2013

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This week's topics include treating reduced blood supply to the heart, fit versus fat myth debunked, chickenpox vaccine impact, and treating anemia in people with heart disease.

Program notes:

0:35 Chickenpox and shingles vaccines
1:38 Give shingles vaccine to adults
2:31 Increased but not secondary to immunizing kids
3:30 Fitness versus fatness
4:30 People's weight and metabolic health
5:30 Cardiovascular manifestations long term
6:10 Treating blood flow compromise to heart
7:10 Does it help prevent cardiovascular events?
8:10 Heart attacks from minimal stenosis vessels
8:36 Treating anemia in cardiovascular disease
9:39 No transfusion unless severe anemia
10:44 End
 

Week of Dec 2, 2013

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This week's topics include the history of immunization and preventable infection, HIV vaccine candidate disappoints, kids with Crohn's, and micronutrients in HIV infection.

Program notes:

0:33 Finally something good to say about thalidomide?
1:30 Kids with refractory Crohn's disease
2:28 Improvement for as long as three years
3:26 Micronutrients and HIV infection
4:30 Needed both selenium and multivitamin
5:30 Antiretrovirals not initiated as early
5:50 HIV vaccine trial
6:50 Haven't found right protein
7:56 Vaccination history
8:50 How many cases prevented?
9:50 Have been remarkably effective
11:00 End
  
 

Week of Nov 25, 2013

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This week's topics include the new cholesterol guidelines, immediate blood pressure lowering in stroke, prehospital cooling for cardiac arrest, and mechanical versus manual compressions in CPR.

Program notes:

0:59 Cholesterol guidelines and risk calculator
1:58 Four groups who would benefit from statins
2:55 Studies don't lower LDL to a goal
3:56 Other factors may be considered
4:56 Shared decision making an important part of these
5:10 Cooling people who've had cardiac arrest
6:10 Cool in the field rather than wait to hospital
7:00 Immediate reduction of blood pressure in stroke
8:06 Did not include markedly high blood pressure
8:25 Mechanical versus manual CPR
9:25 No difference in survival
10:32 End
 

Week of Nov 18, 2013

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8-year anniversary retrospective edition which discusses the early beginnings of how the podcast had started, how the podcast content is selected weekly, and a discussion about listener feedback.
 

Week of Nov 11, 2013

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This week's topics include how much screen time is good for kids, HIV infection and meningitis, steam for respiratory infections.

Program notes:

0:36 Steam and acetaminophen and ibuprofen for respiratory infections
1:36 Didn't help patients feel better quicker
2:23 HIV and meningitis risk
3:20 10x higher risk
4:20 Why does HIV confer increased risk?
4:45 Screen time for kids
5:45 ¾ own a cell phone
6:44 Pediatrician should offer age-specific advice on use
7:42 Co-view with children
7:55 High blood pressure drugs in folks with diabetes
8:55 ACE inhibitors and ARBs similar
10:09 End
 

Week of Nov 4, 2013

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This week's topics include flu vaccines and heart problems, screening for cognitive decline, vaccinating teenagers for whooping cough, and

0:50 Flu vaccine and heart problems
1:40 Vaccine associated with lower risk of cardiovascular events
2:45 Everyone should get a flu shot
3:20 Giving DTP boosters to teens and infection in infants
4:21 Herd immunity
4:38 Screening for cognitive impairment
5:38 Can't offer much to slow down decline
6:37 If you knew would you behave differently
7:01 Statins for people on ventilators
8:02 Statin versus placebo for pneumonia
9:02 Statins do have an anti-inflammatory effect
10:00 End
  
 

Week of Oct. 28, 2013

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This week's topics include HIV testing and counseling, contaminated purchased breast milk, overdiagnosis and overtreatment after cancer screening, and stroke incidence.

