Medical Research: Recent Episodes

ReachMD

Host: Charles Turck, PharmD, BCPS, BCCCP

Guest: Frank Diehl, PhD

A poster presented at the 2022 American Association for Cancer Research Special Conference on Precision Prevention, Early Detection, and Interception of Cancer found that a four-biomarker class multi-cancer early detection (MCED) test configuration had higher overall sensitivity and specificity compared to a three-biomarker test configuration. These results imply that more early-stage cancers could be detected. Dive further into the data and results with Dr. Charles Turck and Dr. Frank Diehl, Senior Vice President of Multi-Cancer Early Detection at Exact Sciences Corporation and co-author of the poster.

This is a non-certified educational series produced and controlled by ReachMD. This series is intended for healthcare professionals only. This program discusses a technology under development. Any features discussed describe current development goals. It has not been cleared or approved by the U.S. FDA or any other national regulatory authority.

Host: Neda Shamie, MD

Guest: Inder Paul Singh, MD

Inder Paul Singh, MD, sits down with Neda Shamie, MD, to discuss a retrospective analysis that evaluated the Medicare claims–based 5-year economic and reintervention burden for patients with primary open-angle glaucoma after incisional glaucoma surgery in the United States. What do the findings suggest for clinical and surgical practice?

Host: Neda Shamie, MD

Guest: Marguerite McDonald, MD, FACS

Marguerite McDonald, MD, FACS, and Neda Shamie, MD, discuss a literature review and panel discussion that sought to develop a consensus statement on the classification of presbyopia by severity. What were the results?

Host: Neda Shamie, MD

Guest: Brandon D. Ayres, MD

Brandon D. Ayres, MD, joins Neda Shamie, MD, to discuss an FDA clinical trial that evaluated the safety and efficacy of a custom-manufactured artificial iris device (CustomFlex ArtificialIris, HumanOptics) for the treatment of congenital and acquired iris defects. Learn the results.

Host: Neda Shamie, MD

Guest: Jay S. Pepose, MD, PhD

Jay S. Pepose, MD, PhD, sits down with Neda Shamie, MD, to talk about a phase 3 multicenter, randomized, placebo-controlled, double-masked clinical trial that evaluated the safety and efficacy of 0.75% phentolamine ophthalmic solution for the reversal of pharmacologically induced mydriasis. What were the findings of the MIRA-2 study?

Host: Neda Shamie, MD

Guest: Cynthia Matossian, MD

Cynthia Matossian, MD, joins Neda Shamie, MD, to discuss a national, noninterventional, cross-sectional, mixed methods survey that evaluated cataract surgery candidates’ knowledge and emotions as they related to cataract surgery and their behavioral intent to adhere to a doctor-recommended presurgical ocular surface prep routine. Learn more about commonly held assumptions.

Host: Neda Shamie, MD

Guest: Kendall Donaldson, MD

Kendall Donaldson, MD, sits down with Neda Shamie, MD, to discuss a retrospective chart review in which investigators evaluated the refractive outcomes of phacoemulsification in eyes with Fuchs endothelial corneal dystrophy. Did results differ between eyes that underwent laser cataract surgery and those that received conventional phacoemulsification?

Host: Neda Shamie, MD

Guest: Francis Mah, MD

Francis Mah, MD, joins Neda Shamie, MD, to discuss a post hoc analysis of data from a phase 3 evaluation of the safety of netarsudil 0.02% compared to timolol 0.5%. Learn the results.

Host: Neda Shamie, MD

Guest: Jason Bacharach, MD

Jason Bacharach, MD, sits down with Neda Shamie, MD, to discuss a randomized, 20-month, multicenter, masked, parallel-group, phase 3 trial that evaluated the IOP-lowering efficacy and safety of the bimatoprost implant (Durysta, Allergan) in patients with open-angle glaucoma or ocular hypertension. What were the results?

Host: Neda Shamie, MD

Guest: Julie Schallhorn, MD

Julie Schallhorn, MD, joins Neda Shamie, MD, to discuss a review conducted by the AAO of the published literature on the safety and efficacy of presbyopia-correcting IOLs available in the United States. Learn more about the findings.

Host: Raj Chovatiya MD, PhD
Guest: Martina J. Porter, MD
For patients with hidradenitis suppurativa (HS), the exact cause of the condition is still being researched. So what therapies are currently available to treat this painful condition? To discuss what you need to know, Dr. Raj Chovatiya is joined by Dr. Martina Porter, Dermatologist at Beth Israel Deaconess Medical Center and Assistant Professor of Dermatology at Harvard Medical School.

Host: Andrew Wilner, MD, Author of "The Locum Life: A Physician's Guide to Locum Tenens"
Guest: David Weisman, MD
Alzheimer’s disease is the most common form of dementia, and symptoms become more severe over time. In fact, it’s the leading cause of disability and poor health in older adults. And although there’s no cure, a new medication called lecanemab recently received accelerated approval by the US Food and Drug Administration. So what might this new development mean for the 6 million Americans living with this debilitating disease? Find out as Dr. Andrew Wilner speaks with fellow ReachMD host Dr. David Weisman, who’s also the Director of Clinical Research at Abington Neurological Associates.

Host: Peter Buch, MD, FACG, AGAF, FACP
Guest: Kyle Staller, MD, MPH
Chronic abdominal pain can be caused by many things—including hereditary angioedema (HAE). Are there any barriers to diagnosing patients with HAE? Dr. Peter Buch speaks with Dr. Kyle Staller from the Gastrointestinal Motility Laboratory at Mass General to explore the differential diagnosis for HAE and share what clinicians should be on the lookout for.

Host: Mario R. Nacinovich, Jr., MSc
Guest: Gregory Sepich-Poore, MD/PhD
Results from a recent study detail the impact that fungi can have in human cancer tumors. What do we need to know? Mario Nacinovich speaks with one of the researchers, Dr. Gregory Sepich-Poore from UC San Diego, to dive further into these results and their impact on cancer therapeutics.

Host: Pavani Chalasani MD, MPH

Guest: Hope S. Rugo, MD

Results from the TROPiCS-02 trial may impact survival for patients with receptor–positive/HER2-negative breast cancer. To find out why, Dr. Hope Rugo from the University of California San Francisco Comprehensive Cancer Center joins Dr. Pavani Chalasani to talk about the study and how it might impact the future of breast cancer treatment.

Host: John J. Russell, MD

Guest: Drew Weissman, MD, PhD

Guest: Katalin Karikó, PhD

As mRNA technology continues to emerge and evolve, Penn Researchers Dr. Drew Weissman and Dr. Katalin Karikó join Dr. John Russell to take a deep dive into the future of mRNA technology.

Host: Jennifer Caudle, DO

Guest: Kathleen Blake, MD, MPH

Guest: Peggy Chen, MD

Behavioral health integration has proven to be an effective solution to improving access to treatment for many mental health conditions… So why is it not more prevalent in the medical community? Joining Dr. Jennifer Caudle to dive into the findings and implications of the joint AMA-RAND Corporation study recently published in the Annals of Internal Medicine are Dr. Kathleen Blake with the AMA and Dr. Peggy Chen from the RAND Corporation.

And, click here to listen to a conversation regarding Behavioral Health Integration and its effect on clinical practice.

Host: Matt Birnholz, MD

Guest: Emeran Mayer, MD, PhD

There’s no organ in the body that has such close connections with the brain as the gut, which can often result in pain for many of our patients with IBD. Listen in as Dr. Emeran Mayer joins Dr. Matt Birnholz to explain this mind-gut connection, why patients with IBD experience pain, and how providers can manage patients who experience pain when inflammation is and isn't present.

Host: Matt Birnholz, MD

Guest: Mark R. Cullen, MD

Here to share what we might soon learn about the COVID-19 pandemic is Dr. Mark Cullen, Scientific Committee Chair for the academic arm of the COVID-19 research database, which is a secure repository of HIPAA compliant, de-identified, and limited patient-level data sets.

Published May 13, 2020

Host: Mario R. Nacinovich, Jr., MSc

Guest: Mark R. Cullen, MD

Even before the COVID-19 pandemic hit, endemic challenges surrounded fragmented data sets and long perspective clinical trials. But now, recently developed data sets are available to public health and policy researchers to not only overcome that challenge, but also to combat this global pandemic. Dr. Mark Cullen, Scientific Committee Chair for the academic arm of the COVID-19 research database at Stanford University School of Medicine, joins Mario Nacinovich to explain.

Published May 13, 2020

Host: Matt Birnholz, MD

Guest: Maria T. Abreu, MD

As emerging data supports the idea that patients with IBD can be managed by focusing on the microbiome, discussing dietary needs, and using cognitive behavioral therapy, it’s important that providers are attentive to the changing paradigms. During the 2020 Crohn’s and Colitis Foundation Congress, Dr. Maria Abreu leverages her triple-threat perspective on bench research, clinical research, and clinical care to share how we can improve care for patients with IBD.

Host: Paul Rokuskie

Guest: David S. Mandell, ScD

As prevalence rates for autism spectrum disorder (ASD) increase, so do economic costs. On average, medical expenditures for individuals with an ASD were 4 to 6 times greater than those without an ASD. Join Paul Rokuskie and his guest Dr. David Mandell, Associate Director of the Center for Autism Research at the Children’s Hospital of Philadelphia, as they dive into the economic impact of ASD.

Host: Paul Rokuskie

Did you know that in just 10 years, the national prevalence rate for autism spectrum disorder (ASD) has nearly tripled, going from 1 in 166 to 1 in 59? Or that 2 percent of the US population under the age of 18 now carries a diagnosis of ASD? Join Paul Rokuskie as he speaks with Dr. Stuart Shapira, Associate Director for Science at CDC’s National Center on Birth Defects and Developmental Disabilities, about these and other findings from the 2018 study regarding prevalence rates for ASD.

Host: Paul Rokuskie

As diagnostic information becomes more readily available, the importance of early diagnosis cannot be underestimated when it comes to helping those with autism spectrum disorder (ASD) and their families. Join Paul Rokuskie and his guest Dr. Stuart Shapira, Associate Director for Science at CDC’s National Center on Birth Defects and Developmental Disabilities, as they discuss the diagnosis criteria for ASD.

Host: Jennifer Caudle, DO

Guest: Jean Bennett, MD, PhD

Guest: Albert Maguire, MD

Power couple Drs. Jean Bennett and Albert Maguire discuss how their new therapy for the RPE65 gene, which causes retinal blindness, was recently approved by the FDA to become the first gene therapy treatment for a genetic disease in the United States and the first worldwide treatment for inherited blindness. Not only do they delve into the mechanics of the corrected gene injection, but they also explain what this milestone means for patient eligibility and how their marriage has played a role in the success of their research partnership.

Dr. Jean Bennett is the F.M. Kirby Professor of Ophthalmology at the Perelman School of Medicine at the University of Pennsylvania, and Dr. Albert Maguire is a Professor of Ophthalmology at the Hospital of the University of Pennsylvania and Attending Physician in the Division of Pediatric Ophthalmology at Children’s Hospital of Philadelphia.

Host: Alicia A. Sutton

Guest: Hilary Schmidt, PhD

Guest: John Ruggiero, PhD, MPA, CHCP

Guest: Gregory Salinas, PhD

Guest: Nili Solomonov

Annually, there are around 150,000 certified activities produced in the US annually. However, meta-analyses and research estimates that less than 20% of those educational activities drive behavior change and probably less than 5% lead to improvements in patient outcomes. With a vast array of continuing education (CE) activities available to healthcare professionals (HCPs) and the delay in data on the effectiveness and outcomes of CE activities, it's difficult for HCPs and CE stakeholders to determine the most effective education that has the greatest potential to lead to behavior change thus improving patient care.

During the Alliance for Continuing Education in the Healthcare Professions annual meeting host Alicia Sutton speaks with guests Hilary Schmidt, PhD, John Ruggiero, PhD, MPA, CHCP, Gregory Salinas, PhD, and Nili Solomonov in a two-part interview covering:

The current state of CE activities and address the lack of objective, reliable, and empirical assessment available to prospectively identify CE activities that have the greatest potential to lead to improvements in health care practice.
The development of a new Instructional Design Rating Scale and its reliability and predictive validity in driving behavior change through rigorous research methods based on the science of human learning.

Host: Shira Johnson, MD

Guest: Bennett Omalu, MD

Many studies have demonstrated long-lasting and even permanent brain damage that can originate from just one concussion. With athletes suffering multiple repeated head traumas due to high-contact sports, the controversies over player safety and long-term health risks remain hot-button issues.

Pathologist Dr. Bennett Omalu coined the term "CTE" and published the first evidence for chronic traumatic encephalopathy after autopsying American football players. In this second of a two-part interview, he shares his perspectives on CTE in athletes and the lifelong dangers of contact sports.

Host: Shira Johnson, MD

Guest: Bennett Omalu, MD

Chronic Traumatic Encephalopathy (CTE) is a degenerative brain disease found in athletes, military veterans, and others who experience repetitive brain trauma. Pathologist Dr. Bennett Omalu coined the term "CTE" and published the first evidence for this condition after autopsying American football players.

Host Dr. Shira Johnson welcomes Dr. Omalu to share the story of his discovery and the medical, athletic, and public responses that followed.

The FDA announced that a review of four large clinical safety trials shows that treating asthma with long-acting beta agonists (LABAs) in combination with inhaled corticosteroids (ICS) does not result in significantly more serious asthma-related side effects than treatment with ICS alone.

A link to the full communication detailing information for health care professionals and the Data Summary can be found at www.fda.gov/DrugSafetyCommunications.

Released 12/20/2017

Infliximab Trough Levels at Induction to Predict Treatment Failure During Maintenance.

Liefferinckx C1, Minsart C, Toubeau JF, Cremer A, Amininejad L, Quertinmont E, Devière J, Gils A, van Gossum A, Franchimont D. BACKGROUND: Infliximab (IFX) is indicated for the treatment of inflammatory bowel diseases (IBD). Nevertheless, loss of response (LOR) to IFX is reported in up to 10% to 30% of patients within the first year of treatment. Our objective was to evaluate the impact of the pharmacokinetics of IFX at induction on treatment failure.

METHODS: This is a longitudinal cohort study on 269 patients with IBD treated with IFX in a single center. A total of 2331 blood samples were prospectively collected from 2007 until March 2015 with a retrospective analysis of clinical data. IFX trough levels (TLs) were measured by enzyme-linked immunosorbent assay. Antibodies to IFX were measured by drug-sensitive bridging assay.

RESULTS: During follow-up, patients were defined according to treatment outcome. At week 6, median IFX TL in patients requiring a switch to another treatment due to LOR (LOR switched group) (2.32 μg/mL [0.12-19.93 μg/mL]) was lower than in patients with long-term response (long-term responders) (8.66 μg/mL [0.12-12.09 μg/mL], P = …

From the 42nd Annual Renaissance Ball in Philadelphia benefiting the Crohn's & Colitis Foundation, host Lu Ann Cahn talks with Dr. David Piccoli, Chief of the Division of Gastroenterology, Hepatology and Nutrition, Director of the Biesecker PediatricLiver Center, and a board-certified pediatric gastroenterologist at Children's Hospital of Philadelphia. Dr. Piccoli discusses the RISK study, supported by the Crohn’s & Colitis Foundation, and the challenges patients face with response to treatment. This pediatric study enrolled 1,800 patients at the time of their diagnosis and collected clinical, genetic, treatment and microbiome information to help to determine how the immune system works over time.

Host: Paul Rokuskie

Scientists have been doing research into many areas of autism spectrum disorder in the hopes of explaining the doubling of its prevalence rate over the past decade.

Both environmental risk factors and genetic components are areas of intense scrutiny for researchers seeking to understand the root causes of autism.

Host Paul Rokuskie talks with Craig Newschaffer, Professor, Associate Dean for Research, and Director of the A.J. Drexel Autism Institute, about the risk factors for autism spectrum disorder that scientists are working to better define.

Anti-TNF Treatment for Extraintestinal Manifestations of Inflammatory Bowel Disease in the Swiss IBD Cohort Study.

Vavricka SR1, Gubler M, Gantenbein C, Spoerri M, Froehlich F, Seibold F, Protic M, Michetti P, Straumann A, Fournier N, Juillerat P, Biedermann L, Zeitz J, Misselwitz B, Scharl M, Heinrich H, Manser CN, Safroneeva E, Raja Ali RA, Rogler G, Schoepfer AM, Greuter T; Swiss IBD Cohort Study Group. BACKGROUND: Extraintestinal manifestations (EIMs) in patients with inflammatory bowel disease (IBD) are frequently observed. Little is known about the efficacy of anti-tumor necrosis factor (TNF) in EIM management. We assessed the effect of 3 anti-TNF agents (infliximab, adalimumab, and certolizumab pegol) on EIM evolution.

METHODS: Data on 1249 patients from the Swiss IBD Cohort Study (SIBDCS) were analyzed. All EIMs were diagnosed by relevant specialists. Response was classified into improvement, stable disease, and clinical worsening based on the physician's interpretation.

RESULTS: Of the 366 patients with at least 1 EIM, 213 (58.2%) were ever treated with an anti-TNF. A total of 299 treatments were started for 355 EIMs. Patients with EIM were significantly more often treated with anti-TNF compared with those without EIM (58.2% versus 21.0%, P < 0.001). …

Host: Shira Johnson, MD

Guest: Robert Vonderheide, MD

For years, the foundations of cancer treatment, surgery, chemotherapy, and radiation therapy were utilized with the objective of weakening cancer.

But over the past several years, immunotherapy – therapies that enlist and strengthen the power of a patient’s immune system to attack tumors - has emerged as a new tool for fighting cancer. In August 2017, one such treatment approach, called Chimeric Antigen Receptor or CAR T-cell Therapy, received FDA approval for the treatment of children and young adults with acute lymphoblastic leukemia (ALL). Additionally, research is continuing to look at CAR-T therapy’s effectiveness for treating solid tumors as well.

Host Dr. Shira Johnson sits down with Dr. Robert Vonderheide, Director of the Abramson Cancer Center of the University of Pennsylvania and the John H. Glick, MD, Abramson Cancer Center Director’s Professor, to talk about the potential of CAR-T therapy alongside other emerging immunotherapies in fighting cancer.

Host: Brian P. McDonough, MD, FAAFP

Allergies occur when your immune system mistakes a normally harmless allergen for a dangerous invader and moves to destroy it, producing an allergic reaction. What exactly causes this response, and what are the best treatments to combat it?

Host Brian McDonough chats with Dr. Avery August, Professor of Microbiology and Immunology at Cornell’s College of Veterinary Medicine, about his research regarding how allergens affect the immune system.

Host: Paul Rokuskie

Researchers have been challenged for years by the simultaneous results of numerous studies into brain network connections in individuals with Autism Spectrum Disorder. Some results show strong connections, while others suggest the opposite. New research has helped bring some clarity to this ongoing paradox.

Host Paul Rokuskie is joined by Dr. Benjamin Yerys, a child psychologist in the Center for Autism Research (CAR) at the Children’s Hospital of Philadelphia. They talk about how it’s possible to see conflicting results and, paradoxically, for both to be true.

Host: Paul Rokuskie

Autism Spectrum Disorder affects communication skills as well as emotional & social development. Researchers have been studying the brain for decades to better understand how these developmental differences manifest as autism. Recent studies that measure rapid eye movement (REM) have been showing great promise in elucidating the origins and mechanisms of disease.

Host Paul Rokusie sits down with Dr. John Foxe to talk about his study on rapid eye movement, its implications on disease pathogenesis, and new insights it can bring to future autism research.

Anti-TNFα Treatment After Surgical Resection for Crohn's Disease Is Effective Despite Previous Pharmacodynamic Failure

Assa A1, Bronsky J, Kolho KL, Zarubova K, de Meij T, Ledder O, Sladek M, van Biervliet S, Strisciuglio C, Shamir R.

BACKGROUND: The outcome of patients with Crohn's disease who failed anti-tumor necrosis factor alpha (anti-TNFα) therapy despite adequate serum drug levels (pharmacodynamic failure) is unclear. We aimed to assess such pediatric patients who underwent intestinal resection and were re-treated with the same anti-TNFα agent postoperatively.

METHODS: Pediatric patients with Crohn's disease who underwent intestinal resection and were treated with anti-TNFα agents postoperatively were assessed retrospectively. Patients were stratified to those with preoperative anti-TNFα pharmacodynamic failure and those with no preoperative anti-TNFα treatment.

