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The latest clinical medicine and health policy news for healthcare professionals, delivered each weekday by host Nick Andrews and MDedge editors. The information in this podcast is provided for informational and educational purposes only.

The latest clinical medicine and health policy news for healthcare professionals, delivered each weekday by host Nick Andrews and MDedge editors. The information in this podcast is provided for informational and educational purposes only.


United States


The latest clinical medicine and health policy news for healthcare professionals, delivered each weekday by host Nick Andrews and MDedge editors. The information in this podcast is provided for informational and educational purposes only.






Appeals court upends ACA’s individual mandate; osteoporosis undertreatment poses growing threat

Osteoporotic fracture risk is undermanaged in older adults By Heidi Splete Study of Medicare database shows decline in treatment of patients who have an increased risk of fracture. Appeals court rules ACA’s individual mandate is unconstitutionalThe Trump administration chose not to defend the ACA, but it does not seem entirely prepared for what might happen if the law is overturned. Vaping marijuana gaining traction among U.S. teensOne in five 10th- and 12th-grade students in the...


Feds want to ease drug importation; the danger of ‘therapeutic nihilism’ in diabetes

HHS drug importation proposals aim to address high costs By Gregory Twachtman Trump administration drops key health care proposal on day of impeachment vote. Other news: End ‘therapeutic nihilism’ in care of older diabetic patients, says expert ‘It’s not hyperglycemia that’s killing people; it’s heart disease and renal disease.’ Well-tolerated topical capsaicin formulation reduces knee OA pain A new vehicle formulation improves tolerability of capsaicin treatment. Identifying...


Diabetes ups ischemic risks; and younger patients show signs of COPD

ENGAGE AF-TIMI: Insulin linked to greater risk for stroke, CV death, bleeding By Doug Brunk Use of novel oral anticoagulants may be preferred over vitamin K antagonists in patients with diabetes and AFib. Other news: Signs of COPD detected among smokers under 50 years A Danish population survey finds a 15% incidence of COPD symptoms in smokers under age 50 years who were exposed to 10 or more pack-years. Atopic dermatitis in egg-, milk-allergic kids may up anaphylaxis risk Egg- and...


How depression changes the heart in sleep; and a fully disposable duodenoscope debuts soon

Heart rate changes during sleep may be diagnostic tool for depression By Lucas Franki A heart rate–profiling algorithm shows promise at distinguishing differences in heart rate patterns during sleep in people with depression. Other news: FDA clears first fully disposable duodenoscope Boston Scientific anticipates early 2020 launch. Flu activity dropped in early December Unusual early spike related to increased influenza B activity, CDC says. SZC passes extension test for...


Mom’s advice may prevent dementia; plus, the truth about cardiovascular risk in women with diabetes

Could preventing dementia be as simple as following your mom’s advice? By Michele Sullivan Emerging evidence agrees: Lots of exercise, a good diet, and social interaction are good for both body and mind. Other news: Do women with diabetes need more CVD risk reduction than men? Two experts came to different conclusions on this question during a heated, but jovial, debate. Emergency physicians not yet embracing buprenorphine for opioid users Recommendations support a new ED protocol,...


FDA probes possible metformin contamination; new guidelines on VTE after surgery

FDA investigates NDMA contamination in metformin By Lucas Franki Officials at the Food and Drug Administration are investigating possible contamination in the United States, following reports in other countries. Other news: Reduced kidney function linked to fractures in older women Women aged 75 years with intermediate kidney function have a significantly greater risk of fracture. New ASH guideline: VTE prophylaxis after major surgery Pharmacologic prophylaxis is not recommended...


Doctors push back on surprise-billing proposal; more backing for colorectal cancer screens at 45

Docs push back on surprise billing compromise By Gregory Twachtman But doctors’ groups say the bipartisan legislation’s proposed solution is not a good one. Other news: New evidence further supports starting CRC screening at age 45 An American Cancer Society recommendation to lower starting age for colorectal cancer screening receives new support from a U.S. population–based study. Bariatric surgery tied to fewer cerebrovascular events Obese people who underwent the procedure had...


How abusive partners drive addiction; and gout guidelines rethink allopurinol dosing

In addiction, abusive partners can wreak havoc By Randy Dotinga Strategies of abusive partners include sabotaging and discrediting their partners’ attempts at recovery. Other news: Updated gout guidelines: Don’t let kidney function dictate allopurinol dosing Inadequate allopurinol dosing has been the bête noire of rheumatology for years. Women have fewer cardiovascular events after non–ST-segment elevation ACS But they also remain undertreated with guideline-directed...


Does strict glycemic control help older adults? And an antibiotic combo targets Crohn’s

Is strict glycemic control meaningless for older adults? By Miriam Tucker Less stringency for high-risk adults does not always mean broader allowance range in glycemic profiles. Other news: A triple-antibiotic cure for Crohn's disease? An oral fixed-dose, triple-antibiotic combination offers a promising new approach to the treatment of Crohn's disease. More states pushing plans to pay for telehealth care Fair payment remains a challenge for providers. Bilateral mastectomy reduces...