Program notes:

0:35 Contaminated purchased breast milk
1:35 May result in health consequences
2:30 Discouraged by American Academy of Pediatrics
2:48 What physicians tell their patients about dangers of screening
3:42 80% would like to be informed
4:42 Need to report data
5:00 Stroke incidence worldwide
6:01 Accounted for by hypertension?
7:05 Better surveillance techniques
7:25 HIV testing and counseling
8:35 Risk reduction counseling did not reduce transmission
10:01 End
 

Week of Oct 21, 2013

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This week's topics include behavior and kid's bedtimes, treating pericarditis, probiotics for diarrhea, and asymptomatic aneurysms in the brain.

Program notes:

0:51 Aneurysms in the brain
1:50 Aneurysm elsewhere in the body
2:50 Treatment of pericarditis
3:50 Half also received colchicine
4:45 Kids' bedtimes and behavior
5:45 More behavior problems with irregular bedtimes
6:45 Hormone secretion and memory formation with sleep
7:17 Utility of probiotics to prevent antibiotic associated diarrhea
8:17 Took over 3000 older inpatients
9:15 Can the microbiome be modified orally?
10:12 End
 

Week of Oct 14, 2013

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This week's topics include surgery after stenting, antibiotics and bronchitis, gowns and gloves in the ICU, and bariatric surgery skill and outcomes.

Program notes:

0:32 Gowns and gloves in the ICU
1:30 In 20 ICUs they always used gowns and gloves, 20 not
2:30 Increased hand hygiene in both groups
3:01 Antibiotics, anti-inflammatories and bronchitis
4:01 No difference in study arms
5:01 Bariatric surgical skill and outcomes
6:01 Skills rated by peers correlated with outcome
7:02 Provides an important way to improve surgeons skills
7:50 Surgical risks after cardiac stent placed
8:52 Within six weeks 12%
9:24 Perioperative state increases inflammation
10:36 End
 

Week of Oct. 07, 2013

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UTIs and cranberry juice, cognitive dysfunction after ICU stay, new diabetes drugs, and hormone replacement therapy.

Program notes:

0:50 UTIs and cranberry juice
1:50 Juice required too much to drink
2:16 Hormone replacement therapy and consequences
3:15 13 year observational period
4:15 Don't prescribe for reduced mortality or cardiovascular disease
4:43 Cognition after the ICU
5:38 One in three had one type of cognitive impairment
6:40 Multiple strategies under study
7:33 New type of drug for diabetes
8:35 Two new drugs in people with diabetes and heart risk
9:30 Side effects may be seen only after marketing
10:20 End
  
 

Week of Sept 30, 2013

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This week's topics include a robotic leg, a new drug against cytomegalovirus, guidelines for breast cancer prevention medications, and arsenic levels and cardiovascular disease.

Program notes:

1:19 Arsenic and cardiovascular disease
2:20 Generally higher risk for CVD in American Indians
3:20 Association seen worldwide
3:26 Cytomegalovirus treatment
4:26 Damage kidneys and suppress bone marrow with current meds
5:30 Treated for three months post- transplant
6:01 Robotic leg
7:01 Record electromyographic signals and transmit
8:01 Now we know it works
8:16 Medical prophylaxis for breast cancer
9:18 Shared decision strategy
10:11 End
 

Week of Sept 23, 2013

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This week's topics include the benefits of colorectal cancer screening, use of braces for scoliosis, vitamin and mineral supplements and mortality, and the salt debate.

Program notes:

0:32 Salt and health consequences
1:30 No evidence that reduction to less than 2.5g per day impacts mortality
2:30 In moderate intake further lowering doesn't really help
3:26 Two studies on colorectal cancer screening
4:24 Reduce mortality significantly
5:27 Braces for scoliosis
6:27 Subjects refused randomization
7:27 Used thermometers to monitor how long braces were worn
8:02 Antioxidants and mortality
9:02 Normal diet people
10:32 End
 

Week of Sept 16, 2013

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This week's topics include E-cigarettes for smoking cessation, ads for smoking cessation, screening for mild cognitive impairment, and vaccination for whooping cough.