RESULTS: A total of 53 children were included, 18 with pharmacodynamic failure and 35 controls. Median age at intestinal resection was 14.8 years with 23 (43%) girls. The median time from intestinal resection to anti-TNFα initiation was 8 months (interquartile range 4-14 months). At the time of postoperative anti-TNFα initiation, there were no differences in clinical, laboratory, and anthropometric measures between groups. Similar proportions of patients from both groups were in clinical remission on anti-TNFα treatment after 12 months and at the …

Host: Brian P. McDonough, MD, FAAFP

It's widely known that genetics, family history, race, and other factors all play important roles in cancer risk. But what kinds of roles do they play, specifically, and how can we leverage these understandings into better primary care?

Dr. Brian McDonough is joined by Dr. Maureen Murphy, research scientist at the Wistar Institute at the University of Pennsylvania. Dr. Murphy has spent the past twenty years studying how genes affect breast cancer risk in women, particularly for African American populations. She discusses her findings on the discovery of p53 protein variants and how this advances the role for precision medicine in treating breast cancer.

Host: Brian P. McDonough, MD, FAAFP

Guest: Annalisa Scimemi

Hemorrhagic strokes account for about 200,000 strokes per year. Of those who survive, about 66 percent suffer some permanent brain damage. Our guest, biophysicist Dr. Annalisa Scimemi, has been studying the receptors in the brain that may contribute to brain damage immediately after hemorrhagic stroke. Alongside host Dr. Brian McDonough, she will discuss how to lessen the effects of brain damage following a stroke.

Host: Matt Birnholz, MD

Guest: Robert McNally, MD

From the Villanova Health Summit's Speaker Event, host Dr. Matt Birnholz speaks with guest Dr. Robert McNally, President, and CEO of GeoVax, Inc. They discuss the challenges that biotech companies face when bringing vaccines through clinical trials, and the long-term project being conducted by his colleagues to deliver an HIV vaccine to market.

Vedolizumab as Induction and Maintenance Therapy for Crohn's Disease in Patients Naïve to or Who Have Failed Tumor Necrosis Factor Antagonist Therapy.

Sands BE1, Sandborn WJ, Van Assche G, Lukas M, Xu J, James A, Abhyankar B, Lasch K.

BACKGROUND: Vedolizumab is a gut-selective α4β7 integrin antagonist for the treatment of moderately to severely active Crohn's disease (CD). Aims of this study were to characterize the efficacy and safety of vedolizumab induction and maintenance therapy in patients who were naïve to tumor necrosis factor-alpha (TNF-α) antagonist therapy (TNF-naïve) or who had discontinued TNF-α antagonist therapy because of inadequate response (i.e., primary nonresponse), loss of response, or intolerance (collectively classified as the TNF-failure population).

METHODS: Post hoc analyses of the efficacy data for 516 TNF-naïve and 960 TNF-failure patients from the GEMINI 2 and GEMINI 3 trials were evaluated at weeks 6, 10, and 52 and included clinical remission (CD Activity Index [CDAI] score ≤150), enhanced clinical response (≥100-point decrease from baseline in CDAI score), durable clinical remission (remission at ≥80% of visits), and corticosteroid-free remission. Adverse events were summarized for the TNF-naïve and TNF-failure subgroups by treatment received.

RESULTS: Among patients who responded to vedolizumab induction at week 6, 48.9% …

In this session of Beyond the Data carrying forward ideas discussed at CDC's Public Health Grand Rounds, Dr. Phoebe Thorpe speaks with Dr. Bobbi Pritt, Director of the Clinical Parasitology Laboratory and Co-Director of Vector-borne Diseases Laboratory Services at the Mayo Clinic. The two expand on Dr. Pritt's lecture focusing on advances in diagnosing tickborne diseases.

Predictors of Emergency Department Use by Persons with Inflammatory Bowel Diseases: A Population-based Study

Nugent, Zoann PhD; Singh, Harminder MD, MPH; Targownik, Laura E. MD; Strome, Trevor MS; Snider, Carolyn MD, MPH; Bernstein, Charles N. MD

Background: To describe the patterns and predictors of emergency department (ED) attendance and post-ED hospitalization by persons with inflammatory bowel disease (IBD).

Methods: We linked the University of Manitoba IBD Epidemiology Database with the Emergency Department Information System of the Winnipeg Regional Health Authority to determine the rates of presentation to the ED by persons with IBD from January 01, 2009 to March 31, 2012. Incident cases were diagnosed during the study period and all others were considered prevalent cases. Multivariate logistic regression was used to determine predictors of attendance in the ED and for hospitalization within 2 days of ED attendance.

Results: The study population included 300 incident and 3394 prevalent IBD cases, of whom 76% and 49%, respectively, attended the ED at least once during the study period. Incident cases with Crohn's disease or with a history of opioid use were more likely to attend the ED. Those …

Host: Matt Birnholz, MD

It's estimated that 80% of serious medical errors involve miscommunications between caregivers during the transfer of patients. But investigations are ongoing to identify the key issues behind these miscommunications, and how patient centered, value based care can address them.

Host Dr. Matt Birnholz speaks with Dr. David Badolato, family physician and founder and CEO of Life Laboratory, a Philadelphia-based nonprofit organization dedicated to research and education in quality models of care. Dr. Badolato authored an article published in Patient Safety and Quality Healthcare titled “The Patient-Family Journey From Outpatient to Inpatient: Improving Quality and Safety With the Outpatient EMR and PCP Collaboration.”

This week, hosts Mark Masselli and Margaret Flinter speak with Dr. Victor Dzau, President of the National Academy of Medicine (the former Institute of Medicine) a private, non-profit entity dedicated to tackling the nation's complex problems in medicine, technology and science. Dr. Dzau talks about the Academy's shift towards more cooperation between the scientific disciplines to advance evidence-based research that will inform the health care providers and policy makers around the country and the world.

Host: Caren Heller, MD

Guest: William J. Sandborn, MD

Clinical trials, among several critical purposes, are essential for the evaluation and approval of medication options for patients living with inflammatory bowel diseases. Despite this, only 6% of clinical trials are completed on time due to unfulfilled enrollment, often stemming to communication barriers between clinicians and patients.

Host Dr. Caren Heller, Chief Scientific Officer at the Crohn's & Colitis Foundation, sits down with Dr. William Sandborn, Professor of Medicine and Adjunct Professor of Surgery at the University of California-San Diego, about the many benefits that clinical trials can provide for IBD patients.

A protein homeostasis signature in healthy brains recapitulates tissue vulnerability to Alzheimer’s disease Rosie Freer, Pietro Sormanni, Giulia Vecchi, Prajwal Ciryam, Christopher M. Dobson, and Michele Vendruscolo

Science Advances 10 Aug 2016: Vol. 2, no. 8, e1600947 DOI: 10.1126/sciadv.1600947

Abstract: In Alzheimer’s disease, aggregates of Aβ and tau in amyloid plaques and neurofibrillary tangles spread progressively across brain tissues following a characteristic pattern, implying a tissue-specific vulnerability to the disease. We report a transcriptional analysis of healthy brains and identify an expression signature that predicts—at ages well before the typical onset—the tissue-specific progression of the disease. We obtain this result by finding a quantitative correlation between the histopathological staging of the disease and the expression patterns of the proteins that coaggregate in amyloid plaques and neurofibrillary tangles, together with those of the protein homeostasis components that regulate Aβ and tau. Because this expression signature is evident in healthy brains, our analysis provides an explanatory link between a tissue-specific environmental risk of protein aggregation and a corresponding vulnerability to Alzheimer’s disease.

[Read the Article]

Suicide is the 10th leading cause of death in the United States and identifying those at risk can be challenging. According to a new study, certain words in hospital discharge notes may be one way to identify patients who are at an increased risk of suicide.

Researchers from Massachusetts General Hospital examined more than 450,000 patients’ discharge notes from 2005 to 2013. They analyzed these notes by using a sentiment analysis computer program which searches for positive or negative words. The researchers found that certain words like gloomy, unfortunate, and sad can predict a higher risk for suicide, as opposed to words like lovely, delightful or pleasant.

In general, there is an elevated risk for suicide after hospital discharge so this is a moment for increased intervention.

[Watch more videos of The JAMA Report]

[Read the Article]

The increasing cost of prescription drugs in the United States has become a source of growing concern for patients, prescribers, payers, and policy makers. A new study examined the reasons for these high prices and also suggests policy changes that could help contain costs.

Researchers from Brigham and Women’s Hospital reviewed the medical and health policy literature on prescription drug prices in the U.S. and found high drug costs stem from various factors such as market exclusivity, limitations on payers and their ability to negotiate prices, and limitations on competition.

The researchers state that the most realistic short-term strategies include enforcing stricter requirements for exclusivity rights, ensuring timely generic drug availability, providing greater opportunities for price negotiation by patients, and effectively educating patients, prescribers, payers, and policy makers about these choices.

[Watch more videos of The JAMA Report]

[Read the Article]

Patients who might benefit from a heart valve replacement but are too ill for open heart surgery can sometimes undergo a less invasive procedure known as transcatheter aortic valve implantation or "TAVI". About 10% of patients undergoing TAVI can experience small strokes and related brain injury as a complication. A new study found that the use of a cerebral protection device, which captures debris dislodged from blood vessels during the TAVI procedure, reduced the number and volume of brain lesions seen on MRI.

Researchers from the University of Leipzig Heart Center, Germany studied 100 patients with an average age of 80 who underwent TAVI. Half of the patients received the cerebral protection device and the other half did not. Patients underwent brain MRIs before the implantation and again at 2 and at 7 days after the procedure. The results found that using the filter device helped to decrease the number of brain lesions seen in the brain by about half.

[Watch more videos of The JAMA Report]

[Read the Article]

According to a new study, eating a diet that includes more plant-based protein is associated with a lower risk of death, while eating more animal protein is associated with a higher risk of death, especially among adults with at least one unhealthy behavior such as smoking, drinking alcohol, being overweight or living a sedentary lifestyle.

Researchers from Massachusetts General Hospital examined how each protein source influenced long-term health. They looked at more than 131,000 adults participating in two long-running national health studies. Participants provided 25 to 30 years of detailed data on diet, lifestyle, and medical conditions. Researchers reviewed detailed food questionnaires that were sent to the participants every four years.

They found that higher intake of animal protein was positively associated with mortality and that the association was higher among adults who lived an unhealthy lifestyle. Substituting plant protein for animal protein, especially processed red meat, was associated with lower mortality, suggesting the importance of protein source.

[Watch more videos of The JAMA Report]

[Read the Article]

Since the legalization of marijuana in Colorado, there has been an increase in hospital visits and calls to regional poison centers due to unintentional marijuana exposure among young children. Researchers from the University of Colorado evaluated the number of children with exposures before and after recreational marijuana was legalized.

Between 2009 and 2015 they found a rise in the annual number of unintentional pediatric exposures. On average, these children were about two years old. Most children ingested the drug in edible forms such as candies and baked goods. Almost half of the patients seen in the children's hospital in the 2 years after legalization had exposures from recreational marijuana, suggesting that legalization did affect the incidence of exposures.

[Watch more videos of The JAMA Report]

[Read the Article]

A new study suggests that teens undergoing bariatric surgery can experience benefits in terms of walking speed and joint pain. Researchers from the University of Minnesota School of Medicine are tracking long-term outcomes for 242 teens that underwent bariatric surgery at five centers around the United States.

For the current study, researchers specifically focused on improvements in mobility and pain related to muscles and joints is a subset of 206 patients. All patients participated in a quarter mile walk test before and after surgery at six months, twelve months and twenty-four months. Improvements in time to complete the walk, resting heart rate and heart rate differences continued at one and two years after surgery.

[Watch more videos of The JAMA Report]

[Read the Article]

Chronic use of prescription pain medications known as opioids is increasing in the United States. New research shows that a portion of patients undergoing several common surgical procedures may be at increased risk for chronic opioid use several months after surgery.

Researchers from Stanford University School of Medicine reviewed the records of more than 641,000 patients who underwent one of 11 common operations and were not taking opioid pain medication during the year prior to surgery.

They found that some patients were at an increased risk for chronic opioid use following surgery, with the risks ranging from about one and a half times more likely, to as high as five times more likely, depending on the procedure. Males and the elderly had a higher risk, as well as patients with a history of drug or alcohol abuse. The overall risk of chronic opioid use remained low at about 1 percent depending on the type of surgery.

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According to a new study, euthanasia and physician-assisted suicide (PAS) in the United States, Canada, and Europe are increasingly being legalized, but remain relatively uncommon. Researchers from the University of Pennsylvania examined the legal status of both procedures and available data on attitudes and practices from the late 1940s to present day.

They found that public support for euthanasia and PAS in the United States had increased through the 1990s, but has since plateaued. More than 70 percent of cases of euthanasia and PAS worldwide involved patients with cancer. Typical patients are older, white, and well-educated. Motivations for requesting PAS include loss of autonomy and dignity, inability to enjoy life and regular activities, and other forms of mental distress. Pain is mostly not reported as the primary motivation.

Although the ethics and legality continue to be controversial, cases of these procedures remain relatively rare. Researchers did not find evidence that vulnerable patients have been receiving euthanasia or PAS at higher rates.

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The U.S. Preventative Services Task Force has updated the recommendations regarding colorectal cancer screening. The Task Force strongly recommends screening average risk adults age 50 to 75 for colorectal cancer, and then making individual screening decisions for adults age 76 to 85, taking into account the patient's overall health and screening history.

Colorectal cancer is the second leading cause of cancer death in the United States, and about one-third of adults in the United States have never been screened.

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According to a new study, in 2013 to 2014 there was an increase in obesity rates among U.S. women but not U.S. men. The overall prevalence of obesity during this time period was 40 percent among women and 35 percent among men.

Researchers from the National Center for Health Statistics examined trends in obesity among U.S. adults from 2005 to 2014. Using data from the National Health and Nutrition Examination Survey (NHANES), researchers looked at a sample of more than 13,000 men and 13,000 women. They found no recent changes in obesity or extreme obesity rates among men, but saw an increase in both for women.

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Despite targeted efforts to reduce obesity through diet and exercise, these rates continue to rise. A new study from Ontario, Canada found that obesity and diabetes rates were lower in more walkable neighborhoods compared to less walkable neighborhoods, where they saw an increase in these rates.

Researchers from St. Michael's Hospital in Toronto studied almost 9,000 neighborhoods in Southern Ontario looking at walkability scores, along with government health data and survey results during a twelve-year period. They examined whether neighborhoods that were more walkable experienced a slower increase in obesity and diabetes compared to less walkable neighborhoods.

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Many critically ill patients are unable to make medical decisions for themselves. Family members or close friends are often asked to serve as surrogate decision makers. However, expectations about a patient's overall prognosis sometimes differ between physicians and surrogate decision makers.

Researchers from the University of Pittsburgh enrolled 99 physicians and 229 surrogates who made decisions for 174 critically ill patients in a new study. They found that in about half of the cases, surrogates were substantially more optimistic about a patient's prognosis compared to physicians and that the physician's estimates were much more accurate than that of surrogates.

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Therapeutic substitution is a practice that replaces chemically different compounds within the same class of medications for one another. A new study examined how using this practice could save money on prescription drug costs.

Researchers from the Ohio State University reviewed records of more than 107,000 patients between 2010 and 2012 and looked at their prescription drug use and estimated how much money could be saved using therapeutic substitution.

The authors report that an extra $73 billion was spent between 2010 and 2012 on brand name medications. Therapeutic substitution could help lower those costs. Although therapeutic substitution is somewhat controversial, the authors conclude that if implemented in a way that does not negatively affect quality of care, this is a useful approach to decreasing healthcare costs.

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Out-of-hospital cardiac arrest (OCHA) is a major public health problem in the United States. Bystander CPR has been shown to double or even triple survival from OCHA. A new study examined whether providing CPR instruction over the phone ("telephone CPR") with the help of trained 9-1-1 dispatchers could improve survival rates after cardiac arrest.

Researchers from the Arizona Department of Health Services provided additional training to dispatchers in two regional centers in the Phoenix on how to be more assertive and confident while on the phone with rescuers. They measured outcomes from more than 2,300 out-of-hospital cardiac arrests during a three year period. The researchers found increases both in the number of patients that survived to hospital discharge as well as those with good functional outcomes, which means patients were able to return to their normal baseline.

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Host: Brian P. McDonough, MD, FAAFP

Cryotherapy, the science of freezong for medical purposes, uses extreme cold temperatures to cool down the body and has both current and emerging medical applications ranging from brain resuscitation in emergency settings to inflammation reduction in medical spas.

Host Dr. Brian McDonough sits down with science and health journalist Renee Ebersole to talk about the rise of cryotherapy, the mechanisms governing its medical utilities, and the benefits vs risks of its applications in various health settings today.

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An estimated 15 million Americans do some kind of rotating shift work, including overnights, evenings and early morning shifts. But can this type of shift work increase the risk of coronary heart disease? A new study examined the link between rotating night shift work and heart disease in a group of female nurses.

Researchers at Brigham and Women's Hospital used data from the Nurses' Health Studies (1 and 2), which followed participants for a twenty-four year period. They specifically looked at 189,000 women who reported their lifetime exposure to rotating night shift work. Over the course of the study period, more than 10,000 new cases of coronary heart disease were reported.

The results suggested that rotating night shift work was associated with modest risk of coronary heart disease, but further research is needed to help determine whether the association is related to specific work hours and/or individual characteristics.

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In a new study, researchers from the University of California-Los Angeles studied tumor response and overall survival following the administration of a new treatment among patients with advanced melanoma. This agent, called pembrolizumab, is an antibody that blocks PD-1, a protein which prevents the body's immune system from attacking the cancer.

The researchers tested pembrolizumab on more than 650 patients in North America, Europe and Australia. They looked at tumor response before and after treatment and found that the lesions were smaller in about one third of patients. In patients who responded to the treatment, seventy-five percent maintained the response at one or two years.

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Host: Paul Rokuskie

Recent studies have uncovered sex differences in both the neurobiology and phenotypical presentations of autism. These emerging understandings for how autism manifests uniquely in girls vs boys may radically change the way autism spectrum disorder is clinically perceived, improving diagnostic sensitivity and personalizing therapies.

Joining host Paul Rokuskie to discuss this line of research developments in autism spectrum disorder is Dr. Kaustubh Supekar, research scientist in the Department of Psychiatry at Stanford University School of Medicine.

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Air pollution is associated with chronic respiratory health problems in children. A new study examined whether decreases in air pollution levels are associated with significant reductions in respiratory symptoms in children.

Researchers from the University of Southern California followed over 4,600 children in eight Southern California communities across three different time periods from 1993-2012. In addition to monitoring air quality, they also looked at children with and without asthma, and whether they reported respiratory symptoms like bronchitis, congestion, phlegm production, or a daily cough for three months in a row, during the previous year.

Along with significant improvements in air pollution levels, the authors found a decrease in reported respiratory symptoms in children both with and without asthma. Respiratory symptoms decreased by 32 percent in children with asthma and 21 percent in children without.

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Among a group of patients with severe obesity who underwent bariatric surgery, a large percentage experienced improvement in pain, physical function, and walking capacity over 3 years, according to a new study.

Severe obesity can be associated with joint pain and impaired physical function, like the ability to bend, lift, carry, and walk.

Researchers from the University of Pittsburgh studied more than 2,200 patients from 10 U.S. hospitals. Patients filled out questionnaires about their pain and physical function before surgery and each year, for 3 years after surgery. Patients also participated in a 400 meter walking test.

The results found that 50 to 70 percent of patients experienced significant improvements in body pain and physical function and in the walking test. In addition, they found three-fourths of participants with severe knee and hip pain experienced improvements in arthritis symptoms.

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Recent outbreaks of vaccine-preventable diseases in the United States have prompted clinicians, public health officials and the public to pay closer attention to the growing phenomenon of vaccine refusal. A new study looks at the role of vaccine refusal and the risk of measles and pertussis. In recent years, a substantial proportion of US measles cases occurred in people who were intentionally unvaccinated. Vaccine refusal was also found to be associated with an increased risk of pertussis in some populations.

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Low back pain is a leading cause of disability in the United States. A new study shows that among adults with chronic back pain, both mindfulness-based stress reduction (MBSR) and cognitive behavioral therapy (CBT) resulted in meaningful improvement in back pain compared to traditional care.

Researchers from Group Health Research Institute randomly assigned 342 adults age 20 to 70 years with chronic low back pain to receive MBSR, CBT, or traditional care. Both MBSR and CBT were delivered in 8 weekly 2 hour groups. They found that study participants who received MSBR and CBT showed more improvement in pain and physical limitations at both 6 and 12 months.