Intensive BP control cuts dementia, hurts cognition; and U.S. patients' insulin rationing rises

Intensive BP control reduced dementia but increased brain atrophy and hurt cognition By Michele Sullivan The small but significant ill effects worried some researchers at the Clinical Trials on Alzheimer’s Disease conference. Other News: Extent of insulin rationing in the U.S. is ‘shameful,’ say experts Cost-driven rationing by people with type 1 diabetes is considerably more common in the United States than in other high-income countries. Health care: More uninsured as...


A new migraine drug could be nearing approval; gunshot victims face long-term risks

More phase 3 ubrogepant data published as FDA decision nears By Jake Remaly An acute treatment for migraine shows positive results in a phase 3 trial. Other news: Gunshot wound victims are at high risk for readmission Individuals who sustain gunshot wounds have an increased risk for rehospitalization years, and even decades, after their initial injury. FDA expands use of Toujeo to childhood type 1 diabetes The new indication includes children as young as 6 years of age. FDA...


Here’s exactly how EHRs burn you out; the drive to cut HIV infections stalls

Quantifying the EHR connection to burnout By Gregory Twachtman New research puts a more standard, quantifiable measure to the relationship between EHR usability and burnout. Other news: CDC finds that efforts to reduce new HIV infections have stalled The agency has proposed a federal initiative to improve diagnosis, treatment, and prevention in areas of greatest need throughout the country. Cardiac arrests peak with pollution in Japan The incidence of out-of-hospital cardiac arrests...


Nearly one in five adolescents have prediabetes; new worries about antibiotics

Nearly one in five U.S. adolescents have prediabetes By Bianca Nogrady Nearly one in five adolescents and one in four young adults in the United States have prediabetes, with a higher prevalence among males. Other news: Antibiotic use may increase the risk of Parkinson’s disease Associations were found for broad-spectrum antibiotics and those that act against anaerobic bacteria and fungi. 2019-2020 flu season starts off full throttle The five states with the highest...


ACGME wants to boost well-being; CMS opens Direct Contracting process

ACGME deepening its commitment to physician well-being, leader says By Doug Brunk Positive social relationships with others are crucial to joy and well-being in the practice of medicine. You can take the MDedge Podcasts survey by clicking here. Other news: CMS announces application process for Direct Contracting model Letters of intent to participate are due by Dec. 10. ART treatment at birth found to benefit neonates with HIV Starting antiretroviral therapy within an...


Adding MRI cut interval breast cancers; how to curb kids’ fear of procedures

Managing pain in kids during minor procedures: A tricky balance By Doug Brunk Other News: Supplemental MRI found to benefit women with dense breast tissue The trial was not large enough to examine the effect of MRI screening on breast cancer-specific or overall mortality. Late-onset MS is often more severe than earlier-onset MS Late-onset MS often has faster accrual of disability and might require different treatment options. DAPA-HF: Dapagliflozin benefits regardless of age,...


Thoughts for practice from the Psychcast

We bring you the best-of Dr. RK, our closing segment of the Psychcast by MDedge. Renee Kohanski, MD, a clinical psychiatrist in New England, is the voice and mind behind the Dr. RK segment. If you like Dr. RK, you can find more from the Psychcast and from MDedge Psychiatry here.


The human side of clinical care from Dr. Ilana Yurkiewicz

In this special Thanksgiving episode, MDedge presents Ilana Yurkiewicz, MD, who is the voice and mind behind the Clinical Correlation segment of Blood & Cancer. Clinical Correlation is a segment all about the human side of hematology and oncology care. You can find more from Dr. Yurkiewicz and Blood & Cancer, the official podcast of MDedge Hematology/Oncology here.


Atopic dermatitis shapeshifts in different patient groups; disinfectants may fuel some COPD cases

Atopic dermatitis acts differently in certain populations By Randy Dotinga AD may require different treatments depending on age, ethnicity. You can take the MDedge Podcasts survey by clicking here. Other news: Regular use of disinfectants at work associated with increased risk of COPD Clinicians should look for sources of exposure to cleaning products and disinfectants. Data build on cardiovascular disease risk after GDM, HDP Risk factors may be elevated as soon as the first...


Osteoarthritis guidelines focus on severity; affordable gout drug cut post-MI heart events

OA management guidelines forgo treatment hierarchy or order but emphasize severity, patient risk factors By Jeff Craven The guidelines lay out a wide range of treatment options without an algorithm. *** You can take the MDedge Podcasts survey by clicking here. *** Other news: Colchicine cut post-MI CVD events Colchicine fulfilled the promise first seen in CANTOS that anti-inflammatory treatment can reduce cardiovascular disease events. Large population-based study...


Patients often pick cannabis for pelvic pain; LDL target of 70 lowers recurrent stroke risk

Cannabis frequently is used for endometriosis pain By Jim Kling Survey finds more than a third of patients have used marijuana or CBD. You can take the MDedge Podcasts survey by clicking here. Other News: Treating LDL to below 70 reduces recurrent stroke Patients had fewer events than those with an LDL cholesterol level between 90 and 110. Geriatric IBD hospitalization carries steep inpatient mortality A major unmet need exists for better guideline-directed management of...