Program notes:

0:32 Should we give mild cognitive impairment screening a miss?
1:30 Diagnostic testing isn't good
2:35 Worry about routine aging matters
2:50 e-cigarettes and their role in smoking cessation
3:50 Helped decrease amount of smoking too
4:40 Analysis of public education campaign for smoking cessation
5:40 75% of Americans recalled seeing them
6:41 Cost effective analysis
7:45 Pertussis vaccination
8:50 Undervaccinated kids had parents who refused
9:50 Thimerosol fears persist
10:40 End
 

Week of Sept 09, 2013

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This week's topics include steroid injections for carpal tunnel, screening for peripheral arterial disease, treatment of rotator cuff injury, and overdiagnosis of thyroid cancer.

Program notes:

0:55 Rotator cuff injuries and what to do
1:54 Easy in office tests to assess
2:55 Prevention best
3:27 Overdiagnosis of thyroid cancer
4:30 Autopsy studies show 1/3 of people have thyroid cancer
5:29 Peripheral arterial disease screening
6:30 Also have other risk factors such as smoking
7:11 Steroid injection for carpal tunnel syndrome
8:15 Placebo, two dosages of steroid
9:16 Individual patient can decide
10:09 End
 

Week of Sept 02, 2013

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This week's topics include preconditioning for cardiac bypass surgery, shoe wedges for knee arthritis, overcoming a genetic tendency for diabetes, and a low risk ankle rule.

Program notes:

0:46 Insoles for knee osteoarthritis
1:42 Bigger angle change helpful?
2:05 Low risk ankle rule
3:05 Educate physicians about how often X-ray needed
4:05 Only 10% of patients desired
4:50 Preconditioning in CABG
5:53 Blood pressure cuff to arm used
6:53 Humoral factors released into blood stream?
7:35 Diabetes genetic risk and diet
8:35 Very specific genetic defect
9:35 You had to adhere to diet
10:16 End
  
 

Week of Aug 26, 2013

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This week's topics include iron supplements, transfusion and infection, flu vaccine and heart attacks, blacks and kidney disease, global attempts to improve blood pressure control

Program notes:

0:37 Can flu vaccine decrease risk of heart attack?
1:37 Recent influenza activity was seen
2:30 Flu vaccine decrease rate of inflammation
3:01 Comprehensive approach to control blood pressure
4:01 Improved by 100%
5:04 Racial differences in chronic kidney disease
6:02 Early marker of kidney disease predicted heart disease in blacks
7:04 African susceptibility?
8:01 IV iron administration and infection
9:02 Can stimulate bacterial growth
10:10 End
 

Week of Aug 19, 2013

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This week's topics include early heart valve surgery, who benefits from CRT, finasteride for prostate cancer prevention, and thalotomy for essential tremor.

Program notes:

0:33 Finasteride and prostate cancer prevention
1:28 18 year follow up
2:30 Reduced only low grade cancers
2:47 Essential tremor treatment
3:47 Thermal ultrasound ablation
4:45 Side effects are seen such as ataxia
5:36 MVP surgery early
6:40 Is it better to have surgery early?
7:40 Dysfunctional valve leads to left ventricular dysfunction
8:08 CRT or cardiac resynchronization therapy
9:08 Conduction through the heart really slow
10:25 End
 

Week of Aug 12, 2013

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This week's topics include approval of additives to food, self-monitoring of blood pressure, glucose and dementia, and peripheral arterial disease worldwide.

Program notes:

0:30 Peripheral arterial disease worldwide
1:30 Over the age of 80 one in six people
2:29 200 million people have it worldwide
3:02 Glucose levels and dementia
4:02 Higher glucose associated with dementia
5:02 High glucose causes inflammation?
5:20 Home blood pressure measurement
6:20 Self monitor plus support has greatest impact
7:10 Food additives and approval
8:10 Looked at 451 GRAS notifications
9:10 Conflict of interest at least potential
10:28 End
 

Week of Aug 5, 2013

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This week's topics include debriding wounds and healing, who needs an echocardiogram, physician attitudes toward health care costs, and menthol cigarette dangers.