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Host: Paul Rokuskie

Host Paul Rokuski welcomes Dr. Sally Rogers, Professor of Psychiatry & Behavioral Sciences and Director of Training and Mentoring at the MIND Institute of the University of California-Davis. Dr. Rogers specializes in conducting developmental and treatment research into autism and other developmental disorders. She is currently focused on developing and improving treatments for early autism using a treatment model that she developed in collaboration with Geraldine Dawson, the Early Start Denver Model.

Host: Matt Birnholz, MD

Only a decade ago, emergency medicine was largely considered an afterthought in large-scale clinical trials. This oversight persisted for years despite the fact that a wide variety of time-sensitive clinical conditions under frequent study were diagnosed and treated predominantly in emergency departments. However, the last several years have witnessed a rapid evolution within this specialty, such that departments nationwide are now granted the means and resources to dedicate efforts exclusively toward advancing emergency medicine research.

From the floors of the American College of Emergency Physicians (ACEP) annual meeting in Boson, Dr. Matt Birnholz speaks with Dr. Philip Levy, Professor of Emergency Medicine & Physiology and Associate Chair for Research in the Department of Emergency Medicine at Wayne State University School of Medicine. Dr. Levy is Chair of the ACEP Research Forum, whose efforts to date have helped put emergency medicine research in the limelight. The two discuss origins, present objectives, and future horizons for this forum and its impact on clinical research advancement in the field.

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Approximately one-third of children who experience a concussion will experience persistent post-concussion symptoms. Researchers have developed a new clinical scoring system that may help predict which patients are at a higher risk for prolonged symptoms.

Canadian researchers evaluated more than 3,000 patients, ages 5 to 18, who presented within 48 hours of an acute head injury. About thirty percent ended up with persistent post-concussion symptoms at 28 days. Researchers identified nine clinical factors that were predictive of post-concussive symptoms. These factors were then used in a twelve point risk score that included items like age, sex, history of migraines or depression, prior history of concussion, and problems with balance.

Although the clinical score was better than a physician's judgement alone, further research is needed before it is fully adopted into clinical practice.

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According to a new study, low dose aspirin taken regularly was associated with a reduced risk for cancer.

Researchers from Massachusetts General Hospital examined data from two large national studies that include about 136,000 men and women who have been providing detailed information about their overall health for decades.

Researchers identified 20,414 cancers among 88,084 women and 7,571 cancers among 47,881 men during a 32-year follow-up. Regular use of aspirin, two times or more per week, was associated with a 3 percent lower overall risk for cancer. This was mostly due to a 15 percent lower risk for gastrointestinal tract cancers and a 19 percent lower risk for cancers of the colon and rectum.

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Sepsis is a clinical syndrome of physiologic, pathologic, and biochemical abnormalities caused by serious infection. Sepsis is a major public health concern. Besides being a leading cause of mortality worldwide, sepsis accounted for more than $20 billion of U.S. hospital costs in 2011. In addition, there is increasing awareness that patients who survive sepsis are often left with long-term disabilities.

Updated definitions and clinical criteria for sepsis should help promote earlier recognition and more timely treatment of patients with sepsis or suspected sepsis. In a related study, researchers reviewed the electronic health records of more than one million patients to assess the usefulness of a clinical score known as "SOFA", which is used to help identify patients with sepsis.

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A new study suggests that family and other unpaid caregivers who provide substantial help with health care were twice as likely to experience physical, financial or emotional difficulty, five times as likely to restrict social activities, and more than three times as likely to experience a loss in job productivity as individuals who did not provide this type of help.

Researchers from Johns Hopkins Bloomberg School of Public Health used data from two nationally representative samples that provided insight into older adults and the caregivers who help them. The study sample represented 14.7 million caregivers assisting 7.7 million older adults, who either had dementia or a severe disability. About 45 percent of caregivers provided substantial help, (around 28 hours of care per week), often resulting in significant emotional difficulty and other caregiver role-related effects.

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Rates of genetic testing for BRCA1 and BRCA2 mutations have increased among younger women diagnosed with breast cancer, according to a new study. The study focused on nearly 900 women diagnosed with breast cancer at age 40 or younger. Researchers looked at rates of genetic testing, barriers to testing, and how the test results affected treatment decisions.

In 2006, the rates of BRCA testing were in the seventy percent range and by 2012 that proportion rose to ninety-five percent. While the majority of women reported being tested for BRCA 1 and 2, many were not, and a small minority reported that no one had discussed genetic risk or testing options. The study authors note that the overall goal of genetic testing is to help women make informed treatment decisions. Assessment of a young woman's genetic risk after a breast cancer diagnosis can affect treatment decisions and the results can also have health implications for her relatives.

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A new study examined the brains of deceased individuals and found that moderate seafood consumption correlated with lesser Alzheimer disease.

Researchers from Rush University Medical Center in Chicago enrolled older people living in public housing and retirement communities in an ongoing study of memory and aging. Participants had normal memory function when they entered the study and were asked to keep track of their diet using a detailed questionnaire. The participants also agreed to brain donation after they died, providing researchers a total of 286 brains to examine.

They found that participants who reported consuming seafood at least once a week had decreased occurrence of the plaques and tangles associated with Alzheimer disease. Increased seafood consumption was associated with increased brain mercury levels, but the mercury did not appear to have an impact on brain health.

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Depression is a common clinical problem, and is a leading cause of disability in adults. This condition is often under recognized and under treated, affecting individuals, families, businesses and society. The U.S. Preventive Services Task Force is an independent group of medical professionals that makes evidence-based recommendations about clinical preventive services in the primary care setting. The Task Force is recommending screening for depression in adults, including pregnant and postpartum women.

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To some, end of life care in the United States is considered resource intensive, expensive, and inattentive to patients' needs. So how does the United States compare to other countries? A new study examined several health care measures at the end of life for cancer patients in five European countries, Canada and the United States.

Researchers from the University of Pennsylvania Perelman School of Medicine compared the health care experience for cancer patients older than 65, in Canada, Belgium, Germany, England, the Netherlands, Norway and the United States. They examined several clinical measures during the final six months of life.

The United States and Netherlands had the lowest percentage of patients dying in the hospital. The United States also had the fewest hospitalizations and the smallest number of days patients spent in the hospital. In contrast, intensive care admissions were twice as common in the United States compared to the other countries.

During the last six months of life, patients in Norway and Canada had higher hospital costs than patients in the United States. There was less spending in Germany and Belgium, but the lowest expenditures were in the Netherlands and …

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Emphysema is a serious lung disease that results in severe shortness of breath and impaired quality of life. Management of emphysema is challenging since there is no cure and current therapies, including lung reduction surgery, can be risky. A new study examined a minimally invasive procedure to see if it could improve shortness of breath and also be a safe and cost effective way to treat emphysema.

Researchers from Hôpital Universitaire de Reims, France studied a new procedure that permanently places several coils into the lung. The study included one hundred patients from ten centers across France. Fifty patients had coils placed in their lungs and the other fifty received standard medical treatment. Both groups were followed closely and assessed at six and twelve months. They participated in a six minute walk test to see if their breathing had improved, allowing them to walk farther.

Results showed that thirty-six percent of patients who received the coil treatment had improvement in the six minute walk test, compared to only eighteen percent in the control group. There was also a significant improvement in quality of life at six and twelve months for patients who received …

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Among obese older patients with an increasingly common type of heart failure, calorie restriction and/or exercise training improved their ability to participate in physical activity without experiencing shortness of breath, according to a new study.

Heart failure with preserved ejection fraction (HFPEF) is the most rapidly increasing form of heart failure in the United States. Although the heart pumps normally, it does not fill with enough blood because the lower chamber of the heart is too stiff. More than eighty percent of patients with HFPEF are overweight or obese. Despite multiple studies, so far, no currently available medications have improved symptoms in patients with HFPEF.

Researchers from the Wake Forest School of Medicine randomly assigned 100 older obese participants with HFPEF to 20 weeks of diet, exercise, or both. They found that the exercise participants lost three percent of body weight, the diet group lost seven percent and the combined group lost ten percent of body weight. Patients in both the diet and exercise groups showed improvement in their ability to participate in exercise without significant symptoms.

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Laboratory safety may sound straightforward, but in reality it is supported by complex and ever-changing science. Safety standards and practices evolve as scientists learn more about the materials they handle regularly.

In this session of Public Health Grand Rounds from the CDC, presenters will discuss how standards of laboratory safety have improved over the years, what we’ve learned from past incidents, and how establishing safety protocols and training systems can lead to an overall culture of workplace safety, resulting in continued public trust in our science and recommendations.

For more details on this Grand Rounds session and its participants, click here.

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Even in the general population, people often don't want to talk about depression, which is one of the major reasons it isn't always treated properly. Depression is also a concern in the medical community, particularly affecting physicians in training known as medical residents. A considerable number of medical residents suffer significant depressive symptoms at various times during their training. What should be done to address the problem?

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CDC's Dr. Phoebe Thorpe speaks with Dr. Sherif Zaki about the important work being done to further reduce the risk of unusual transplant-associated infections.

Ensuring that organs are safe requires:

Involvement by many disciplines including: pathologists, epidemiologists, clinicians, and others
Global collaboration between federal and state agencies as well as academic institutions
Continued focus on improving regulations and screening procedures

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The most common operation done worldwide is the cesarean or C-section. Cesarean delivery is lifesaving for obstructed labor and other obstetrical emergencies; however, as with any surgical procedure, there are risks of complications and overuse can be harmful to both mothers and newborns. There were about 22.9 million cesarean deliveries worldwide in 2012. Based on older analyses from the mid-1980s, the World Health Organization (WHO) recommends that cesarean delivery rates should not exceed 10 to 15 per 100 live births.

In a study in the December 1 issue of JAMA, Harvard Researchers examine the relationship between cesarean delivery rates and maternal and infant death, and other adverse outcomes in children following planned cesarean delivery. The results indicate that the optimal cesarean delivery rate in relation to maternal and neonatal mortality is approximately 19 per 100 live births. Higher cesarean delivery rates were not associated with better outcomes in mothers and children.

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CDC's Dr. John Iskander and Dr. Janet Wright discuss the progress that has been made with Million Hearts®, along with the work that is still needed to reach the goal of preventing one million heart attacks and strokes by 2017.

Providers should:

Utilize electronic health records to proactively reach individuals with elevated blood pressure or cholesterol
Place emphasis on detecting cases of uncontrolled high blood pressure which are hiding in plain sight

Communities can:

Implement smoke-free policies to lower exposure to smoke
Adopt food procurement policies that make healthier foods more readily available
Encourage and train individuals to self-monitor their blood pressure

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Preschool children who experience repeated episodes of severe lower respiratory tract infections (LRTI) often present with symptoms like wheezing and difficulty breathing. A new study looked at whether the use of the common antibiotic, azithromycin, would help prevent progression of the illness, if given early enough in the episode.

Researchers from Washington University in Saint Louis School of Medicine, studied more than 600 children, ranging from ages one to six years old, with a history of repeated episodes of severe respiratory illness. Children were randomly assigned to either receive azithromycin or a placebo early in these episodes.

They found that children in the antibiotic group experienced a lower risk of progressing to severe LRTI than the placebo group.

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Proliferative diabetic retinopathy (PDR) is a leading cause of vision loss in patients with diabetes, resulting in up to 24,000 cases of blindness each year in the United States. Laser therapy has been the most common treatment used to help reduce severe vision loss, but the procedure has many side effects including permanent loss of peripheral vision and swelling of the retina.

A group of researchers from across the US tested an alternative treatment using an injectable medication called ranibizumab, to see if it would be as effective as the laser therapy. They studied more than 300 patients with PDR, assigning them to either receive standard laser therapy or an injection into the eye. In total, they treated close to 400 eyes.

Outcomes, especially loss of vision, were compared at two years. Over the two year period, researchers found that patients receiving the injections of medication had fewer side effects and did somewhat better in terms of vision loss than those who received laser therapy.

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Dr. John Iskander and Dr. George Luber revisit their discussion on climate change and its impact on human health to update some of the important new scientific findings that have taken place.

Since the first session on climate change:

2014 has been confirmed as the hottest year on record,
Extreme climate events are occurring more frequently, and
Communities are facing heightened health risks due to drought.

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Financial incentives for physicians or patients are one way healthcare organizations are trying to improve health outcomes. A new study examined whether providing these financial incentives would help improve low-density lipoprotein cholesterol (LDL-C) in patients with a high-risk for cardiovascular disease.

Researchers from the University of Pennsylvania, Philadelphia studied 1,500 patients and 340 primary care physicians. Physicians were randomly assigned to one of four groups. One group solely focused on providing physicians with financial incentives, while another group focused on financially rewarding patients when they showed improvements in their cholesterol levels. A third group consisted of shared incentives for both physicians and patients, while the last group (a control group) did not receive any financial incentives.

Overall, shared financial incentives for both physicians and patients, but not incentives to physicians or patients alone, resulted in a significant reduction of LCL-C levels at 12 months.

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Use of prescription drugs represents a major healthcare expense in the United States, and the number of adults taking prescription medications continues to increase. Researchers from the Harvard T.H. Chan School of Public Health examined trends in prescription drug use from 1999-2012 using data from nearly 40,000 adults, 20 years and older, who participated in the National Health and Nutrition Examination Survey. They found that the prevalence of prescription drug use increased from 51 percent in 1999-2000 to 59 percent in 2011-2012, while the use of five or more prescription drugs increased from 8 percent to 15 percent.

Eight of the 10 most commonly used drugs in 2011-2012 are used to treat components of the cardiometabolic syndrome, including high blood pressure, diabetes, and high cholesterol. Researchers note that the increase in use of several medications may reflect the growing need to treat obesity related complications. Use of antidepressants also increased from 7 percent in 1999-2000 to 13 percent in 2011-2012. The most commonly used individual drug was simvastatin, a medication used to treat high cholesterol. Simvastatin was used by 8 percent of the adult population in 2011-2012, up from 2.0 percent in 1999-2000.

Host: Barnett Mennen, MD

Host Dr. Barry Mennen welcomes Dr. Ashwin Ananthakrishnan, Assistant Professor of Medicine at Harvard Medical School and medical co-director at the MGH Crohn’s and Colitis center. Dr. Ananthakrishnan is involved in several large cohort studies that are attempting to examine established and novel environmental factors, including diet, that influence the risk of development of inflammatory bowel diseases. His recent study focusing on the potential role of dietary zinc in preventing bowel inflammation becomes the focus of this discussion.

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In the United States, it is estimated that approximately 230,000 women will be diagnosed with breast cancer, and more than 40,000 will die from the disease this year alone. Early detection using mammography remains the best way to prevent premature death from breast cancer. A panel of experts examined decades of research to update the American Cancer Society's (ACS) recommendations for breast cancer screening. Based on this review, the 2015 recommendations for breast cancer screening for women at average risk of cancer include the following:

Women should undergo regular screening mammography starting at age 45.
Women 45 to 54 years of age should be screened annually.
Women 55 years and older should transition to every other year screening or have the opportunity to continue annual screening.
Women should have the opportunity to begin annual screening between the ages of 40 and 44 years.
Women should continue screening mammography as long as their overall health is good and they have a life expectancy of 10 years or longer.
Clinical breast examination is not recommended for breast cancer screening among average-risk women of any age.

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In the United States, seasonal influenza epidemics are responsible for an estimated 226,000 hospitalizations and between 3,000 and 49,000 deaths each year. Pneumonia, the leading infectious cause of hospitalization and death in the United States, is a serious complication of influenza. A new study examined whether getting a flu shot can help reduce hospitalizations due to influenza pneumonia.

Researchers from Vanderbilt University Medical Center evaluated more than 2,700 patients from January 2010 to June 2012. All patients had pneumonia and were admitted to the hospital from the emergency department. Overall, about six percent of patients had pneumonia due to influenza.

Researchers estimated that the patients who received influenza vaccine had a 57 percent less chance of getting hospitalized with influenza-pneumonia than those patients who were not vaccinated.

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JAMA Report videos provided pursuant to license. ©2015 American Medical Association, publisher of JAMA® and The JAMA Network® journals.

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Successful treatment of stage II or stage III rectal cancer relies on surgical removal of the tumor. However, researchers from Baylor University Medical Center wanted to know if a "minimally invasive" procedure called a laparoscopy, would be as effective as a standard or "open" operation for patients with rectal cancer.

Researchers assigned 486 patients to receive either a standard open operation or the less invasive laparoscopic approach. All procedures were done by forty-six highly trained surgeons. Specimens from each procedure were examined to see whether all the tumor was removed ("complete resection").

Results found that 90 percent of the patients who underwent the open operation had a complete resection, where patients who underwent the laparoscopy only had an 81 percent success rate. The researchers concluded that these findings do not support laparoscopic removal of rectal cancer.

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Agitation is common in patients with dementia and can contribute to distress for patients and caregivers and an increased risk of institutionalization. Nonpharmacological interventions are recommended as first-line therapy, but many patients fail to respond, and medications are often needed. Currently available medications don't work very well and can have serious side effects. A new study tested a combination of two existing medications, dextromethorphan hydrobromide and quinidine sulfate, to see if this would help control agitation in patients with Alzheimer's dementia.

Researchers from the Cleveland Clinic recruited 220 patients with Alzheimer's dementia and agitation. During a preliminary 10 week trial, participants were randomly assigned to receive either the dextromethorphan- quinidine combination or a placebo.

Results showed that patients receiving the combination medication demonstrated fewer episodes of agitation compared to patients who received the placebo. When agitation did occur, it tended to be less severe. Researchers also found that not only is the combined drug effective, but safe.

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JAMA Report videos provided pursuant to license. ©2015 American Medical Association, publisher of JAMA® and The JAMA Network® journals.

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About 42 percent of the general U.S. population has low vitamin D levels. In addition to promoting calcium and bone health, vitamin D may also affect the brain and cognitive function. A new study by JAMA Neurology looked at the association between baseline vitamin D levels and the rate of cognitive decline in a group of ethnically diverse older adults.

A researcher from Rutgers University, along with colleagues from the University of California Davis, studied 382 older adults with an average age of 75. Among the group, 61 percent of participants were women, 41 percent white, about 30 percent were African American and 25 percent were Hispanic. At study enrollment, about 18 percent had dementia, 33 percent had mild cognitive impairment and half were cognitively normal.

Vitamin D levels and cognitive function were measured at baseline. Cognitive function was also followed in 318 of the participants for an average of 5 years.

Researchers found:
- About 60 percent of the group, regardless of their race or ethnicity, was low in vitamin D.
- Vitamin D levels were lower for African American and Hispanics, compared with their white counterparts.
- …

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Autism Spectrum Disorder (ASD) represents a diverse group of neurodevelopmental conditions. If researchers can better understand the genetics of ASD, it may be possible to identify and diagnose at-risk children sooner. A new study looked at the results of two newer genetic testing technologies, chromosomal microarray and whole-exome sequencing, in children diagnosed with ASD.

Researchers from Newfoundland, Canada studied more than 250 children diagnosed with ASD. All participants underwent the chromosomal microarray analysis, however, only 95 randomly selected participants had whole-exome sequencing. Results found that sixteen percent of the children had an ASD related genetic finding on either microarray or whole-exome sequencing.

In addition to the new tests, researchers also closely examined the children for subtle physical differences and screened them for birth defects. Based on these exams, they were put into three groups of increasing physical severity: essential, equivocal, and complex. Researchers found that thirty-five percent of children in the complex group had a positive genetic test. In that group, the diagnosis of autism was more delayed than in the children of the other groups.

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Some evidence suggests that physical activity can help slow cognitive decline. A new study evaluated whether a program of moderate physical activity would result in better cognitive function, lower risk of dementia, or both, for older adults compared with a health education program.

Researchers from Wake Forest School of Medicine, Winston-Salem, North Carolina evaluated more than 1,600 sedentary adults, between the ages of 70 and 89, and randomly assigned them to either physical activity or a health education program. The participants were monitored for 24 months, during which their cognitive function was measured using a variety of clinical tests.

Results found that both groups preserved their cognitive function over the two year study period. Although there was no difference between the groups, the outcomes still prove notable, since steady decline in cognitive function would generally be expected within this age group.

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Electronic cigarettes (e-cigarettes) are becoming increasingly popular among teens. A new study looks at whether younger teens who never smoked cigarettes and who begin using e-cigarettes might be more likely to go on to use conventional tobacco products.

Researchers from the University of Southern California, Los Angeles surveyed more than 2,300 Los Angeles area high school students who reported never using tobacco products at the beginning of 9th grade. The students were surveyed again six months later and also when entering the 10th grade.