Program notes:

0:30 FDA announces menthol cigarette dange07rs
1:30 More difficult to quit
2:25 Who needs an echocardiogram?
3:35 Half got echo and half did not
4:30 Really not beneficial
4:45 Physician attitudes toward healthcare costs
5:42 Everybody outside of physicians with more responsibility
6:48 Don't want outcomes to determine reimbursement
7:07 Would debridement and time of healing
8:07 Wounds of very different types
9:06 Results in less scarring
10:16 End
  
 

Week of July 29, 2013

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This week's topics include breast cancer death racial disparity, kids care in retail clinics, rabies from solid organ transplant, and maternal smoking and child conduct.

Program notes:

0:33 Rabies transmission in organ transplant
1:33 Looked at tissue from donor months later
2:33 Infectious agents are transmissible
3:36 Differences in survival in breast cancer based on race
4:35 Looked at 7500 black women and white women
5:36 Maternal smoking and child's behavior
6:39 Clearly a risk factor
7:00 Retail clinics and kids' care
8:00 More convenient and minor illness
9:00 Less than half mentioned to pediatrician
10:04 End
 

Week of July 22, 2013

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This week's topics include infertility in women who've survived childhood cancer, targeting lung cancer screening, aspirin and colorectal cancer in women, and antihypertensive drugs, compliance and stroke risk.

Program notes:

0:31 Women who survive childhood cancer
1:31 Did have increased risk of infertility
2:30 Sequelae of cancer treatment picture
2:54 Targeting lung cancer screening
3:53 Added other risk factors to smoking
4:51 Routine screening in low risk people isn't helpful
5:18 Can an aspirin every other day prevent colorectal ca in women?
6:18 Confirms observational trials
7:18 Talk to your physician before adopting
7:35 High blood pressure medicines, and stroke risk
8:42 Magnitude of risk substantial
10:11 End
 

Week of July 15, 2013

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This week's topics include survival and disability in the US, the effect of limiting work hours for interns, vitamin D level impact and ethnicity, and catheterization rates in the US and Canada.

Program notes:

0:33 Should we limit work week for interns
1:30 Did decrease surgical cases significantly
2:30 Boot camp to assure skills
3:30 Cardiac catheterization in Canada and US
4:31 In NY only 19% were high or intermediate risk
5:30 Patients should ask why they need it
6:01 Health life expectancy
7:01 Last few years increased morbidity
7:45 Vitamin D and health problems and ethnicity
8:45 Associated with coronary heart disease in some
10:12 End
 

Week of July 8, 2013

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This week's topics include pharmacists and home blood pressure monitoring, overuse of cholesterol testing, inflammation and diabetes, and IVF and mental disorders.

Program notes:

0:32 Banking and blood pressure
1:30 Blood pressure control much better with pharmacists and telemonitoring
2:31 Relying on pharmacist to monitor and manage
3:32 Smartphone app may help
3:59 Consequences of IVF
4:59 In Sweden all children evaluated
5:59 Pregnancy loss
6:28 Are we overusing cholesterol testing?
7:30 Payment and performance factor
7:42 Relative of aspirin helpful in diabetes
8:42 Salsalate did help
9:30 Anti-inflammatories could help
10:10 End
 

Week of July 1, 2013

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This week's topics include lifestyle interventions and heart disease in people with diabetes, treatment of low risk prostate cancer, insulin pump developments, and can we reduce medical costs in high risk Medicare patients.

Program notes:

0:34 Type 2 diabetes management
1:34 Disappointing results and no cardiovascular benefit
2:31 Prevention first of diabetes
3:03 Insulin pump managing nighttime levels
4:04 Does it predispose to higher blood sugar?
5:03 Preventable spending in Medicare patients?
6:03 Only 10% were preventable
6:40 Management of low risk prostate cancer
7:40 Active surveillance taking some time to penetrate
8:40 Use of advanced technologies really increased costs
9:40 For African American men may need closer surveillance
10:40 End
  
 

Week of June 24, 2013

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This week's topics include MRI to assess post-injection infection in the back, statins and antibiotics, prompt stroke treatment, and autoantibodies and type 1 diabetes.

Program notes:

0:38 Utilizing MRI to assess infection after back injection
1:35 Occurs months afterward
2:34 Compounding facilities not regulated well
3:07 Brain attack and treatment
4:07 Over 58,000 patients
5:09 FAST acronym
5:52 Autoantibodies and type 1 diabetes
6:50 Three different types of autoantibodies
7:50 Statins and antibiotics
8:50 Targeted those that use the same enzyme
9:50 These antibiotics may be treatment of choice
10:41 End
 

Week of June 17, 2013

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This week's topics include music in the ICU, predicting acute exacerbations of COPD, keeping an eye on MERS, and sequelae of childhood cancer treatment.

Program notes:

0:38 Music in the ICU
1:40 Slows brain waves
2:40 Inexpensive, doesn't interfere with care
3:30 Consequences of childhood cancer treatment
4:30 Specific follow up to treatment
5:31 About 50% of problems found with routine surveillance
6:05 MERS
7:05 All have severe respiratory symptoms
8:05 SARS-like illness
8:30 COPD exacerbations
9:30 Three measures of inflammation predictive
10:48 End
 

Week of June 10, 2013

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This week's topics include vegan diets and mortality, metabolic surgery for diabetes, sunscreen and aging, and the health effects of fructose.

Program notes:

0:31 Sunscreen and photoaging of skin
1:33 4 groups and looked at microtopography
2:31 SPF and UVA and UVB labeling
3:05 Benefits of vegetarian diets
4:05 Followed over 6 years for 12% reduction in mortality
5:05 Metabolic surgery for diabetes
6:05 Half had surgery and about half of them met guidelines
7:05 One year data only but long term many failures
7:50 Fructose health effects
8:50 Disadvantages of glucose and fructose
9:50 Very refined foods rather than sugars
10:47 End
 

Week of June 03, 2013

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This week's topics include universal treatment for MRSA in ICU patients, British Menopause Society guidelines, anticoagulants and other procedures, and medical emergencies on airplanes.

Program notes:

0:38 British Medical Society and hormone replacement therapy
1:35 May increase risk of thromboembolic events
2:34 No assessment of alternative therapies
3:26 Medical emergencies on airlines
4:30 Death very rare
5:35 Supplement describes contents of kit
6:01 Screen or decolonize for MRSA?
7:01 Universal decolonization best
7:52 Anticoagulant continuance
8:53 Colonoscopy and other procedures maybe continue
10:20 End
  
 

Week of May 27, 2013

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This week's topics include supine versus prone ventilation in the ICU, best treatment for COPD exacerbations, who benefits from prostate cancer treatment, and sports participation after ICD implantation.

Program notes:

0:37 Implanted cardiodefibrillators and sports participation
1:38 Looked at a number of athletes and assessed risk
2:38 Support groups were the conduit
3:00 Body position and ventilation in the ICU
4:01 CPR in supine or prone position
5:02 Common complication of severe flu
5:46 Benefit from prostate cancer treatment
6:46 Men with three of more comorbid conditions
7:48 Cancer screening very emotionally charged
8:12 Short versus long term steroids in COPD
9:15 No difference in the short versus longer treatment
10:04 End
 

Week of May 20, 2013

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This week's topics include bugs for dinner, a new treatment for hepatitis C, pelvic prolapse surgery, and paying for health in developing countries.

Program notes:

0:40 Insects and their potential to alleviate starvation
1:40 Opportunistic harvesting
2:40 Cicadas about to emerge in Eastern US
3:40 Any insect recipes?
4:39 New treatment for hepatitis C
5:36 As effective or more effective as current therapies
6:05 Potential for cash payments to improve health outcomes
7:07 How do costs compare with other programs?
8:00 Surgery for pelvic prolapse
9:00 More laparoscopic surgery now
10:06 End
 

Week of May 13, 2103

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This week's topics include preventing inappropriate shocks with implanted defibrillators, cleaning baby's pacifier, supplements and macular degeneration, and recommendations for lung cancer screening in smokers.