In a comparison of teens who had used e-cigarettes to those who had not, the researchers found that those who had used e-cigarettes were four times more likely to have gone on to use conventional tobacco products, including cigarettes and cigars. The researchers acknowledge that their findings, while suggestive, cannot prove that e-cigarette use directly causes subsequent tobacco use.

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JAMA Report videos provided pursuant to license. ©2015 American Medical Association, publisher of JAMA® and The JAMA Network® journals.

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The popularity of testosterone supplementation among older men has increased substantially over the past decade. However, the risks and benefits of long-term administration are still unclear. A new study examined whether using testosterone supplements affected the development of atherosclerosis (hardening of arteries), which is linked to heart attack and stroke.

Researchers from Brigham and Women's Hospital in Boston studied more than 300 men who were sixty years of age and older, in relatively good health, and had low or low-normal testosterone levels. Half the men applied a testosterone gel daily to the skin for three years, while the other half were given a placebo gel. During the course of the trial, hardening of the arteries was measured in the carotid and coronary arteries, which supply the brain and heart.

Results were that during the three year study, there was no significant effects in terms of hardening of the carotid or coronary arteries. Testosterone supplementation also did not improve overall sexual function or health-related quality of life.

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JAMA Report videos provided pursuant to license. ©2015 American Medical Association, publisher of JAMA® and The JAMA Network® …

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Posttraumatic stress disorder (PTSD) affects twenty-three percent of veterans returning home from deployments in Afghanistan and Iraq. Left untreated, PTSD is associated with high rates of other disorders, disabilities, and poor quality of life. A new study evaluated a different approach to managing PTSD related symptoms, a mindfulness-based stress reduction therapy.

Researchers at the Minneapolis Veterans Affairs Health Care System randomly assigned 116 veterans with PTSD to receive nine sessions of mindfulness-based stress reduction therapy, which teaches participants to be present in the moment in a nonjudgmental, accepting manner. The others attended group therapy, primarily focusing on current life problems. The veterans were monitored before, during and after treatment.

Results found that among veterans with PTSD, mindfulness-based stress reduction therapy, compared to group therapy, resulted in a greater decrease in PTSD symptom severity.

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JAMA Report videos provided pursuant to license. ©2015 American Medical Association, publisher of JAMA® and The JAMA Network® journals.

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America's landmark health care programs, Medicare and Medicaid, celebrate their 50th anniversaries on July 30th. Over the past five decades, the United States healthcare system has experienced dynamic changes, most notably in recent years with improvements in technology, care delivery and health related behaviors. A new study examined key outcomes among the Medicare population over a 15 year period.

Researchers from Yale University School of Medicine reviewed the records of nearly 70 million Medicare beneficiaries enrolled in fee-for-service and Medicare Advantage plans from 1999 to 2013, to better understand long-term trends in mortality, hospitalizations, and healthcare costs.

Results found that among Medicare beneficiaries, death rates have dropped an estimated twenty percent, there have been ten percent fewer hospitalizations, and overall expenditures have decreased from 1999 to 2013. In the last six months of life, total hospitalizations and inpatient costs have also decreased.

[Watch more videos of The JAMA Report]

JAMA Report videos provided pursuant to license. ©2015 American Medical Association, publisher of JAMA® and The JAMA Network® journals.

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Out-of-hospital cardiac arrest is a major public health issue, accounting for approximately 200,000 deaths per year in the United States. A new study examined whether increased use of defibrillators and cardiopulmonary resuscitation (CPR) by first responders and bystanders could help increase survival for people who experience an out-of-hospital heart attack.

In recent years, statewide initiatives in North Carolina have encouraged improvement in the use of CPR and automated external defibrillators (AEDs) by training more members of the general public.

Bystander-initiated CPR was associated with a greater likelihood of survival with favorable neurologic outcome. The combination of bystander CPR and first responder defibrillation increased from 14 percent in 2010 to 23 percent in 2013. Results found, patients who received bystander or first responder interventions before arrival of the emergency medical services (EMS) were more likely to survive compared to those who received EMS intervention alone.

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JAMA Report videos provided pursuant to license. ©2015 American Medical Association, publisher of JAMA® and The JAMA Network® journals.

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An increasing number of pregnant women are undergoing noninvasive prenatal testing to help identify fetal genetic abnormalities. This is done using a blood test that looks at the DNA of both the mother and fetus. In a small percentage of these tests, the results appear abnormal, but the baby's genetics are later shown to be normal. A new study examined if the rare diagnosis of maternal cancer could be one cause of such discrepancies. The study is being released to coincide with its presentation at the 19th International Conference on Prenatal Diagnosis and Therapy in Washington, D.C.

Researchers at Tufts Medical Center in Boston examined more than 125,000 noninvasive prenatal test results over the course of a two year period. Approximately 3,800 women had abnormal test results, and ten of those women were subsequently diagnosed with cancer. Medical records and additional genetic information were examined in eight of those women to look for patterns suggestive of underlying cancer.

Based on the results of the study, researchers estimate there is between a twenty and forty-four percent risk of maternal cancer if an abnormal number of chromosomes are detected. Further studies are needed to fully understand …

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Each year, nearly 800,000 Americans experience a stroke, and for survivors, cognitive decline including memory and thinking speed, is a major cause of disability. Many patients experience these declines immediately after a stroke, but a new study examined whether cognitive decline continues several years after the initial stroke.

Researchers from the University of Michigan Medical School, Ann Arbor examined changes in cognitive function in more than 23,000 individuals who were 45 years of age or older. All participants were free of cognitive impairment at the start of the study. Memory and other measures of cognitive function were recorded at the beginning and at regular intervals throughout a six year follow up period. 515 participants experienced a stroke during the study, the rest remained stroke free.

Results found that stroke survivors had a faster rate of cognitive decline after stroke compared with the pre-stroke rate. Stroke was associated with an early decline in cognitive function and also accelerated and persistent cognitive decline over the next six years.

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JAMA Report videos provided pursuant to license. ©2015 American Medical Association, publisher of JAMA® and …

Noninvasive Prenatal Testing and Incidental Detection of Occult Maternal Malignancies Diana W. Bianchi, MD; Darya Chudova, PhD; Amy J. Sehnert, MD; Sucheta Bhatt, MD; Kathryn Murray, MS; Tracy L. Prosen, MD; Judy E. Garber, MD; Louise Wilkins-Haug, MD, PhD; Neeta L. Vora, MD; Stephen Warsof, MD; James Goldberg, MD; Tina Ziainia, MD; Meredith Halks-Miller, MD JAMA. 2015;314(2):162-169. doi:10.1001/jama.2015.7120 Importance: Understanding the relationship between aneuploidy detection on noninvasive prenatal testing (NIPT) and occult maternal malignancies may explain results that are discordant with the fetal karyotype and improve maternal clinical care.

Objective: To evaluate massively parallel sequencing data for patterns of copy-number variations that might prospectively identify occult maternal malignancies.

Design, Setting, and Participants: Case series identified from 125 426 samples submitted between February 15, 2012, and September 30, 2014, from asymptomatic pregnant women who underwent plasma cell-free DNA sequencing for clinical prenatal aneuploidy screening. Analyses were conducted in a clinical laboratory that performs DNA sequencing. Among the clinical samples, abnormal results were detected in 3757 (3%); these were reported to the ordering physician with recommendations for further evaluation.

Exposures: NIPT …

Outcomes of Daytime Procedures Performed by Attending Surgeons after Night Work Anand Govindarajan, M.D., David R. Urbach, M.D., Matthew Kumar, M.Sc., Qi Li, M.Sc., Brian J. Murray, M.D., David Juurlink, M.D., Ph.D., Erin Kennedy, M.D., Ph.D., Anna Gagliardi, Ph.D., Rinku Sutradhar, Ph.D., and Nancy N. Baxter, M.D., Ph.D.

N Engl J Med 2015; 373:845-853 DOI: 10.1056/NEJMsa1415994

August 27, 2015

Background: Sleep loss in attending physicians has an unclear effect on patient outcomes. In this study, researchers examined the effect of medical care provided by physicians after midnight on the outcomes of their scheduled elective procedures performed during the day.

Methods: The study authors conducted a population-based, retrospective, matched-cohort study in Ontario, Canada. Patients undergoing 1 of 12 elective daytime procedures performed by a physician who had treated patients from midnight to 7 a.m. were matched in a 1:1 ratio to patients undergoing the same procedure by the same physician on a day when the physician had not treated patients after midnight. Outcomes included death, readmission, complications, length of stay, and procedure duration. Generalized estimating equations were used to compare outcomes between patient groups.

Results: The authors included 38,978 patients, treated by 1448 …

Host Dr. Barry Mennen welcomes Dr. Ryan Stidham, Assistant Professor of Internal Medicine at the Inflammatory Bowel Diseases Center of the University of Michigan Health System, to discuss the current therapeutic landscape for IBD based on recent comparative clinical trials.

This week, Mark and Margaret speak with Dr. Eric Green, Director of the National Human Genome Research Institute at the National Institutes of Health, the world's largest organization dedicated solely to genomics research. Dr. Green was on the team that mapped the human genome and talks about new initiatives at NIH to create better platforms for storing and sharing big data in this new era of scientific research.

This week, hosts Mark Masselli and Margaret Flinter speak with Margaret Anderson, Executive Director of FasterCures, an action tank dedicated to saving lives by speeding up and improving medical research systems. They discuss the ongoing threat to NIH research due to funding reductions, but also the game-changing potential of new technologies and increased patient engagement to advance biomedical research.

Host: Matt Birnholz, MD

In today's clinical practice, there is no appropriate "one size fits all" treatment approach for COPD. But while this progressive trend toward personalized medicine standards helps optimize COPD care for each patient, the cost-to-benefit ratio for drug development changes as COPD evolves from one disease state into a larger disease spectrum. What is the current to future pipeline for drug R&D in the COPD arena, and is the horizon optimistic for delivering better treatment methods to patients? Joining Dr. Matt Birnholz to discuss the "Pulmonary Pipeline" is Dr. Nicholas Gross, pulmonologist and industry news reporter. Dr. Gross is emeritus professor of medicine and molecular biology at Loyola University in Chicago.

Guest: AK

Host: Alicia A. Sutton

Visual representations of data come in many shapes and forms in medical education, but their clarity, meaningfulness, and utility are always intended to be top-notch. Unfortunately, this is sometimes not the case, with visual depictions of important information that may appear confusing or, even worse for the educator, uninteresting. What is the rhyme and reason to generating effective designs for medical data? Host Alicia Sutton welcomes Andy Kirk, data visualization expert and founder of Visualizing Data Ltd, to address this subject in depth. Mr. Kirk is author of Data Visualization: a successful design process, a practical guide for creating data visualisation solutions in the most effective and efficient way.

Host: Howard Levy, MD, PhD

Guest: David H. Ledbetter, PhD, FACMG

From the ASHG Meeting in San Diego, Dr. Howard Levy is joined by Dr. David Ledbetter, Executive Vice President and Chief Scientific Officer at Geisinger Health System. Dr. Ledbetter shares his career story as an internationally recognized researcher in the advancement of medical genomics, and the initiatives he is leading at Geisinger to bring genomic sequencing to primary care settings for improved risk assessments and better patient outcomes.

Host: Alicia A. Sutton

Guest: Jennifer Golbeck, PhD

How will new computational techniques leveraging "big data" analytics impact healthcare systems and medical practices, and where should this data come from? Alicia Sutton welcomes Jennifer Golbeck, director of the Human Computer Interaction Lab and associate professor at the College of Information Studies of the University of Maryland, to discuss present and future directions in big data usage for medicine and society.

Host: Lee Freedman, MD

Oropharyngeal cancer is part of a growing proportion of head and neck malignancies. This has also been associated with the increase in infection of the oropharynx by oncogenic strains of the human papillomavirus (HPV). And, transoral robotic surgery, or TORS, has allowed for minimally invasive surgery for HPV-related and non-HPV-related oropharyngeal cancer. To discuss this topic and much more, host Dr. Lee Freedman welcomes Dr. Gregory Weinstein, Professor and Vice Chair and the Director of the Division of Head and Neck Surgery. He is also the Co-Director of The Center for Head and Neck Cancer in The Department of Otorhinolaryngology: Head and Neck Surgery at the Hospital of the University of Pennsylvania.

Host: Frank Russomano

"When political considerations trump basic medical strategies proven effective over centuries, the danger can be grave." That's a passage taken from a recent article called "The Deadly Politicization of Ebola," written by Dr. Richard Amerling, guest on this episode of Voices. Dr. Amerling is President of The Association Of American Physicians And Surgeons. He is Associate Professor of Clinical Medicine and a renowned academic nephrologist at the Beth Israel Medical Center in New York City.

Host: Alicia A. Sutton

Quality Improvement in medical education can take place along several stages of behavior change, from orientation to enablement to sustainment. The timing of QI intervention, and the ways in which QI teams collaborate creatively within each phase, become critical. Joining host Alicia Sutton to elaborate on this type of modeling for education improvement is Chitra Subramaniam, Ph.D., Assistant Dean and Director for Continuing Medical Education at Duke University's Clinical Research Institute. Dr. Subramaniam is also Assistant Dean at the Duke Center for Educational Excellence.

Host: Alicia A. Sutton

Host Alicia Sutton welcomes Dr. Arif Kamal, Director of Quality and Outcomes at the Duke Cancer Institute, to talk about ways in which clinicians can become more involved or even take the reins of leadership in quality improvement initiatives within their health systems. The discussion pays close attention to the burgeoning field of Big Data, and how its rapid entry into healthcare impacts quality improvement efforts.

This week, Mark and Margaret speak with Dr. Arjun Srinivasan, Associate Director for Healthcare Associated Infection Prevention Programs, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases at the Centers for Disease Control and Prevention. Dr. Srinivasan is a prominent spokesman for the CDC's response to the Ebola crisis, as well as an expert on the rise of antibiotic resistant bacteria, which has killed an estimated 75 thousand Americans through hospital acquired infections.

This week, Mark and Margaret speak with Dr. Eric Green, Director of the National Human Genome Research Institute, one of the 27 Institutes at NIH. They have launched a new program called Big Data to Knowledge, or BD2K, which seeks to create better platforms for storing and sharing the large volumes of big data that have emerged in the world of scientific research since the mapping of the human genome. Dr. Green also talks about the threats to future research from young scientists struggling to achieve in a climate of reduced grant funding nationwide.

Host: Lee Freedman, MD

Heated/Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is one of the most innovative treatments available today for complex abdominal cancers. What is it? Who is a candidate? And, what are the expected outcomes for our patients? Host Dr. Lee Freedman welcomes Dr. Giorgos Karakousis, Assistant Professor of Surgery at the Hospital of the University of Pennsylvania to discuss HIPEC.

Host: Lee Freedman, MD

How does surgery and stenting for carotid lesions help prevent stroke? What are the latest approaches, clinical trials, and philosophy for dialysis access for patients? Host Dr. Lee Freedman welcomes Dr. Benjamin Jackson to answer these questions and the latest innovations in vascular surgery at the University of Pennsylvania Hospital. Dr. Jackson is an Assistant Professor of Surgery in Radiology at the University of Pennsylvania Hospital.

Host: Lee Freedman, MD

Joining host Dr. Lee Freedman is William C. Welch, MD, FACS, FICS, Professor of Neurosurgery and Professor of Orthopaedic Surgery, and Vice Chair of the Department of Neurosurgery at Pennsylvania Hospitall. Dr. Welch will discuss the surgical treatment options for both lumbar spinal stenosis and cervical stenosis. He will also explore the causes and treatment options for lower back pain.

Host: Lee Freedman, MD

Hip pain can be a major roadblock to an active lifestyle, and even effect activies of daily living. This is sometimes even more profound when seen in younger patients. How can we preserve hip function in younger patients, for whom replacement is not an option? In this segment, Dr. Lee Freedman speaks to Dr. Atul Kamath, Director, Center for Hip Preservation and Assistant Professor of Orthopaedic Surgery at the Hospital of the University of Pennsylvania.

Host: Lee Freedman, MD

According to the American Cancer Society, about 10,000 pituitary tumors are diagnosed each year in the United States. What is the state of the art approach to the diagnosis and treatment of these tumors? Dr. Lee Freedman talks to Dr. Sean Grady, Chairman, Department of Neurosurgery Charles Harrison Frazier Professor of Neurosurgery Perelman School of Medicine at the University of Pennsylvania.

Host: Alan S. Brown, MD, FACC, FAHA, FNLA

A paradigm shift in the management of lipid disorders has been witnessed of late based on evidence reviews by the AHA and the ACC. Where the clinical dogma once focused on targeting specific lipoproteins, clinicians are now trending toward using appropriate dosages of statins for lowering non-HDL cholesterol. What are the ramifications of this change in approach, and how does the NLA weigh in on recommendations for targets and goals? To address these and other questions, host Dr. Alan Brown welcomes Kevin Maki, PhD, FNLA, CLS, Chief Science Officer for Midwest Center for Metabolic and Cardiovascular Research and Adjunct Faculty in Biostatistics and Applied Epidemiology at DePaul University, Chicago, IL.

Host: Alan S. Brown, MD, FACC, FAHA, FNLA

What's the evidence for LDL and other non-HDL targets for primary and secondary prevention of heart disease? What are the comparative benefits versus toxicities of all lipid-lowering medications in clinical use? Addressing these and other questions from the standpoing of recent NLA recommendations is Kevin Maki, PhD, FNLA, CLS, Chief Science Officer for Midwest Center for Metabolic and Cardiovascular Research and Adjunct Faculty in Biostatistics and Applied Epidemiology at DePaul University, Chicago, IL.

Produced in partnership with

The Gender, Sexuality and HIV Prevention Center at Ann & Robert H Lurie Children's Hospital of Chicago is the first of its kind facilty for adolescent patients. Host Dr. Jennifer Caudle welcoms the center's director, Dr. Robert Garofalo. Dr. Garofalo will share the center's mission of supporting multidisciplinary academic subjects including sexual health, gender, sexuality, HIV prevention and health disparities which affect adolescent and young adult populations at risk of acquiring HIV. The Center partners with similar organizations throughout the country in creating an environment where clinicians, academics and scientists can collaborate to design projects with public health significance.

Robert Garofalo, MD, MPH, is Professor of Pediatrics and Preventive Medicine at Northwestern University Feinberg School of Medicine. He is also an Attending Physician at Lurie Children's, where he directs the Adolescent/Young Adult HIV Program. Dr. Garofalo is a national authority on LGBT health issues, adolescent sexuality, and HIV clinical care and prevention.

Host: Brian P. McDonough, MD, FAAFP

What are the differences in managing the Ebola virius in Africa versus the United States? It has been relatively controlled to date, but what are the major concerns in spreading? Host Dr. Brian McDonough welcomes special guest Dr. Kamar Adeleke, cardiologist in New Castle, Delaware, whose practice includes frequent travels to Nigeria where he teaches at affiliated medical schools.

Host: Matt Birnholz, MD

Twenty-five years ago CDC played a pivotal role in the discovery of the virus that causes hepatitis C. After the isolation of HCV, implementation of screening of blood products and organs for donation led to a decrease in rates of HCV infection between 1990 and 2009. In spite of these successes, HCV still remains a serious threat, both domestically and abroad. HCV remains the most common chronic blood borne infection in the United States, affecting approximately 3.9 million individuals. However up to 50% of HCV-infected persons are unaware of their infection. Globally, there are 180 million people who are chronically infected with the virus, and 3-4 million new infections occur every year.

Recent therapeutic advances hold the potential to halt the progression of HCV infection and disease. While HCV-infected persons can be effectively treated, more effort is needed to screen, diagnosis, treat and provide continuity of care. This session of Public Health Grand Rounds will discuss how new screening guidelines, testing methods and therapeutic advances will provide us with an opportunity to improve individual outcomes and to eventually eliminate HCV infection.

To view the complete video recording of this and other CDC Public Health Grand Rounds sessions, visit http://www.cdc.gov/about/grand-rounds/

…

Host: Brian P. McDonough, MD, FAAFP

Dr. Brian McDonough interviews Dr. Kimberly Richter, a professor at University of Kansas Medical Center--Author of "Big Marijuana--Lessons from Big Tobacco" in the New England Journal of Medicine. The United States is divided over legalization of marijuana. Some of the points discussed include individual rights, tax revenue, medical effects, and social benefits and costs of marijuana legalization.

Host: Alicia A. Sutton

Host Alicia Sutton is joined by Chitra Subramaniam, Ph.D., Assistant Dean and Director for Continuing Medical Education at Duke University's Clinical Research Institute. Dr. Subramaniam is also Assistant Dean at the Duke Center for Educational Excellence. She describes several initiatives being undertaken at her academic setting to drive forward quality improvement in clinical education with innovative practice models.