Program notes:

0:56 Book called 'Bad Pharma'
1:50 Pacifiers and parental mouths
2:54 Less asthma, eczema and environmental allergens
3:46 Macular degeneration supplements
4:46 Antioxidants plus additional supplements no more benefit
5:40 Low dose CT for lung cancer screening
6:40 Great time to attempt cessation
7:41 Relatively modest reduction in lung ca death
8:28 Prevention of inappropriate shock from ICDs
9:28 Reprogrammed device
11:02 End
 

Week of May 6, 2013

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This week's topics include surgery versus PT for meniscal repairs, dangers of azithromycin, HIV screening recommendations, and allergies in kids in the US and elsewhere.

Program notes:

0:39 Meniscal tears and PT
1:39 Surgery or PT and could cross over to surgery
2:39 70% responded to PT alone
3:30 Heart risk of azithromycin
4:31 Compared to no antibiotics and to penicillin
5:28 Limit to people with low risk of cardiovascular risk
6:10 Kids move to US and become allergic
7:10 Environmental and infectious exposures and less allergy
8:10 What are they missing in exposure in US?
8:33 USPSTF recommendations on HIV
9:33 Routine test
10:50 End
  
 

Week of April 29, 2013

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This week's topics include H7N9, diabetes report card, valproate and autism, and worms in Chinese schoolchildren.

Program notes:

0:42 Worm burden in Chinese schoolchildren
1:37 Reinfection common
2:40 Culturally relevant
2:53 Diabetes report card
3:53 No gain at all in preventing smoking
4:53 Prevention still best
5:29 H7N9
6:30 CDC recommendations
7:32 Key right now is surveillance
8:05 Valproate and autism
9:06 Over 5000 with autism spectrum disorder
10:29 End
 

Week of April 22, 2013

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This week's topics include glutamine and antioxidants in ICU patients, CT scans to diagnose osteoporosis, childhood migraine and colic, and chronic kidney disease predictors.

Program notes:

0:44 Glutamine and antioxidants in ICU patients
1:45 28 day mortality
2:49 Even things that looked benign may be harmful
3:21 CT scanning and osteoporosis diagnosis
4:21 Looked at paired CT and DEXA scans
5:25 Utilize scan for another purpose
5:40 Chronic kidney disease predictors
6:40 Need studies to help define risk
7:17 Colic and migraine
8:17 Association seen between them
9:10 May be that melatonin can help
10:09 End
 

Week of April 15, 2013

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This week's topics include carnitine and red meat, controlling the childhood obesity problem, PSA screening guidelines, and walking versus running benefits.

Program notes:

0:35 Running versus walking
1:36 Equivalent energy expenditure results in same risk reduction
2:36 VO2 max not as important
2:54 Carnitine and red meat
3:50 Meat eaters versus vegans
4:50 Supplements may not be a good idea
5:55 PSA guideline update
6:55 One death prevented for every 1000 screened
7:57 Decided not to have PSA screening
8:27 Childhood obesity, eating frequency, school meals
9:33 Benefit in small, more frequent meals
10:42 End
 

Week of April 8, 2013

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This week's topics include omega-3 levels and mortality, duloxetine for chemotherapy induced nerve pain, costs of dementia, and statin discontinuation.

Program notes:

0:34 Discontinuation of statins
1:30 Most people tolerated restarting of same statin
2:30 Most serious complications very rare
3:39 Omega-3 fatty acids and mortality prediction
4:39 Higher blood levels experienced less mortality
5:34 May be that if deficiency exists it helps
6:17 Duloxetine for chemotherapy induced nerve pain
7:19 After five weeks of therapy a decrease in pain
8:05 Costs of dementia
9:05 Greatest cost with institutional care
10:07 End

 

Week of April 1, 2013

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This week's topics include off pump coronary artery bypass surgery, under the tongue immunotherapy, vitamin D and pregnancy outcomes, and chelation therapy after heart attack.

Program notes:

2:01 Sublingual immunotherapy
3:01 Strong for improving asthma symptoms
4:01 Can avoid sitting in office after injection
4:18 Chelation therapy after heart attack
5:18 Very modest benefit with this therapy
6:13 Not sufficient evidence to recommend
7:01 Off pump CABG
8:01 No significant difference in off pump versus on pump
8:54 Vitamin D levels during pregnancy
9:45 Did not report on confounders
10:34 End
  
 

Week of March 25, 2013

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This week's topics include using DNA to track metastatic breast cancer, radiation dangers to the heart following cancer treatment, atherosclerosis in mummies, and inappropriate screening colonoscopy.

Program notes:

0:53 Atherosclerosis in mummies
1:47 About a third of all types of mummies had it
2:47 Exists in disparate populations
3:31 Heart disease following radiotherapy for breast cancer
4:28 Dose related increase in risk of heart disease
5:28 Aggressively modify risk factors
6:01 Monitoring circulating DNA to check metastasis
7:01 Detect tumor DNA in 29 of 30
8:00 Inappropriate screening colonoscopy in older people
9:00 23% were inappropriate
10:01 Dam studies: doesn't apply to me
10:32 End
 

Week of March 18, 2013

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This week's topics include a lack of benefit in sildenafil and heart failure, pertussis uptick, MRI and back pain, and family members presence during CPR.

Program notes:
0:36 MRI and back pain assessment
1:36 Patients spontaneous improvement
2:35 Inflammation resolution solves
3:14 CPR and family presence
4:14 Offered opportunity to witness CPR
5:16 Only 4% survived
6:15 Transparency can be helpful
6:37 Pertussis increase
7:31 First cohort to receive acellular vaccine
8:34 Adults recommended booster
9:12 Sildenafil and a type of heart failure
10:35 End
 

Week of March 11, 2013

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This week's topics include endovascular treatment of stroke, Internet searches and drug side effects, HIV infection and heart attack risk, and a new drug resistant gut bug.

Program notes:

1:02 Using Internet searches to find negative drug effects
2:02 Individuals who looked at two drugs together were found
3:02 Lots to learn from searches or tweets
3:39 Endovascular management of strokes
4:39 Three studies showed no better outcome
5:38 Apply therapy as quickly as possible
6:30 Emerging GI bug
7:30 Mortality as high as 40 to 50%
8:01 HIV infection and MI risk
9:01 Something else accounts for increased risk
10:09 End
 

March 4, 2013

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This week's topics include synthetic marijuana, new anticlotting agents, recommendations on vitamin D, and HIV and liver damage.

Program notes:

0:37 Synthetic marijuana
1:32 Increased heart rate, blood pressure, now kidney injury
2:33 May have chronic injury in future
3:10 Supplementation with vitamin D
4:10 Do not reduce fractures and do increase kidney stones
5:01 HIV and liver disease
6:02 Have liver fibrosis a decade earlier
7:00 DVT prevention
8:00 Dabigatran and apixaban
9:00 Self monitoring with coumadin
10:27 End
  
 

February, 25, 2013

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This week's topics include robotic gyn surgery, telomere length and respiratory infection, volume resuscitation with starch, and a new device for GERD.

Program notes:

0:30 Telomeres and upper respiratory infection
1:32 Challenged with virus, shorter the telomere the more likely to become infected
2:30 Older individuals were more likely to have shorter telomeres and infection
3:05 Robots for routine hysterectomy
4:05 No better outcome or complication rate
4:30 A device for GERD
5:30 100 people treated
6:20 Initial difficulty swallowing
6:55 Replacing blood volume using starch
7:50 Many studies retracted
8:50 Studies must be validated
9:16 End
 

February 18, 2013

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This week's topics include the dangers of calcium supplements for women, folic acid and autism, consumer pricing of hip surgery, and H.pylori treatment in Latin America.

Program notes:

0:48 Dangers of calcium supplements
1:42 Total calcium intake both dietary and supplemental
2:42 Biological plausibility
3:22 Folic acid and autism
4:24 85,000 children
5:23 May be increasing incidence of autism
5:57 True price of hip replacement
6:55 For those that could provide a price the range was huge
7:57 Risk of recurrent H. pylori infection in Latin America
8:58 Recurrence in about 11%
10:14 End
 

Week of February 11, 2013

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This week's topics include myths about obesity, adult immunization update, diabetes management in kids, and antidepressants and an EKG abnormality.
 