Host: Matt Birnholz, MD

Dr. Andrew Wagner, Associate Professor of Obstetrics and Gynecology at the University of Oklahoma Health Sciences Center, joins host Dr. Matt Birnholz to discuss the roles of the OB/GYN as both primary care providers and specialists in screening, diagnosing, and treating hereditary cancer syndromes in women. Their discussion covers cancers of the breast, ovaries, endometrium and cervix, as well as related heriditary conditions such as Lynch Syndrome.

Host: Mimi Secor, DNP, FNP-BC, FAANP

Guest: Helen Carcio, NP

Mimi Secor is joined by Nurse practitioner Helen Carcio, Associate Professor in the Graduate School of Nursing at the University of Massachusetts in Amherst. Director of the Health and Continence Institute in South Deerfield, Massachusetts. Ms. Carcio trains doctors and advanced practice clinicians in how to set up community based continence centers.

This week, Mark and Margaret speak with Dr. Wendy Everett, CEO of the Network for Excellence in Health Innovation (NEHI). With a breadth of health care experience spanning several decades, Dr. Everett's vision for NEHI since its founding in 2002 has been to create an independent, research-based organization convening diverse members of the health care industry to achieve the common goal of addressing the most urgent health care issues. Under her leadership, this vision has resulted in ground breaking research on medical innovation, patient safety, health care spending and health care information technology, and has influenced significant national policy changes. Dr. Everett works with public and private policymakers to translate NEHI's research findings into long-term solutions that improve health care quality and lower health care costs.

Host: Matt Birnholz, MD

"We are what our parents and grandparents ate, and how they lived," says Dr. Mark Hanson, Director of the Academic Unit of Human Development and Health at the University of Southhampton in the United Kingdom. This chilling but increasingly recognized prospect concerning intergenerational passsages of disease risk helped found the Developmental Origins of Health and Disease (DOHaD) study, a worldwide collaboration aimed at better understanding environmental to genetic determinants of health across multiple generations. In this discussion with host Dr. Matt Birnholz, Dr. Hanson highlights the science behind broadening our scope of individualized care to include both past and future generations of each patient.

Host: John J. Russell, MD

Author and journalist Molly Caldwell Crosby joins host Dr. John Russell to discuss her second book, Asleep: The Forgotten Epidemic that Remains One of Medicine's Greatest Mysteries. Asleep is another fascnating look into medical history. In the 1920s and '30s, a team of neurologists investigated a rare but disturbing group of patients spread across various hospitals and insane asylums to try to solve the worldwide epidemic of encephalitis lethargica, or sleeping sickness.

Tune in and listen today!

Host: Brian P. McDonough, MD, FAAFP

Dr. Brian McDonough is joined by Torpey White, Director of the Governance, Risk and Compliance Group. Their discussion will focus on compliance, as well as how to utilize electronic technology in order to benefit your patients. Mr. White will also touch on the HIPAA privacy rule, accepting credit card payments from patients, and how to securely handle patient data. He will also share his opinion on how physicians can protect their practices, as well as their patients' confidential information.

Host: Matt Birnholz, MD

Tuberculosis is an ancient disease that remains an important global cause of morbidity and mortality. In most cases, TB can be treated and cured by taking a combination of several drugs for 6 to 12 months. When inappropriate or incomplete treatment takes place, however, TB bacteria can develop multidrug resistance (MDR). Annually, there are approximately 500,000 cases of MDR TB, and 150,000 deaths. Although there are simple rapid tests that have improved the diagnosis of the disease, there is immense potential to increase the number of persons diagnosed with MDR TB, and to do so more quickly to initiate treatment sooner.

This session of CDC′s Public Health Grand Rounds will explore how more patients can benefit from advances in diagnostic and treatment options, resulting in an overall reduction in morbidity from MDR TB. The role of CDC, WHO and other partners in combating this public health epidemic will also be discussed.

To view the complete video recording of this and other CDC Public Health Grand Rounds sessions, visit http://www.cdc.gov/about/grand-rounds/

Host: Paul Rokuskie

For some time, serotonin and vitamin D have been proposed to play a role in autism, but until recently no causal mechanism has ever been established. Autism researchers Dr. Bruce Ames and Dr. Rhonda Patrick of Children's Hospital Oakland Research Institute (CHORI) join host Paul Rokuskie to discuss their study on the demonstrated impact of Vitamin D on social behavior associated with Autism Spectrum Disorder (ASD). Their research implicates vitamin D as an activator of serotonin, oxytocin, and vasopressin, three brain hormones that affect social behavior related to autism.

Host: John J. Russell, MD

A horrifying epidemic of smallpox was sweeping across North America when the War of Independence began, and until now we have known almost nothing about it. Author Elizabeth A. Fenn is the first historian to reveal how deeply Variola affected the outcome of the war in every colony and the lives of everyone on the continent. Join Dr. John Russell in exploring Fenn's innovative work, which brings to light how this megatragedy was met and what its consequences were for the young republic.

Host: John J. Russell, MD

When the next pandemic arrives, what will it look like? From which innocent host animal will it emerge? Will we be ready? Addressing these and other questions is David Quammen, author of Spillover: Animal Infections and the Next Human Pandemic. Mr. Quammen's book illuminates the origins and dynamics of Ebola, SARS, bird flu, Lyme disease, and other emerging threats.

Host: John J. Russell, MD

At the turn of the last century, a powerful smallpox epidemic swept the United States from coast to coast. The age-old disease spread swiftly through an increasingly interconnected American landscape: from southern tobacco plantations to the dense immigrant neighborhoods of northern cities to far-flung villages on the edges of the nascent American empire. In Pox, award-winning historian Michael Willrich offers a gripping chronicle of how the nation's continentwide fight against smallpox launched one of the most important civil liberties struggles of the twentieth century.

Host: John J. Russell, MD

In his book, The Wildlife of Our Bodies, biologist Rob Dunn from the Department of Biology at North Carolina State University opines that while "clean living" has benefited us in some ways, it has also made us sicker in others. We are trapped in bodies that evolved to deal with the dependable presence of hundreds of other species. As Dunn reveals, our modern disconnect from the web of life has resulted in unprecedented effects that immunologists, evolutionary biologists, psychologists, and other scientists are only beginning to understand.

Host: Alan S. Brown, MD, FACC, FAHA, FNLA

Is there a patient age at which statin therapy should be discontinued? Likewise, what does the current evidence tell us about initiating vs not initiating statin therapy in older patients? Joining Lipid Luminations to discuss these and other important questions is Dr. W. Virgil Brown, Charles Howard Candler Professor of Medicine Emeritus at Emory University School of Medicine in Atlanta, Georgia.

Host: Alan S. Brown, MD, FACC, FAHA, FNLA

Joining host Dr. Alan Brown is Dr. John Guyton, Associate Professor of Medicine and Assistant Professor of Pathology of the Division of Medicine-Endocrinology and Metabolism at Duke University School of Medicine. Their discussion will focus on data and results from HPS-2 THRIVE, a large-scale study comparing the use of statins and niacin versus statins alone. THRIVE stands for the Treatment of HDL to Reduce the Incidence of Vascular Events.

This week, Mark and Margaret speak with Jack Andraka, 16 year old winner of last year's Intel Science and Engineering First Prize. Mr. Andraka has been nicamed the "Teen Prodigy of Pancreatic Cancer" by the Smithsonian for the device he created for early detection of pancreatic, ovarian and lung cancer. It's cheap, fast and accurate in numerous blind tests. He has been awarded by the White House, the Vatican, and the Royal College of Physicians, and he was deemed by his Lab Mentor at Johns Hopkins as the "Thomas Edison of our times."

Host: John J. Russell, MD

In 1998 Andrew Wakefield, a British gastroenterologist with a history of self-promotion, published a paper with a shocking allegation: the measles-mumps-rubella vaccine might cause autism. The media seized hold of the story and, in the process, helped to launch one of the most devastating health scares ever. Yet despite the numerous studies that failed to find any link between childhood vaccines and autism, it has since been popularized by media personalities, and declining vaccination rates have led to outbreaks of deadly illnesses like Hib, measles, and whooping cough. In The Panic Virus: The True Story Behind the Vaccine-Autism Controversy, author Seth Mnookin draws on interviews with parents, public-health advocates, scientists, and anti-vaccine activists to tackle a fundamental question: How do we decide what the truth is?

Host: John J. Russell, MD

500,000 Americans died over a 6 week period; is this the latest thriller from Hollywood, or a piece of American history? Joining host Dr. John Russell to elaborate is Gina Kolata, acclaimed reporter for The New York Times and author of Flu:The Story Of The Great Influenza Pandemic of 1918 and the Search for the Virus that Caused It. In Flu, Ms. Kolata unravels the mystery of this lethal virus. From Alaska to Norway, from the streets of Hong Kong to the corridors of the White House, Kolata tracks the race to recover the live pathogen and probes the fear that has impelled government policy ever since. A gripping work of science writing, Flu addresses the prospects for a great epidemic's recurrence and considers what can be done to prevent it.

Host: Linda Bernstein, Pharm.D.

In this edition of The Pharmacy Report®, host Dr. Linda Bernstein spotlights type 1 diabetes and the new paradigms of research in disease detection, prevention and treatment. In the Movers and Shakers segment, Dr. Stephen E. Gitelman, M.D., Professor of Clinical Pediatrics and Chair of Pediatric Diabetes and Clinical Research at the University of California, San Francisco shares his fascinating path of discovery and research into this complex disease and how someday it could revolutionize therapeutic approaches for not just the patient, but at-risk family members as well.

References mentioned in this segment:

Diabetes Center, University of California, San Francisco
Centers for Disease Control and Prevention's 2013 Tips From Former Smokers campaign, including 1-800-QUIT NOW, a number that links callers to their state quitlines. The website is www.cdc.gov/tips and features information on the campaign, as well as information on how to quit smoking from the National Cancer Institute's www.smokefree.gov

Host: Alan S. Brown, MD, FACC, FAHA, FNLA

Speaking with host Dr. Alan Brown on the state of genetic testing for familial hypercholesterolemia (FH) is Dr. Joshua W. Knowles, MD, PhD, Instructor of Cardiovascular Medicine at Stanford University and Attending Physician of the Stanford Center for Inherited Cardiovascular Disease Familial Hypercholesterolemia (FH) Clinic.

Host: Linda Bernstein, Pharm.D.

In this premiere edition of The Pharmacy Report®, host Dr. Linda Bernstein focuses on the growing threat of antimicrobial drug resistance. Top news stories include the CDC's "Threat Report 2013," and FDA drug and new indication approval updates. In this week's Movers and Shakers segment, Joseph Guglielmo, PharmD, Dean of the UCSF School of Pharmacy and a clinical pharmacist specialist in infectious disease will address antimicrobial stewardship and the role of the physician and pharmacist in these multidisciplinary programs.

References mentioned in this segment:

Centers for Disease Control and Prevention:
Threat Report 2013 Antibioitic Resistance Threats in the United States, 2013
Antimicrobial stewardship guidelines Dellit TH, Owens RC, McGowan Jr JE, Gerding DN, Weinstein RA, Burke JP, Huskins WC, Paterson DL, Fishman NO, Carpenter CF, Brennan PJ, Billeter M, and Hooton TM. Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America Guidelines for Developing an Institutional Program to Enhance Antimicrobial Stewardship. Clin Infect Dis. 2007 Jan 15;44(2):159-77
IDSA REPORT: Bad Bugs, No Drugs: No ESKAPE! An Update from the Infectious Diseases Society of America Boucher HW, Talbot GH, Bradley JS, Edwards JE, Gilbert D, Rice LB, Scheld M, Spellberg B, …

Host: Alan S. Brown, MD, FACC, FAHA, FNLA

Postprandial hypertriglyceridemia occurs when the rapid absorption of dietary fat (in the form of chylomicron triglycerides) overwhelms the body's ability to clear plasma triglyceride. In its most severe form, postprandial hypertriglyceridemia can lead to chylomicronemia and a greatly increased risk of acute, life-threatening pancreatitis. Joining host Dr. Alan Brown to talk about this condition and a trial drug treatment in research and development is Dr. Dan Meyers, one of the top winners in the Abstracts Program of the National Lipid Association's Annual Scientific Sessions. Dr. Meyers is currently a Translational Medicine Expert with Novartis Institutes of Biomedical Research (NIBR) in Cambridge, MA. While at NIBR, he has designed and executed first-in-human, proof of concept, and mechanistic studies with novel compounds intended for the treatment of dyslipidemia, diabetes and related metabolic disease.

Host: Alan S. Brown, MD, FACC, FAHA, FNLA

Dr. Alan Brown is joined by Dr. Thomas Dayspring, Director of Cardiovascular Education for the Foundation for Health Improvement and Technology in Richmond, VA and clinical assistant professor of medicine at the UMDNJ - NJ Medical School. He is also a Fellow of both the American College of Physicians and the National Lipid Association. The two discuss Dr. Dayspring's research on discordances between LDL-P and ApoB, two biomarkers that are otherwise thought to correlate well with one another.

Host: Paul Rokuskie

Autism Spectrum Disorder is one of the greatest medical and social challenges facing not only the United States, but the entire world. As the medical community focuses resources on finding the causal factors for autism and delivering viable treatment options for patients, key specialists in translational neurobiology research are leading the charge. Dr. Robert Ring, Vice President and Head of Translational Research for Autism Speaks, the world's leading autism science and advocacy organization, speaks with host Paul Rokuskie about current advances in understanding, diagnosis, and treatment for this disorder.

Host: Alan S. Brown, MD, FACC, FAHA, FNLA

Dr. Alan Brown welcomes Dr. Daniel J. Rader, Cooper-McLure Professor of Medicine and Pharmacology and Chief of the Division of Translational Medicine and Human Genetics at the Perelman School of Medicine at the University of Pennsylvania. Their discussion focuses on the clinical diagnosis, genetic complexity and prevalence of HoFH while exploring the current and novel modalities available to help HoFH patients achieve their LDL goals.

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Host: Alan S. Brown, MD, FACC, FAHA, FNLA

Dr. Harold Bays, Chair for the National Lipid Association's expert panel on Adiposity, Obesity, and Dyslipidemia, discusses with host Dr. Alan Brown the panel's consensus statement published in the Journal of Clinical Lipidology.

Hosts Mark Masselli and Margaret Flinter from CHC's Conversations on Health Care program speak with Dr. William Newsome, Stanford University neurobiologist and co-chair of the President's BRAIN Initiative which is seeking to map the human brain. Similar to the Human Genome Project, the BRAIN Intiative will require significant collaboration from all varied fields within neuroscience to unravel the secrets of medical science's "final frontier" - the human brain.

Host: Peter S. Jensen, MD

What do we know about depression? And, what is going on at the level of the neuron? Traditional treatments have had impressive results in children with depression. But, why does efficacy of treatment vary in children? Host Dr. Peter Jensen welcomes Dr. Paul Croarkin, Assistant Professor of Psychiatry at Mayo Clinic, to answer these questions and discuss recent clinical trials, child and adolescent psychopharmacology and transcranial magnetic stimulation (TMS) and brain stimulation modalities.

Download and listen today!

Host: Brian P. McDonough, MD, FAAFP

Dr. Marcia Pelchat, physiological psychologist and Associate Member of the Monell Chemical Senses Center, discusses her research on the neuroscience and behavioral psychology of eating disorders, from picky eating to food addiction. She also describes current recovery methods for patients with recent-onset anosmia, or loss of the sense of smell.

Host: Peter S. Jensen, MD

Host Dr. Peter Jensen welcomes Dr. Martin Stein, Professor of Pediatrics at the University of California, San Diego, and Rady Children's Hospital, San Diego. Dr. Stein's academic interest has been the development of methods to incorporate concepts about child development and behavioral pediatrics into educational models, as well as the practice of primary care pediatrics. In this program, Dr. Stein will review the most commonly used stimulants in treating ADHD and how to best manage manage their side effects, specifically weight loss, weight gain, headaches, and sleep onset problems.

Please email all questions and comments to info@reachmd.com.

Host: Alan S. Brown, MD, FACC, FAHA, FNLA

Joining Dr. Alan Brown is Revathi Balakrishnan, MD, MPH, a general cardiology fellow at NYU and winner of the NLA Young Investigator Competition. Dr. Balakrishnan's research, titled "Prevalence of unrecognized prediabetes, diabetes and metabolic syndrome in patients undergoing non-urgent PCI," found that nearly 1 out of every 10 patients admitted to the NYU cardiac catheterization lab had diabetic hemoglobin A1c levels (6.5 and over) without a prior diagnosis of diabetes. An even larger proportion had prediabetes (57%) and metabolic syndrome (54%). Put another way, only 30% of the patients undergoing PCI had a normal glycemic status on admission. Drs. Balakrishnan and Brown reflect on these concerning results and discuss the need for a call to action among preventive cardiologists.

Guest: Robert C. Young, MD

Host: Matt Birnholz, MD

The American Society of Clinical Oncology (ASCO) Conference brings over 30,000 people each year and has a membership of over 33,000, a third of which are international. Discussing important clinical research updates unveiled at this event by scientists from across the world is Dr. Robert C. Young, President of RCY Medicine in Philadelphia and past-President of ASCO. Dr. Young was also awarded ASCO's Distinguished Service Award for Scientific Leadership in 2004.

Host: Alan S. Brown, MD, FACC, FAHA, FNLA

There may be something unique about the avocado, far beyond its monosaturated fat content. Li Wang, graduate student at Penn State University and winner of the NLA Young Investigator Award, investigated this notion with a clinical study monitoring the effects of eating one avocado every day on risk factors for cardiovascular disease compared to a similar moderate fat diet without avocados, an average American diet, and a low-fat diet. Tune in for this discussion revealing her thought-provoking findings.

Host: Alan S. Brown, MD, FACC, FAHA, FNLA

Host Dr. Alan Brown is joined by David Tehrani, MS, a medical student at the University of California - Irvine School of Medicine and winner of the NLA's Young Investigator Competition for his research into the negative impact of inflammation on HDL's known cardioprotective effects. Tune in for new understandings on HDL and the inflammatory biomarkers attenuating its protective functions.

Host: Peter S. Jensen, MD

Host Dr. Peter Jensen welcomes Dr. Christopher Wall, a pediatric and adolescent psychiatrist from the Mayo Clinic, to discuss pediatric mood disorders. Dr. Wall shares his research on the topic of pharmacogenomic utility in pediatric psychopharmacology, as well as his collaboration in the development of a pediatric bipolar disorder biobank that adds to the understanding of this complex mood illness.

Download and listen in on this engaging conversation!

Guest: Mark D. Williams, MD

Host: Peter S. Jensen, MD

Dr. Mark Williams is a psychiatrist at the Mayo Clinic, as well as, a leader and innovator in helping primary care systems get up to speed in providing state-of-the-art mental health services in primary care. Dr. Williams speaks with host Dr. Peter Jensen on the revolutionary changes in practice as primary care providers collaborate with psychiatrists to deliver more mental health services.

Download and listen today!

Host: Matt Birnholz, MD

This session of Grand Rounds explores the burden of human papillomavirus (HPV) -associated cancer and disease in the United States and prevention through HPV vaccination. Each year, there are an estimated 26,000 HPV-attributable cancers in the United States. About 17,000 occur in women, most of which are cervical cancers, and about 9,000 occur in men, most of which are oropharyngeal cancers. CDC estimates that $8 billion are spent each year on direct medical costs for preventing and treating HPV-associated disease.

This session provides more insight about the HPV vaccination program and how CDC, state and local health departments, and health care providers are working together to achieve high vaccination levels and reduce the substantial burden of HPV-associated disease.

This is Part 3 of a lecture in three parts.

Part 1 >>

Part 2 >>

To view the complete video recording of this and other CDC Public Health Grand Rounds sessions, visit http://www.cdc.gov/about/grand-rounds/

Host: Matt Birnholz, MD

This session of Grand Rounds explores the burden of human papillomavirus (HPV) -associated cancer and disease in the United States and prevention through HPV vaccination. Each year, there are an estimated 26,000 HPV-attributable cancers in the United States. About 17,000 occur in women, most of which are cervical cancers, and about 9,000 occur in men, most of which are oropharyngeal cancers. CDC estimates that $8 billion are spent each year on direct medical costs for preventing and treating HPV-associated disease.

This session provides more insight about the HPV vaccination program and how CDC, state and local health departments, and health care providers are working together to achieve high vaccination levels and reduce the substantial burden of HPV-associated disease.

This is Part 2 of a lecture in three parts.

Part 1 >>

Part 3 >>

To view the complete video recording of this and other CDC Public Health Grand Rounds sessions, visit http://www.cdc.gov/about/grand-rounds/

Host: Matt Birnholz, MD

This session of Grand Rounds explores the burden of human papillomavirus (HPV) -associated cancer and disease in the United States and prevention through HPV vaccination. Each year, there are an estimated 26,000 HPV-attributable cancers in the United States. About 17,000 occur in women, most of which are cervical cancers, and about 9,000 occur in men, most of which are oropharyngeal cancers. CDC estimates that $8 billion are spent each year on direct medical costs for preventing and treating HPV-associated disease.

This session provides more insight about the HPV vaccination program and how CDC, state and local health departments, and health care providers are working together to achieve high vaccination levels and reduce the substantial burden of HPV-associated disease.

This is Part 1 of a lecture in three parts.

Part 2 >>

Part 3 >>

To view the complete video recording of this and other CDC Public Health Grand Rounds sessions, visit http://www.cdc.gov/about/grand-rounds/

Guest: Shelly Batra, MD

Host: Maurice Pickard, MD

Multidrug Resistant (MDR) Tuberculosis is a growing public health epidemic in India. Experts estimate there could easily be over 5 million cases of MDR TB at present, with each untreated patient capable of spreading the disease to 10-15 others per year. The non-profit organization Operation ASHA has expanded its role considerably over the past few years to stem this tide of TB transmission from the poorest to the most prosperous communities, bringing innovative treatment protocols right to the patients' doorsteps. Dr. Shelly Batra, president of Operation ASHA, discusses the progress being made in this increasingly global public health campaign. Hosted by Dr. Maurice Pickard.

Guest: Linda D. Bradley, MD

Host: Brian P. McDonough, MD, FAAFP

Dr. Brian McDonough is joined by Dr. Linda Bradley, Professor of Surgery and Vice Chair of the Department of Obstetrics and Gynecology at the Women's Health Institute of the Cleveland Clinic, for a discussion on abnormal uterine bleeding. Topics of note include evaluation and treatment strategies, alternatives to hysterectomy, and office-based procedures to aid in the pre-operative workup for patients with this condition.

Guest: Shelly Batra, MD

Host: Maurice Pickard, MD

Multidrug Resistant (MDR) Tuberculosis is a growing public health epidemic in India. The non-profit organization Operation ASHA has expanded its role considerably over the past few years to stem this tide of TB transmission within both the poorest and the most prosperous communities, bringing innovative treatment protocols right to the patients' doorsteps. Dr. Shelly Batra, president of Operation ASHA, discusses the progress being made in this increasingly global public health campaign. Hosted by Dr. Maurice Pickard.

Host: Matt Birnholz, MD

This session of Grand Rounds Nation is provided by the American College of Osteopathic Family Physicians (ACOFP), and features Dr. Robert Hasty speaking on anticoagulation therapy guidelines for nonvalvular atrial fibrillation. Topics explored in depth include first vs second line drug regimens, updates on "golden windows" for initiating therapies, and effective risk stratification methods in practice.

Host: Matt Birnholz, MD

This session of Grand Rounds Nation is provided by the American College of Osteopathic Family Physicians (ACOFP), and features Dr. Robert Hasty speaking on anticoagulation therapy guidelines for nonvalvular atrial fibrillation. Topics explored in depth include first vs second line drug regimens, updates on "golden windows" for initiating therapies, and effective risk stratification methods in practice.

Host: Matt Birnholz, MD

This session of Grand Rounds Nation is provided by the American College of Osteopathic Family Physicians (ACOFP), and features Dr. Robert Hasty speaking on anticoagulation therapy guidelines for nonvalvular atrial fibrillation. Topics explored in depth include first vs second line drug regimens, updates on "golden windows" for initiating therapies, and effective risk stratification methods in practice.

Host: Matt Birnholz, MD

This session of Grand Rounds Nation is provided by the American College of Osteopathic Family Physicians (ACOFP), and features Dr. Anthony Brown, clinical assistant professor of medicine at the University of Medicine and Dentistry of New Jersey.

This is Part 3 of a lecture in three parts.

Part 1 >>

Part 2 >>

Host: Matt Birnholz, MD

This session of Grand Rounds Nation is provided by the American College of Osteopathic Family Physicians (ACOFP), and features Dr. Anthony Brown, clinical assistant professor of medicine at the University of Medicine and Dentistry of New Jersey.

This is Part 2 of a lecture in three parts.

Part 1 >>

Part 3 >>

Host: Matt Birnholz, MD

This session of Grand Rounds Nation is provided by the American College of Osteopathic Family Physicians (ACOFP), and features Dr. Anthony Brown, clinical assistant professor of medicine at the University of Medicine and Dentistry of New Jersey.

This is Part 1 of a lecture in three parts.

Part 2 >>

Part 3 >>

Host: Matt Birnholz, MD

This session of Grand Rounds Nation is provided by the American College of Osteopathic Family Physicians (ACOFP), and features Dr. Susan Zito, DO, MPH. Dr. Zito is a faculty physician at the Largo Medical Center in Largo, Florida.

This is Part 2 of a lecture in two parts.

Part 1 >>

Host: Matt Birnholz, MD

This session of Grand Rounds Nation is provided by the American College of Osteopathic Family Physicians (ACOFP), and features Dr. Susan Zito, DO, MPH. Dr. Zito is a faculty physician at the Largo Medical Center in Largo, Florida.

This is Part 1 of a lecture in two parts.

Part 2 >>

Host: Brian P. McDonough, MD, FAAFP

Guest: Mark Moyad, MD, MPH

This discussion focuses on the current state of evidence behind vitamins, herbs, and supplements in popular demand. What does the latest research recommend for use, and what should we be avoiding? Featured is Dr. Mark Moyad, the Jenkins/Pokempner Director of Preventive & Complementary Medicine at the University of Michigan Medical Center. Dr, Brian McDonough hosts.

Guest: Benjamin J. Ansell, MD, FACC, FACP, FNLA

Host: Alan S. Brown, MD, FACC, FAHA, FNLA

Host Dr. Alan Brown welcomes Benjamin Ansell, MD, professor of medicine and cardiology at University of Califronia at Los Angeles, CA and co-director of the Cholesterol and Hypertension Management Program at UCLA. Dr. Ansell reviews the latest trials: dal-OUTCOMES and AIM-HIGH. Dr. Ansell will address the objectives and study designs of both studies and explain why the studies were stopped early. Drs. Brown and Ansell also discuss the future of HDL therapy.

Brought to you by:

Host: Alan S. Brown, MD, FACC, FAHA, FNLA

Guest: Jerome D. Cohen, MD

Statins play a critical role in reducing the risk of heart disease. Not only are the benefits greatly appreciated by both physicians and patients, the majority of statins are also well tolerated. Despite this, many patients discontinue statin therapy against medical advice, oftentimes without notifying their doctors. For this reason, the National Lipid Association embarked on a study that used internet surveys to determine why patients discontinue their statins. This was called the USAGE Study, and its results are the subject of this discussion. Host, Dr. Alan Brown welcomes Dr. Jerome Cohen, emeritus professor of Internal Medicine at St. Louis University School of Medicine.

For more information on the USAGE survey, including resources for patients and healthcare providers, please visit the USAGE website at www.StatinUSAGE.com.

Host: Matt Birnholz, MD

This Presidential Plenary Scientific Session of the American College of Medical Genetics and Genomics (ACMG) is titled "The Coming Revolution in Medical Genetics: From Double Helix to Genomics and Back Again." Speaking is Dr. Wayne W. Grody, President of the ACMG and Professor in the Departments of Pathology & Laboratory Medicine, Pediatrics, and Human Genetics at the UCLA School of Medicine.

Host: Matt Birnholz, MD

This Prova Education program, presented by Deborah O'Connor PhD, RD, Professor of Pediatrics at the University of Toronto and Director of Clinical Dietetics at The Hospital for Sick Children, has been developed from the May 2011 live meeting in Denver, CO, A Month in the Life: Achieving Recommended Nutritional Status in Preterm, Low Birth Weight Infants Before, During and Beyond Hospital Discharge.

This program discusses preterm infant nutritional needs beginning at the NICU, the complexities of ensuring good nutritional status, and monitoring care through the transition to home and community settings. Through a review of new evidence-based information, physicians can apply practices that will support nutrition decisions for pre-term and low birth weight infants upon admittance to the NICU and continue through transitions.

Host: Matt Birnholz, MD

Guest: Michael Lewiecki, MD, FACP, FACE

Anyone in medicine will freely admit that osteoporosis is a major health threat in the United States, and yet the majority of patients with osteoporosis remain undiagnosed and untreated. In fact, fewer than one-third of cases have even been diagnosed, and only 14% of women with osteoporosis receive treatment. This comes in stark contrast to the fact that more than 50% of women over age 50 will encounter an osteoporosis-related fracture. So what can the healthcare community do in the face of those odds? Addressing this issue is Dr. Michael Lewiecki, Osteoporosis Director at the New Mexico Clinical Research and Osteoporosis Center. He's also Clinical Assistant Professor of Medicine at the University of New Mexico School of Medicine. Dr. Matt Birnholz hosts.

Host: Matt Birnholz, MD

This Prova Education program, presented by Jae H. Kim, MD, PhD, Assistant Professor of Pediatrics at University of California, San Diego, has been developed from the May 2011 live meeting in Denver, CO, A Month in the Life: Achieving Recommended Nutritional Status in Preterm, Low Birth Weight Infants Before, During and Beyond Hospital Discharge.

This program discusses preterm infant nutritional needs beginning at the NICU, the complexities of ensuring good nutritional status, and monitoring care through the transition to home and community settings. Through a review of new evidence-based information, physicians can apply practices that will support nutrition decisions for pre-term and low birth weight infants upon admittance to the NICU and continue through transitions.

Host: Matt Birnholz, MD

National organizations such as the American Cancer Society and the American College of Obstetricians and Gynecology have published updated guidelines for cervical cancer screening. Crucial variations in these guidelines make implementing a sound, effective clinical protocol for management of gynecologic screening and treatment a challenge; and it is imperative that women's healthcare providers have a thorough understanding of clinical implications.

This Omnia Education program is presented by Dr. Thomas C. Wright, Jr., MD, Professor of Pathology at Columbia University College of Physicians and Surgeons.

Host: Matt Birnholz, MD

This Prova Education program, presented by Eyla G. Boies, MD, FAAP, FABM, Clinical Professor of Pediatrics at University of California, San Diego, has been developed from the May 2011 live meeting in Denver, CO, A Month in the Life: Achieving Recommended Nutritional Status in Preterm, Low Birth Weight Infants Before, During and Beyond Hospital Discharge.

This program discusses preterm infant nutritional needs beginning at the NICU, the complexities of ensuring good nutritional status, and monitoring care through the transition to home and community settings. Through a review of new evidence-based information, physicians can apply practices that will support nutrition decisions for pre-term and low birth weight infants upon admittance to the NICU and continue through transitions.

Host: Matt Birnholz, MD

Traumatic brain injury, or TBI, is a serious public health problem that affects approximately 1.7 million Americans every year. Of all injury deaths in our country, one in three cases are TBI-related, and an estimated 5.3 million Americans are living with a TBI-related disability. Beyond the potential for impairment to the cognitive, sensory, and motor functions in an individual, the economic burden of TBI is in excess of $76.5 billion. While significant advances in early treatment and prevention policies such as seat belt and motorcycle helmet laws have proven successful in reducing severe cases of TBI, many public health challenges remain. In addition to the economic impact of TBI, there is need for better surveillance, data, and coordination among the medical, public health and community sectors on both the civilian and military sides of the aisle.

This session of CDC′s Public Health Grand Rounds further addressed these challenges and explored promising policies, guidelines, and interventions such as progesterone treatments to further reduce the severity and number of cases of traumatic brain injury in the U.S.

This is Part 3 of a lecture in three parts.

Part 1 >>

Part 2 >>

To view the complete video recording of …

Host: Matt Birnholz, MD

Traumatic brain injury, or TBI, is a serious public health problem that affects approximately 1.7 million Americans every year. Of all injury deaths in our country, one in three cases are TBI-related, and an estimated 5.3 million Americans are living with a TBI-related disability. Beyond the potential for impairment to the cognitive, sensory, and motor functions in an individual, the economic burden of TBI is in excess of $76.5 billion. While significant advances in early treatment and prevention policies such as seat belt and motorcycle helmet laws have proven successful in reducing severe cases of TBI, many public health challenges remain. In addition to the economic impact of TBI, there is need for better surveillance, data, and coordination among the medical, public health and community sectors on both the civilian and military sides of the aisle.

This session of CDC′s Public Health Grand Rounds further addressed these challenges and explored promising policies, guidelines, and interventions such as progesterone treatments to further reduce the severity and number of cases of traumatic brain injury in the U.S.

This is Part 2 of a lecture in three parts.

Part 1 >>

Part 3 >>

To view the complete video recording of …

Host: Matt Birnholz, MD

Traumatic brain injury, or TBI, is a serious public health problem that affects approximately 1.7 million Americans every year. Of all injury deaths in our country, one in three cases are TBI-related, and an estimated 5.3 million Americans are living with a TBI-related disability. Beyond the potential for impairment to the cognitive, sensory, and motor functions in an individual, the economic burden of TBI is in excess of $76.5 billion. While significant advances in early treatment and prevention policies such as seat belt and motorcycle helmet laws have proven successful in reducing severe cases of TBI, many public health challenges remain. In addition to the economic impact of TBI, there is need for better surveillance, data, and coordination among the medical, public health and community sectors on both the civilian and military sides of the aisle.

This session of CDC′s Public Health Grand Rounds further addressed these challenges and explored promising policies, guidelines, and interventions such as progesterone treatments to further reduce the severity and number of cases of traumatic brain injury in the U.S.

This is Part 1 of a lecture in three parts.

Part 2 >>

Part 3 >>

To view the complete video recording of …

Host: Matt Birnholz, MD

Current Guidelines conclude that enlisting greater numbers of primary care clinicians to improve access to quality care will help people gain control of their asthma and allergy, thusly improving patients' quality of life. This activity was developed based on the current recommendations and guidelines issued by national organizations, and is designated to close gaps in knowledge, awareness, attitudes, and decision-making patterns related to the treatment and referral of patients with asthma and allergy.

Presenting this Prova Education Live Event is Dr. Michael Wechsler, Assistant Professor of Medicine at Harvard Medical School and Associate Director of the Brigham and Women's Hospital Asthma Research Center.

This is Part 2 of a lecture in two parts.

Part 1 >>

To view the complete video recording of this and other Prova Education Live Events, visit http://www.provaeducation.com

And to download a copy of the American Lung Association's "Asthma Action Plan" referenced in this program, visit http://www.lungusa.org/lung-disease/asthma/living-with-asthma/take-control-of-your-asthma/asthma-action-plan.html

Host: Matt Birnholz, MD

Current Guidelines conclude that enlisting greater numbers of primary care clinicians to improve access to quality care will help people gain control of their asthma and allergy, thusly improving patients' quality of life. This activity was developed based on the current recommendations and guidelines issued by national organizations, and is designated to close gaps in knowledge, awareness, attitudes, and decision-making patterns related to the treatment and referral of patients with asthma and allergy.

Presenting this Prova Education Live Event is Dr. Michael Wechsler, Assistant Professor of Medicine at Harvard Medical School and Associate Director of the Brigham and Women's Hospital Asthma Research Center.

This is Part 1 of a lecture in two parts.

Part 2 >>

To view the complete video recording of this and other Prova Education Live Events, visit http://www.provaeducation.com

And to download a copy of the American Lung Association's "Asthma Action Plan" referenced in this program, visit http://www.lungusa.org/lung-disease/asthma/living-with-asthma/take-control-of-your-asthma/asthma-action-plan.html

Guest: Shellie Williams, MD

Guest: Reed Tuckson, MD

Host: Matt Birnholz, MD

Host: Michael Greenberg, MD

Currently more than 5.4 million Americans are living with Alzheimer's disease, a number that could triple by 2050 unless advances are made in early detection, treatments and prevention. Second Opinion Live hosts Dr. Michael Greenberg and Dr. Matt Birnholz discuss the many benefits for patients who receive an early diagnosis of Alzheimer's disease, one of which is the ability to participate in a clinical trial, with guest Dr. Shellie Williams from The University of Chicago Medical Center and the Alzheimer's Association.

Our Second Opinion Live hosts also discuss the latest national survey on the state of American Health with Dr. Reed Tuckson from the United Health Foundation.

Broadcast Funding for this program was provided in part by the Alzheimer's Association and its free nation-wide Alzheimer's clinical trials matching service - TrialMatchTM.

Guest: Michael H. Davidson, MD

Host: Alan S. Brown, MD, FACC, FAHA, FNLA

Is there a difference between biomarker cardiovascular risk assessment for broad population studies vs the role in personalized medicine? And, in individual patients, if a difference is found between the Framingham score and the biomarker risk assessment, which is more likely to correctly predict risk? Host Dr. Alan Brown talks with Dr. Michael Davidson, director of preventive cardiology and associate vice chairman for continuing medical education at the University of Chicago, about the role of biomarkers in improving cardiovascular risk prediction and guiding treatment, compared to traditional risk factor assessment.

Host: Anthony Alessi, MD

Guest: Jeffrey Kutcher, MD

Most athletes' concussions are not the result of the kind of hits that NFL players take, but they still need to be taken very seriously. The American Academy of Neurology now recommends all athletes suspected of a concussion be removed from the field immediately. Dr. Jeffrey Kutcher, director of Michigan NeuroSport, the sports neurology program at the University of Michigan and chair of the American Academy of Neurology's sports neurology section, joins host Dr. Anthony Alessi to discuss changes in neurologists' philosophy toward concussion, who the new guidelines are aimed at and how to reach them, and what treatment will be like in the future.

Host: Anthony Alessi, MD

Guest: Lisa Shulman

Would it be better for Parkinson's patients to meet with their doctor in a group setting? Group visits are among the the novel approaches being studied for Parkinson's patients. Dr. Lisa Shulman, professor of neurology and co-director of the Maryland Parkinson's Disease and Movement Disorders Center in Baltimore, joins host Dr. Anthony Alessi to discuss who might benefit from group visits, how it compares to traditional care, and the practical billing issues involved. They also discuss new research on treadmill walking in the treatment of patients with Parkinson's disease.

Host: Lee Freedman, MD

Guest: Neil Malhotra, MD

How much do quality improvement efforts improve quality of life for neurosurgical patients? Host Dr. Lee Freedman talks to Dr. Neil Malhotra, assistant professor of neurosurgery at the University of Pennsylvania and the Penn Neurological Institute of the Pennsylvania Hospital, about new efforts to improve outcomes in this area. They also look at latest treatments and techniques in Dr. Malhotra's area of surgical expertise, the treatment of degenerative disc disease.

Host: Matt Birnholz, MD

ReachMD, in cooperation with HealthDay, Presents Conference Coverage of the 71st Annual Meeting of the American Diabetes Association, held from June 24 to 28 in San Diego.

This year's meeting attracted more than 14,000 participants from around the world, including scientists, physicians, and other health care professionals. The conference highlighted the latest advances in diabetes research and improving patient care, with presentations focusing on treatment recommendations and advances toward a cure for diabetes.

Host: Matt Birnholz, MD

Presenting this session of Grand Rounds is Dr. Gordon Ewy, professor and chief of cardiology at the University of Arizona College of Medicine.

To view the complete video recording of this and other Grand Rounds sessions from the University of Arizona College of Medicine, visit their website.

Host: Matt Birnholz, MD

Presenting this session of Grand Rounds is Dr. Gordon Ewy, professor and chief of cardiology at the University of Arizona College of Medicine.

To view the complete video recording of this and other Grand Rounds sessions from the University of Arizona College of Medicine, visit their website.

Host: Matt Birnholz, MD

Presenting this session of Grand Rounds is Dr. Gordon Ewy, professor and chief of cardiology at the University of Arizona College of Medicine.

To view the complete video recording of this and other Grand Rounds sessions from the University of Arizona College of Medicine, visit their website.

Guest: Aaron Kowalski, PhD

Host: Timothy Bailey, MD

The artificial pancreas project lead by the Juvenile Diabetes Research Foundation has made tremendous progress towards eventual outpatient clinical studies. A recent panel of experts met with the FDA and NIH to determine appropriate guidelines. What are regulatory guidelines for the artificial pancreas project? Join guest host Dr. Timothy Bailey and his guest, Assistant Vice President and Director of Glucose Control Research at the Juvenile Diabetes Research Foundation, Dr. Aaron Kowalski as they discuss developments from controlled inpatient settings to real-world conditions and the need for regulation.