Program notes:
 
0:26 Adult immunization schedule update
1:30 MMR not necessary
2:30 Flu vaccine reduces severity of disease
3:00 Managing diabetes in children
4:00 Medications right from the start
5:01 When kids get it they develop complications earlier
5:15 Impact of some antidepressants on heart function
6:15 Dose response relationship with three drugs
7:07 Myths regarding obesity
8:08 Myths, presumptions or facts
9:08 Fact that exercise helps
9:55 End
 

Week of February 04, 2013

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This week's topics include dual therapy for high blood pressure and congestive heart failure, delayed versus immediate repair of the anterior cruciate ligament, antibiotics for severe malnutrition, and prostatectomy versus radiation for localized prostate cancer.

Program notes:

0:32 Delayed or immediate repair of ACL?
1:33 After five years no difference and 50% avoided surgery
2:30 There is no harm in delayed surgical strategy
3:14 Dual strategy targeting renin-angiotensin system
4:14 No benefit to dual therapy
5:13 Angiotensin receptor blockers
5:45 Antibiotics for severe malnutrition
6:45 Reduced mortality up to 44%
7:18 Prostatectomy versus radiation for prostate cancer
8:14 Prostatectomy fives times more likely to have incontinence
9:07 Intermediate assessment help inform decision
10:05 End
  
 

Week of January 28, 2013

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This week's topics include 30 day readmissions, chicken soup and melamine, hearing loss and cognitive decline, and screening for partner violence.

Program notes:

0:29 Chicken soup and melamine
1:30 Eight fold higher in melamine cookware
2:30 Should raise suspicion to ask questions
3:02 Cognitive decline and hearing loss
4:02 What is exactly the relationship?
5:02 Hearing loss accelerates the likelihood that you'll have cognitive decline
6:07 Screening for intimate partner violence
7:08 Women of childbearing age should be screened
8:11 Thirty day readmission rates
9:12 Analyzed Medicare claims to see patterns
10:02 Need to refocus how we gauge quality of care
10:51 End
 

Week of January 21, 2013

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This week's topics include fecal infusion for Clostridium difficile infection, persistence of cough, best injection site for children, and detecting alcohol abuse.

Program notes:
0:40 How long should a cough persist?
1:40 Lasted an average of 17.8 days
2:45 Is a patient having an alcohol problem?
3:42 Physicians were compared with questionnaire
4:43 Should be a routine part of visit
5:01 Best site for routine immunizations
6:01 Great if we can come up with something else
6:20 Probiotics for Clostridium difficile
7:20 Infusion of fecal material into duodenum
8:20 Measured the microflora
9:20 Very effective
10:14 End
 

Week of January 14, 2013

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This week's topics include IUD for heavy menstrual bleeding, alcohol use in women and teenagers, vitamin D and osteoarthritis, and resistant gonorrhea in North America.

Program notes:

0:35 Treatment of heavy menstrual bleeding
1:30 2/3 of women continued treatment with IUD
2:30 MMWR binge drinking in females
3:30 One in three high school girls report drinking
4:33 Treatment resistant gonorrhea
5:36 Cephalosporins no longer effective
6:31 Condoms should be used
7:00 Vitamin D and osteroarthritis
8:00 Vitamin D supplements didn't help knee pain
9:00 What about prophylaxis?
9:46 End
 

Week of January 07, 2013

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This week's topics include SSRIs and infant risk, fructose and the brain, BMI and mortality, and transfusion in gastrointestinal bleeding.

Program notes:
0:30 BMI and mortality
1:30 Obesity graded
2:32 Pretty convincing meta-analysis
3:26 BMI tables misleading
4:04 Transfusions and GI bleeding
5:01 Restrictive strategy led to better outcomes
6:01 Almost eliminated infections relative to transfusions
7:01 Fructose in the brain
8:08 In moderation
8:20 SSRIs in pregnancy and infant outcomes
9:21 No significant association between drugs and stillbirth
10:49 End
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