Host: Matt Birnholz, MD

ReachMD, in cooperation with HealthDay, Presents Conference Coverage of the 47th annual meeting of the American Society of Clinical Oncology, held from June 3 to 7 in Chicago.

This year's meeting attracted more than 30,000 participants from around the world, including scientists, physicians, and allied health professionals. The conference featured the latest advances in clinical cancer research, with presentations focusing on patient and survivor care. Topics covered in presentations included cancer-related complications, quality-of-life management, and end-of-life care.

Host: Matt Birnholz, MD

ReachMD, in cooperation with HealthDay, Presents Conference Coverage of the 164th Annual Meeting of the American Psychiatric Association, held from May 14-18 in Honolulu.

This year's meeting attracted over 8,000 participants from around the world. The conference highlighted recent advances in the prevention, detection, and treatment of psychiatric conditions, with presentations focusing on mental illnesses, including substance use disorders.

Host: Matt Birnholz, MD

Lyme disease is one of the most rapidly emerging infectious diseases in North America and Europe. In 2009, nearly 30,000 confirmed and more than 8,500 probable cases of Lyme disease were reported to the CDC in the United States alone. Named after a small Connecticut town, Lyme disease is transmitted to humans by the bite of ticks infected with the bacterium Borrelia burgdorferi. This multi-system infection typically occurs in stages with different clinical manifestations at each stage. While it can be treated effectively with antibiotics, in some cases recovery may be incomplete - although there is no evidence that any of these post-Lyme disease syndromes respond to further courses of antibiotic therapy.

Dr. Allen Steere, the renowned discoverer of Lyme disease, joins an esteemed panel of speakers for CDC's Public Health Grand Rounds to explore the clinical manifestations and treatment of Lyme disease, innovations in laboratory testing, prevention strategies, and national trends of disease emergence. The session gives a rare glimpse into the front lines of those battling and treating Lyme disease while addressing the data gaps, unmet needs, and overall challenges and opportunities for its prevention and control.

This is Part 3 of a lecture in three parts.

Host: Matt Birnholz, MD

Lyme disease is one of the most rapidly emerging infectious diseases in North America and Europe. In 2009, nearly 30,000 confirmed and more than 8,500 probable cases of Lyme disease were reported to the CDC in the United States alone. Named after a small Connecticut town, Lyme disease is transmitted to humans by the bite of ticks infected with the bacterium Borrelia burgdorferi. This multi-system infection typically occurs in stages with different clinical manifestations at each stage. While it can be treated effectively with antibiotics, in some cases recovery may be incomplete - although there is no evidence that any of these post-Lyme disease syndromes respond to further courses of antibiotic therapy.

Dr. Allen Steere, the renowned discoverer of Lyme disease, joins an esteemed panel of speakers for CDC's Public Health Grand Rounds to explore the clinical manifestations and treatment of Lyme disease, innovations in laboratory testing, prevention strategies, and national trends of disease emergence. The session gives a rare glimpse into the front lines of those battling and treating Lyme disease while addressing the data gaps, unmet needs, and overall challenges and opportunities for its prevention and control.

This is Part 2 of a lecture in three parts.

Host: Matt Birnholz, MD

Lyme disease is one of the most rapidly emerging infectious diseases in North America and Europe. In 2009, nearly 30,000 confirmed and more than 8,500 probable cases of Lyme disease were reported to the CDC in the United States alone. Named after a small Connecticut town, Lyme disease is transmitted to humans by the bite of ticks infected with the bacterium Borrelia burgdorferi. This multi-system infection typically occurs in stages with different clinical manifestations at each stage. While it can be treated effectively with antibiotics, in some cases recovery may be incomplete - although there is no evidence that any of these post-Lyme disease syndromes respond to further courses of antibiotic therapy.

Dr. Allen Steere, the renowned discoverer of Lyme disease, joins an esteemed panel of speakers for CDC's Public Health Grand Rounds to explore the clinical manifestations and treatment of Lyme disease, innovations in laboratory testing, prevention strategies, and national trends of disease emergence. The session gives a rare glimpse into the front lines of those battling and treating Lyme disease while addressing the data gaps, unmet needs, and overall challenges and opportunities for its prevention and control.

This is Part 1 of a lecture in three parts.

Guest: Christie Ballantyne, MD

Host: Alan S. Brown, MD, FACC, FAHA, FNLA

Dr. Christie Ballantyne discusses with host Dr. Alan Brown the use of genetic testing in various phases of disease onset in patients facing heart disease. They talk about how clinicians can utilize the current technologies, what the costs are and the benefits. How does learning more about the genetic mutation behind familial hypercholesterolemia affect treatment? Dr. Ballantyne and Dr. Brown also discuss what new genetic testing techniques are on the horizon.

Brought to you by:

Guest: Joyce Ross, MSN, CRNP, CS, CLS, FNLA, FPCNA

Host: Alan S. Brown, MD, FACC, FAHA, FNLA

Host Dr. Alan Brown discusses management issues and practical advice with certified registered nurse practitioner and clinical lipid specialist Joyce Ross, who says that familial hypercholesterolemia (FH) is the most common genetic disorder, and many who have it are totally unaware of their condition until a cardiovascular event occurs. Find out why early identification, in addition to fostering good lifestyle choices, can mean patients with FH can enjoy a normal lifespan when the disorder is treated throughout the lifespan.

Brought To You By:

Guest: Robert Wild, MD, MPH, D.Phil.

Host: Alan S. Brown, MD, FACC, FAHA, FNLA

What are the components of useful, evidence-based data? Dr. Robert Wild discusses with host Dr. Alan Brown the spectrum of data — from expert opinion, to observational studies, to different types of analytic studies, including cross-sectional, case-controlled studies, cohort studies, and clinical trials — and the shortcomings and biases of each. Dr. Wild explores cardiovascular epidemiology, clinical interpretation of biostatistical principles and how to critically evaluate research, in order to better integrate evidence, experience and patient values in clinical decisions.

Guest: Edward Gill, MD

Host: Alan S. Brown, MD, FACC, FAHA, FNLA

The Society of Atherosclerosis Imaging and Prevention recently developed appropriate use criteria for carotid IMT. What is the procedure? Why is it used? Why is it controversial? Which patients are candidates? Dr. Edward Gill, professor of medicine in the division of cardiology in the department of medicine at the University of Washington and clinical professor of diagnostic ultrasound at Seattle University, talks with host Dr. Alan Brown about the details of the procedure and how to locate a center for the test.

Brought to you by:

Guest: James Falko, MD

Host: Alan S. Brown, MD, FACC, FAHA, FNLA

About 1 in 500 people have familial hypercholesterolemia (FH), the genetic disorder characterised by very high levels of low-density lipoprotein in the blood. Host Dr. Alan Brown talks to Dr. James Falko, professor of medicine in the division of endocrinology, metabolism and diabetes at the University of Colorado, Denver, about technology behind LDL apheresis to remove LDL cholesterol from blood. They cover the frequency of the procedure, possible complications, and what the data shows about the benefits of LDL apheresis in FH patients with refractory hypercholesterolemia. Dr. Falko also directs physicians to resources for locating LDL apheresis sites in the United States and Canada.

Brought to you by:

Guest: Thomas Moore, MD

Host: Steven Edelman, MD

New screening standards for gestational diabetes could significantly increase the number of women and babies we identify as at-risk. Guest host Dr. Timothy Bailey talks with Dr. Thomas Moore, chairman of the department of reproductive medicine at the University of California, San Diego, about diabetes in pregnancy, and how gestational diabetes affects infant, childhood, and even adolescent obesity and overall health. They discusses screening methods for gestational diabetes, who is at risk, and the benefit from dietary interventions.

Host: Steven Edelman, MD

Guest: Sunder Mudaliar, MD

How can we prevent and treat pre-diabetes? Can a pill delay or prevent the onset of disease in high-risk individuals? Host Dr. Steven Edelman talks to Dr. Sunder Mudaliar, clinical professor of medicine in the division of endocrinology and metabolsim at the VA Medical Center and University of California San Diego School of Medicine, about the data on pioglitazone for diabetes prevention and the results of the ACT NOW study.

Guest: Lutz Heinemann, PhD

Host: Steven Edelman, MD

Biosimilar insulin is an attractive market to a number of American and European pharmaceutical companies. Biosimilar insulin manufacture is complicated for a number of reasons. Guest host Dr. Timothy Bailey talks with Dr. Lutz Heinemann, director of scientific services at Profil Institute for Clinical Research in San Diego and headquartered in Neuss, Germany, about the challenges and guidelines around producing safe and effective biosimilars. And, for healthcare providers, what are the practical aspects of switching to a biosimilar insulin?

Host: Matt Birnholz, MD

ReachMD, in cooperation with HealthDay, Presents Conference Coverage of Digestive Disease Week 2011, held from May 7 to 10 in Chicago.

This year's meeting attracted approximately 15,000 participants from around the world, including researchers and academics in the fields of gastroenterology, hepatology, endoscopy, and gastrointestinal surgery. The conference featured approximately 5,000 abstracts and hundreds of lectures, highlighting recent advances in gastroenterology research, medicine, and technology.

Guest: John Walsh, PA, CDE

Host: Steven Edelman, MD

Insulin pump practice studies reveal new approaches in the management of diabetes, including carb-counting, carb boluses, hypoglycemia and transdermal insulin drug delivery. What are actual pump practices that lead to improved control? Join host Dr. Steven Edelman and his guest, John Walsh, PA, and certified diabetes educator at Advanced Metabolic Care and Research in Escondido, California, as they discuss pump practices that lead to improved control.

Host: Matt Birnholz, MD

This year's meeting in Washington, DC, highlighted recent advances in the prevention, detection, and treatment of conditions impacting women. Presentations focused on fibroids, pregnancy, pelvic pain, breast and ovarian cancers, hormone imbalance, psychological issues, and overall health and well-being.

Guest: Howard Bauchner, MD

Host: Bruce Japsen

For 127 years, the Journal of the American Medical Association has been one of the nation's best-known medical journals. This summer, its 16th editor, pediatrician Dr. Howard Bauchner, takes over editorial oversight from Dr. Catherine DeAngelis, who has served as the Journal's editor since 2000. Dr. Bauchner talks to host Bruce Japsen about the steps he plans to take in order to lead the publication into a new era of medicine, and a new digital age of medical publications.

Guest: Bruce Aylward, MD, MPH

Host: Jennifer Shu, MD, FAAP

This year's meeting was held from April 9 to 16 in Honolulu, attracting approximately 10,000 participants from around the world, including clinicians, academicians, allied health professionals, and others interested in neurology, and highlighting recent advances in neurological disorders.

Host: Lee Freedman, MD

Guest: Michael Ruckenstein, MD

In this week's Medical Breakthroughs from Penn Medicine, Dr. Michael Ruckenstein, director of the Center for Implantable Hearing Devices at Penn Medicine, discusses with host Dr. Lee Freedman the only human sense for which total loss can be medically restored: hearing. They talk about which patients with hearing loss might benefit from a cochlear implant instead of a hearing aid. And they'll explore what we know so far about personal music players' role in hearing loss.

Host: Mimi Secor, DNP, FNP-BC, FAANP

Guest: Terri Warren, NP

The CDC has recommendations when it comes to the treatment, testing and counseling of patients who may have sexually transmitted infections or at high risk of contracting an STI. There are a number of ways to test for diseases like gonnorhea, chlamidiya, and syphillis and that can be confusing for NPs and their patients. Nurse Practitioner Terri Warren with the Westover Clinic in Portland, Oregon explains to host Mimi Secor some of the most important changes recommended by the CDC to help reduce the number of sexually transmitted infections in the country especially among teens.

Guest: Alan Roberts, MD

Guest: James Levine, MD, PhD

Host: Matt Birnholz, MD

Host: Michael Greenberg, MD

Dr. Matt Birnholz hosts this program solo, as his co-host, Dr. Michael Greenberg, recovers from knee surgery. This week, Dr. Birnholz considers what the physician learns when he finds himself in the position of the patient. This week's program includes an interview with Dr. Alan Roberts, author of the memoir Hot Flashes in a Cold World: My Struggle to Be a Husband a Doctor and a Man in the Face of Prostate Cancer. Also: Dr. James Levine joins us to talk about his inactivity studies at the Mayo Clinic; plus, the Brain Observatory at UCSD, and more.

Guest: Allen Taylor, MD

Host: Alan S. Brown, MD, FACC, FAHA, FNLA

Dr. Allen J. Taylor, director of advanced cardiac imaging at the Washington Hospital Center in Washington, DC, joins host Dr. Alan Brown to discuss the practical application and appropriateness of imaging guidlines related to screening for cardiovascular risk as well as carotid intima-media thickness.

Brought to you by:

Guest: Kevin C. Maki, PhD, FNLA, CLS

Host: Alan S. Brown, MD, FACC, FAHA, FNLA

Dr. Kevin Maki, chief science officer of BioFortis-Provident Clinical Research, discusses the fundamentals of fatty acids with host Dr. Alan Brown.

Brought to you by:

The National Lipid Association

Host: Matt Birnholz, MD

The American College of Cardiology's 60th Annual Scientific Session and Expo, held April 2 to 5 in New Orleans, attracted approximately 30,000 participants from around the world, including clinicians, academicians, allied health professionals, and others interested in cardiology. The conference highlighted recent advances in the treatment, management, and prevention of cardiovascular diseases, with presentations also focusing on novel drugs and surgical approaches to improve the quality of care for patients with cardiovascular diseases.

Host: Matt Birnholz, MD

The American College of Physicians Internal Medicine 2011, held April 7 through 9 in San Diego, highlighted recent advances in the prevention, detection, and treatment of illnesses in adults, with over 250 scientific sessions covering a variety of topics, including updates in neurology, oncology, infectious diseases, endocrinology, and cardiology.

Host: Matt Birnholz, MD

The CDC commemorates Dr. Robert Koch's 1882 discovery of Mycobacterium tuberculosis, the bacteria that causes TB. Over the past 129 years, history has witnessed many advances over in TB control. Through the intervention efforts of CDC, USAID, WHO's Stop TB Partnership, and many others, TB death rates have fallen by 35% since 1990, and as many as 6 million lives have been saved since 1995.

In spite of these successes, TB still remains a serious threat, especially for those infected with HIV. HIV is the single most powerful risk factor for TB disease and one of the leading causes of death among people infected with HIV. Among the 1.7 million lives that TB claimed in 2009, 380,000 were among people with HIV infection. While people with HIV who have TB can be effectively diagnosed and treated, more effort is needed to diagnose and treat TB promptly and effectively, and to scale-up preventive treatment for TB.

This special session of Public Health Grand Rounds shed light on myths and misconceptions about TB and HIV, and discussed actions needed in preventing deaths from this lethal combination.

This is Part 3 of a lecture in three parts.

Part 1 >>

Part …

Host: Matt Birnholz, MD

The CDC commemorates Dr. Robert Koch's 1882 discovery of Mycobacterium tuberculosis, the bacteria that causes TB. Over the past 129 years, history has witnessed many advances over in TB control. Through the intervention efforts of CDC, USAID, WHO's Stop TB Partnership, and many others, TB death rates have fallen by 35% since 1990, and as many as 6 million lives have been saved since 1995.

But in spite of these successes, TB still remains a serious threat, especially for those infected with HIV— the single most powerful risk factor for TB disease and one of the leading causes of death among people infected with HIV. Among the 1.7 million lives that TB claimed in 2009, 380,000 were among people with HIV infection. While people with HIV who have TB can be effectively diagnosed and treated, more effort is needed to diagnose and treat TB promptly and effectively, and to scale-up preventive treatment for TB.

This special session of Public Health Grand Rounds sheds light on myths and misconceptions about TB and HIV, and discusses actions needed in preventing deaths from this lethal combination.

This is Part 2 of a lecture in three parts.

Part 1 >>

Part …

Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA

Guest: Nguyen Park, MS, PA-C

Almost 4 million people in the US have high triglycerides. What can you do to help improve your patients' health? Nguyen Park, clinical assistant professor in the physician assistant studies program, at Wayne State University in Detroit, Michigan, joins host Lisa Dandrea Lenell to discuss the benefits of fish oil for treating hypertriglyceridemia. They also look at the risk factors, causes and other treatment options for this very common disease.

Host: Matt Birnholz, MD

This year's meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI), held in San Francisco over March 18th through the 22nd, attracted over 7,000 participants from around the world, including clinicians, academics, allied health professionals, and others interested in allergic and immunologic disease. The conference highlighted recent advances in allergy and immunology research, with presentations also focusing on other developments in allergy, asthma, and immunologic diseases.

Host: Steven Edelman, MD

Guest: Azza El-Remessy, PhD, RPh

Retinopathy is one of the most common complications for patients living with diabetes but there are few treatment options and no early-stage interventions. How is research helping to pinpoint potential targets for early intervention and a possible oral treatment? Join host Dr. Steven Edelman and his guest, assistant professor and director of clinical and experimental therapeutics at the University of Georgia, Dr. Azza El-Remessy, as they discuss the latest research into the potential of statins to prevent diabetic-related blindness.

Guest: Dorothy Mitchell-Leef, MD

Host: Gary Epstein

Dr. Dorothy Mitchell-Leef tells host Gary Epstein why she decided to go into medicine, despite the lack at the time of female physician role models, details many of the changes she has seen in the evolution of the role of women in medical practice. She also discusses the changes in reproductive medicine she has seen and worked on. Her practice had the very first IVF baby born in Georgia, the first ICSI baby in the United States, as well as the first frozen egg pregnancy in the United States, the first gestational pregnancy in Georgia, and other firsts.

This week's guest was nominated by the

Host: Matt Birnholz, MD

The United States is in the grip of an epidemic of prescription drug overdoses. Over 27,000 people died from overdoses in 2007, a number that has risen five-fold since 1990 and has never been higher. Prescription drugs are now involved in more overdose deaths than heroin and cocaine combined.

For health professionals, policymakers and legislators, addressing this problem is complicated. While they push for education, prevention, and enforcement to reverse this epidemic, they must also ensure that patients with a legitimate need for these medications still have access to them. This important session of the CDC's Public Health Grand Rounds addressed these challenges and explored the innovative state and federal policies and interventions that are showing promise in reducing injury and death from this epidemic.

This is Part 3 of a 45-minute lecture in three parts.

Part 1 >>

Part 2 >>

To view the complete video recording of this and other CDC Public Health Grand Rounds sessions, visit http://www.cdc.gov/about/grand-rounds/.

And for those interested in receiving continuing education credits for the live broadcasts of Public Health Grand Rounds, register at http://www2a.cdc.gov/TCEOnline.

CDC's participation in the activity is not meant to serve as …

Host: Matt Birnholz, MD

The United States is in the grip of an epidemic of prescription drug overdoses. Over 27,000 people died from overdoses in 2007, a number that has risen five-fold since 1990 and has never been higher. Prescription drugs are now involved in more overdose deaths than heroin and cocaine combined.

For health professionals, policymakers and legislators, addressing this problem is complicated. While they push for education, prevention, and enforcement to reverse this epidemic, they must also ensure that patients with a legitimate need for these medications still have access to them. This important session of the CDC's Public Health Grand Rounds addressed these challenges and explored the innovative state and federal policies and interventions that are showing promise in reducing injury and death from this epidemic.

This is Part 2 of a 45-minute lecture in three parts.

Part 1 >>

Part 3 >>

To view the complete video recording of this and other CDC Public Health Grand Rounds sessions, visit http://www.cdc.gov/about/grand-rounds/

And for those interested in receiving continuing education credits for the live broadcasts of Public Health Grand Rounds, register at http://www2a.cdc.gov/TCEOnline.

CDC's participation in the activity is not meant to serve as an …

Host: Matt Birnholz, MD

The United States is in the grip of an epidemic of prescription drug overdoses. Over 27,000 people died from overdoses in 2007, a number that has risen five-fold since 1990 and has never been higher. Prescription drugs are now involved in more overdose deaths than heroin and cocaine combined.

For health professionals, policymakers and legislators, addressing this problem is complicated. While they push for education, prevention, and enforcement to reverse this epidemic, they must also ensure that patients with a legitimate need for these medications still have access to them. This important session of the CDC's Public Health Grand Rounds addressed these challenges and explored the innovative state and federal policies and interventions that are showing promise in reducing injury and death from this epidemic.

This is Part 1 of a lecture in three parts.

Part 2 >>

Part 3 >>

To view the complete video recording of this and other CDC Public Health Grand Rounds sessions, visit http://www.cdc.gov/about/grand-rounds/

And for those interested in receiving continuing education credits for the live broadcasts of Public Health Grand Rounds, register at http://www2a.cdc.gov/TCEOnline.

CDC's participation in the activity is not meant to serve as an …

Host: Anthony Alessi, MD

Guest: Jeffrey Cohen, MD

For years, patients with multiple sclerosis have had to rely on injectable medications. But several new oral medications are emerging, and one drug has already been approved by the FDA. Why has it taken so long to develop oral formulations? Dr. Jeffrey Cohen, director of the Millen Experimental Therapeutics program at the Cleveland Clinic and professor of medicine at the Cleveland Clinic Lerner College of Medicine, joins host Dr. Anthony Alessi to discuss how these new drugs work, the side effects, and which patients can most benefit from new oral therapy.

Host: Anthony Alessi, MD

Guest: Eelco Wijdicks, MD, PhD

The American Academy of Neurology released new guidelines for determining brain death in adults, providing a step-by-step process for making this decision consistent among hospitals in the United States. One major departure in these guidelines is the recommendation of a single exam, rather than multiple exams occurring at several-hour intervals. How does this change impact organ donation following brain death? Dr. Eelco Wijdicks, professor of neurology at the Mayo Clinic College of Medicine and chair of the division of critical care, joins Dr. Anthony Alessi to discuss how to evaluate a brain dead patient without jeopardizing their organs for transplant.

Host: Matt Birnholz, MD

This year's meeting, February 15th through the 19th, in San Diego, attracted approximately 30,000 participants from around the world, highlighting recent advances in the diagnosis and management of musculoskeletal conditions, with presentations focusing on joint fractures, osteoarthritis, and other musculoskeletal injuries as well as factors impacting joint replacement procedure outcomes.

Host: Matt Birnholz, MD

The 69th annual meeting of the American Academy of Dermatology took place February 4th through the 8th, in New Orleans. Attracting approximately 16,000 participants from around the world. The conference highlighted recent advances in the diagnosis and management of dermatologic conditions, with presentations and abstracts focusing on acne, rosacea, basal cell carcinoma, squamous cell carcinoma, melanoma, among other skin conditions.

Host: Anthony Alessi, MD

Guest: David Simpson, MD

14 million Americans suffer migraine headaches every day. Many go untreated and many who are treated continue to have headaches. But an old drug proved to offer a new way to treat migraines, with the FDA approval of botulinum toxin injections for severe chronic migraine. Dr. David Simpson, professor of neurology at Mount Sinai School of Medicine in New York City and director of the clinical neurophysiology lab at Mount Sinai Hospital, joins host Dr. Anthony Alessi to discuss what patients qualify for this treatment, problems and risks associated with taking the injections, and the controversial results of the earlier clinical trials for this treatment.

Host: Anthony Alessi, MD

Guest: Don Iverson, MD

Nationwide there are an estimated several hundred thousand licensed drivers with Alzheimer's disease. A new study shows that more than half can still pass a road test, leaving physicians to help patients and caregivers decide when it's time to stop driving. Dr. Donald Iverson, lead author of the American Academy of Neurology's most recent guidelines on driving and dementia, joins host Dr. Anthony Alessi to discuss what tests are available to help make this decision, and how to approach the delicate discussion of this loss of independence with Alzheimer's patients.

Guest: Jaime Davidson, MD

Host: Steven Edelman, MD

The relationship of insulin regimens to race and ethnicity is a new and growing area of research to better understand and provide clinical care at a personalized level. What are significant differences and approaches to these patients' diabetes management? Join host Dr. Steven Edelman and his guest, professor of internal medicine at the University of Texas Southwestern Medical School, Dr. Jaime Davidson, as they discuss the need for more clinical trials to better understand the differences of race and ethnicity on the efficacy and safety of commonly-used insulin regimens.

Host: Janet Wright, MD

Guest: David Kaplan, PhD

Although most bypass grafts are sourced from other parts of a patient's body, bioengineers are examining new materials that might be used for bypass grafts to reduce the risk of second-site complications. Silk has been a standard material in sutures for decades, and is now showing promise as a biomaterial in bypass grafts. Might silkworms help repair clogged arteries? Dr. David Kaplan, endowed chair, the Stern Family Professor of Engineering, and professor & chair of the department of biomedical engineering at Tufts University, discusses the advantages of silk protein as a biomaterial and related applications to cardiology. When might this new technology be applied from the bench to the bedside? Dr. Janet Wright hosts.

Produced in Cooperation with

Host: Janet Wright, MD

Guest: Robert Harrington, MD

Recent studies have raised doubts about the efficacy of some common treatments for cardiovascular disease, including: the use of PFO closures (based on the CLOSURE trial); some methods of cardiac resynchronization therapy (or CRT, based on the SMART-AV trial); telemonitoring for patients with congestive heart failure (based on the Tele-HF trial); and doubling the dose of clopidogrel in patients who had a poor response to the drug after percutaneous coronary intervention (based on the GRAVITAS trial). Dr. Robert Harrington, director of the Duke Clinical Research Institute at Duke University Medical Center in Durham, North Carolina, reviews the evidence in each of these trials, and gauges the clinical impact of their findings. Dr. Janet Wright hosts.

Produced in Cooperation with

Host: Mimi Secor, DNP, FNP-BC, FAANP

Guest: Norma Hannigan

Laughter has been shown to lower blood pressure, increase blood flow and build endorphins. Nurse practitioner Norma Hannigan, associate professor of clinical nursing at Columbia University in New York, joins host Mimi Secor for a serious discussion of the anecdotal and evidence-based research on laughter and how to use laughter as medicine in your clinical practice.

Guest: Tom Bartol

Host: Mimi Secor, DNP, FNP-BC, FAANP

As medicine takes an increasingly evidence-based approach to care, it's more important than ever for busy clinicians to be able to evaluate the benefits and risk-reduction associated with new treatments and medications. This week's guest, Tom Bartol, nurse practitioner at the Richmond Area Health Center in Richmond, Maine, discusses with host Mimi Secor how to wade through the research data and evaluate statistical significance versus clinical significance, and find the information you need in order to treat your patients more effectively.

Host: Matt Birnholz, MD

Tune in for the highlights of findings presented at the 33rd Annual San Antonio Breast Cancer Symposium, held from December 8th through the 12th, 2010, covering recent advances in the diagnosis, treatment, and prevention of breast cancer, including the risk of breast cancer and hormone therapy, lack of mammogram screening, combination therapy for hormone receptor positive breast cancer, and predictors of breast cancer outcomes.

Guest: Everett Winslow Lovrien, MD

Host: Matt Birnholz, MD

Host: Michael Greenberg, MD

This week, hosts Drs. Matt Birnholz and Michael Greenberg wrap up 2010 with a look at the year's most notable research; as well as some notably retracted research, with Jef Akst of The Scientist; and talk with Dr. Everett Winslow Lovrien, whose book Doctor Guilt? looks at how thousands of hemophilia patients in the 1970s and 80s came to be treated with HIV-tainted medication. Plus: Just in time for your holiday parties, notable findings on cheese fondue and vodka, gleaned from the pages of the British Medical Journal's Christmas issue.

Host: Matt Birnholz, MD

Tune in for significant summaries from the Radiological Society of North America's 96th Scientific Assembly and Annual Meeting, November 28th through December 3rd in Chicago.

Host: Matt Birnholz, MD

Tune in for a summary of some of the important information and research findings from the Annual Meeting of the American College of Allergy, Asthma & Immunology (ACAAI), held November 11th through the 16th, 2010, in Phoenix. This year's meeting attracted over 3,000 participants from around the world. The conference highlighted advances in allergy, asthma, and immunology research, procedures, and technologies. Presentations focused on allergies to food, medications, and chemicals as well as the use of immunotherapy and steroids for the treatment of asthma.

Host: Jason Birnholz, MD

Host Dr. Jason Birnholz talks with experts on the conference floor from the Radiological Society of North America's 96th Scientific Assembly and Annual Meeting in Chicago. His guests include:

Dr. Candice Aitken, radiation oncologist and assistant professor of medicine at Dartmouth Medical School
Dr. Jacques Souquet, founder and CEO of SuperSonic Imagine
Dr. Judy Kalinyak, chief medical officer of Naviscan
Dr. William Denman, chief medical officer of GE Healthcare

Host: Matt Birnholz, MD

Tune in for a summary of some of the important information and research findings from the American College of Surgeons 96th Annual Clinical Congress, held October 3 - 7, 2010, in Washington, DC. This year’s meeting attracted more than 13,000 participants from around the world, who attended presentations on novel surgical techniques, the impact of surgeon availability on survival rates, application of surgical techniques to expanding patient populations, and risk factors associated with trauma incidents.

Guest: Ken Fujise, MD

Host: Janet Wright, MD

Targeted molecular therapy has been successful in cancer therapeutics. How might this approach be applied in cardiology to prevent the development of atherosclerosis? Dr. Ken Fujise, chief of cardiology at University of Texas Medical Branch, where he is also professor of medicine and biochemistry and molecular biology, talks about his preliminary research investigating the role of fortilin in the progression of atherosclerosis and subsequent coronary artery disease. What are the prospects for development of anti-fortilin medication to prevent or slow atherosclerosis? Dr. Janet Wright hosts.

Produced in Cooperation with

Guest: G. Alexander Fleming, MD

Host: Bruce Bloom, DDS, JD

Researchers are looking at hundreds of ways to treat and cure type one diabetes. Most of the advances so far have come in newly diagnosed children. Is there anything on the horizon to help adults with established type one diabetes? Dr. Alexander (Zan) Fleming, chairman and chief medical officer of Exsulin, joins host Dr. Bruce Bloom to discuss the new therapies for reversing established diabetes.

Host: Matt Birnholz, MD

The 2010 meeting of the Infectious Diseases Society of America, held in Vancouver, Canada, October 21 - 24, attracted over 47-hundred participants from 82 countries around the world. This year's conference included presentations highlighting advances in a number of important areas — including the development of antibiotics and prevention of antibiotic resistance; HIV management; and both seasonal and H1N1 vaccine uptake and safety.

Host: Matt Birnholz, MD

Listen for highlights from the American College of Gastroenterology's 75th Annual Scientific Meeting, October 15 - 20 in San Antonio, Texas. The meeting attracted approximately 4,000 participants from around the world. The meeting focused on advances in the management of patients with gastrointestinal disorders, focusing on cancer, esophageal and bowel disorders, liver disease, and pancreatic and biliary conditions.

Guest: Robert Harrington, MD

Host: Lawrence Sherman, FACEHP, CCMEP

As continuing medical education continues to evolve, assessing quality in the provision of CME is vital. Joining host Lawrence Sherman this week is Dr. Robert Harrington, director of the Duke Clinical Research Institute at Duke University Medical Center, to discuss quality and performance improvement in CME.

Guest: Steven N. Austad, PhD

Host: Mary Leuchars, MD

The bowhead whale is the longest-living mammal on Earth. Its lifespan can exceed 200 years. What can we learn about fostering human longevity from the extraordinarily long-living animals in what author Dr. Steven Austad calls "Methuselah’s Zoo" (so named for Methuselah, the oldest figure in the Bible, said to have lived for 969 years)? Dr. Austad, professor of cellular and structural biology at the Barshop Institute for Longevity and Aging Studies at the University of Texas Health Science Center, talks to host Dr. Mary Leuchars.

Guest: Steven N. Austad, PhD

Host: Mary Leuchars, MD

We assume that we know the answer to the question, Why does the body age? In short, we age, and eventually die, because we live. But what can we learn from studying aging on a cellular level? Host Dr. Mary Leuchars talks with Dr. Steven Austad, professor of cellular and structural biology at the Barshop Institute for Longevity and Aging Studies at the University of Texas Health Science Center at San Antonio and research chair of the American Federation for Aging Research, about why humans age, why we age, how to extend longevity, and the ramifications of extending our lives.

Host: Matt Birnholz, MD

Hear highlights from the American Academy of Pediatrics National Conference and Exhibition, held October 2-5, 2010, in San Francisco. This year’s conference focused on advances in the health, safety, and well-being of infants, children, adolescents and young adults, attracting over 8 thousand participants from around the world.

Guest: Marc Abrahams

Host: Matt Birnholz, MD

Host: Michael Greenberg, MD

In this re-broadcast of the October 13th live show, we’ve invited Marc Abrahams, the editor of the Annals of Improbable Research and the mastermind behind the annual Ig-Nobel Prize, for science that makes people laugh, then makes them think. Plus: a few others making a difference in fields of science and medicine; and making a difference locally this Halloween.

Guest: Emmanuel Baetge, PhD

Host: Steven Edelman, MD

Current stem cell therapy research is leading the way into producing functional pancreatic, insulin-producing cells. How will this translate into clinical trials and human therapy for diabetes from a scale, delivery and efficacy position? Join host Dr. Steven Edelman and his guest Dr. Emmanuel Baetge, chief scientific officer of Viacyte, Inc., as they discuss the benefits of stem cell research therapy for diabetes.

Guest: Judith Karp, MD

Host: Matt Birnholz, MD

Host: Michael Greenberg, MD

In this show, Drs Birnholz and Greenberg talk Dr. Judith Karp, an authority on molecular mechanisms of leukemia and lymphoma, from John Hopkins University School of Medicine, and chair of the Oncology Care Live virtual congress. Why a virtual conference? How does it work? What will attendees learn? Plus: the continuing debate on mammography, and a bra that could save your life.

Host: Janet Wright, MD

Guest: Christopher O'Donnell, MD, MPH

We know that genes play a role in cardiovascular health, but new research has identified specific DNA regions that are associated with risk factors for coronary heart disease. It's estimated that 30-50% of cardiovascular health is influenced by family history or genetics, while the rest is influenced by other environmental factors, diet and exercise. How might these new genetic discoveries lead to new treatment options? Dr. Christopher O'Donnell, associate director and scientific director of the SHARe Project of the Framingham Heart Study at the National Heart, Lung and Blood Institute, and associate clinical professor of medicine at Harvard Medical School in Massachusetts, talks about his work genotyping the single-nucleotide polymorphisms of large cohort study participants. How are genome-wide association studies leading to discovery of new genes associated with various diseases, and will these findings move us into a new era of prevention and treatment of cardiovascular disease? Dr. Janet Wright hosts.

Guest: David Kendall, MD

Host: Steven Edelman, MD

The assessment of intensive glycemic control in preventing cardiovascular disease is unclear. Discrepancies in recent clinical trials such as ACCORD, ADVANCE, PROactive and UKPDS 80 may reflect difference in study design and patients, versus glycemic control. How can using the Archimedes model illuminate this quandary? Join host Dr. Steven Edelman and his guest, chief scientific and medical officer of the American Diabetes Association, Dr. David Kendall, as they discuss the effect of glycemic control on macrovascular outcomes in patients with diabetes.

Host: Janet Wright, MD

Guest: Albert Starr, MD

On the 50th anniversary of the first successful prosthetic mitral valve replacement, how far has cardiac surgery come, and where are we headed? Tune in to hear Dr. Albert Starr, co-founder of the first artificial mitral valve, medical director of the Providence Heart and Vascular Institute, and director of Academic Affairs & Bioscience Development for Providence Health & Services in Portland, Oregon, recounts his first foray into the field of valvular disease and the extraordinary process of inventing the first artificial mitral valve. What complications did Dr. Starr encounter during the design process, and what breakthrough allowed for success in long-term artificial valve replacement? He also discusses the development of what was perhaps one of the first ventures into outcomes research, with the creation of a system for long-term follow up of patients receiving valve replacement. What does Dr. Starr see as the "next big thing" in cardiac surgery? Dr. Janet Wright hosts.

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Guest: David Freyer, DO, MS

Host: Jerome Lisk, MD

The National Cancer Institute defines the 'lost generation' of cancer patients as adolescent and young adult patients 15 to 39 years of age. These patients have demonstrated lower rates of improvements in survival and the lowest rate of participation in federally-funded clinical trials. Host Dr. Jerome Lisk talks with Dr. David Freyer, director of the LIFE Survivorship and Transition Program at Children's Hospital Los Angeles, about the challenges facing this group of cancer patients.

Guest: Berish Rubin, PhD

Host: Bruce Bloom, DDS, JD

Only a few years ago familial dysautonomia (FD) was a fatal disease, but some "Rediscovery Research" from the FD lab at Fordham University in Bronx, New York, is turning this killer into a chronic manageable disease. What have we learned from familial dysautonomia research, and how might this help patients with other diseases? Joining host Dr. Bruce Bloom to provide an update on current FD research and treatment is Dr. Berish Rubin, professor in the department of biological sciences and head of the laboratory for familial dysautonomia research at Fordham University.

Guest: Susan Scanland, MSN, CRNP, GNP-BC

Host: Mimi Secor, DNP, FNP-BC, FAANP

How can we limit the risk of Alzheimer's disease? New research suggests a correlation between obesity, type 2 diabetes and dementia. Susan Scanland, gerontological nurse practitioner, discusses this research with host Mimi Secor. She discusses how Alzheimer's, weight and waist size seem to be related, and how clinicians can help patients reduce their risk of Alzheimer's disease.

Guest: Lynne Mofenson, MD

Host: Maurice Pickard, MD

Although HIV transmission through breast milk is a significant global health issue, many mothers and their babies depend on breastfeeding for survival. About 90% of children who become infected with HIV each year are in sub-Saharan Africa. What therapeutic interventions are recommended for mothers with HIV in order to prevent transmission of the virus to their babies? Dr. Lynne Mofenson, chief of the pediatric, adolescent and maternal AIDS branch at the National Institute of Child Health and Human Development, at the National Institutes of Health in Rockville, Maryland, discusses two exciting new developments found to reduce the risk of HIV transmission from mothers to their babies in places where replacement feeding for infants isn't available. Hosted by Dr. Maurice Pickard.

Host: Mark Chyna, MD

Hear highlights from research on the management of obesity, endocrine disorders, diabetes, menopause, and thyroid cancer presented at the Endocrine Society's 92nd Annual Meeting and Expo. The meeting took place June 19 to 22, 2010, in San Diego.

Guest: Seth Corey, MD, MPH

Host: Bruce Bloom, DDS, JD

Physician scientists keep one foot in clinical care and the other in the lab, hoping to bridge that gap to help patients. Are breakthroughs on the horizon? Dr. Seth Corey, the Sharon Murphy and Steven Rosen Professor of Cancer Biology and Chemotherapy at Northwestern University Feinberg School of Medicine and director of oncology research at Children's Memorial Hospital and the Robert H. Lurie Comprehensive Cancer Center, joins host Dr. Bruce Bloom to discuss his research on repurposing safe pharmaceutical and botanical medicines for relapsed pediatric cancers.

Guest: Steven Pearson, MD, MSc, FRCP

Host: Bruce Bloom, DDS, JD

Evidence-based medicine is a movement that assumes care will be better, safer, and more cost-efficient when physicians base clinical judgments on solid empirical science instead of clinical observation and experience. But who creates such guidelines, how good is the evidence underlying them, and why are these guidelines more important than ever? And are data and intuition mutually exclusive? Guest Dr. Steven Pearson, founder and president of the Institute for Clinical and Economic Review at Massachusetts General Hospital and an expert in the area of evidence-based medicine, joins host Dr. Bruce Bloom to discuss the confluence of art and evidence in medicine.

Series Produced in Cooperation With

Guest: Frances Toneguzzo, PhD

Host: Bruce Bloom, DDS, JD

Guest: David Borsook, MD, PhD

The discovery of a new use for a failed or existing drug has often been entirely serendipitous: a drug in development to treat angina failed, but became famous as Viagra when some of the test subjects reported interesting side effects. There are other notable examples, and now scientists are beginning to repurpose drugs in a more systematic way. How is drug repurposing research carried out, why is it important, and what are the hurdles to bringing these new uses to market? Hosted by Dr. Bruce Bloom.

Series Produced in Cooperation With

Guest: Steven Nissen, MD

Host: Martin Samuels, MD

How can clinical trials be made above reproach? How can a healthcare professional best interpret the results of clinical trials? Dr. Steven Nissen, chairman of the department of cardiovascular medicine at the Cleveland Clinic and past-president of the American College of Cardiology, joins Host Dr. Martin A. Samuels to discuss these and other topics

Guest: Kaiser Fung

Host: Matt Birnholz, MD

Host: Michael Greenberg, MD

In this rebroadcast of the March 17th show, your hosts talk to Kaiser Fung, author of the book Numbers Rule Your World: The Hidden Influence of Probability and Statistics on Everything You Do, about controversies in PSA screening, mammogram guidelines, personalized medicine and placebos. Plus: Smartphones, primary care salaries, and more.

Guest: James Watson

Guest: Joseph Kim, MD, MPH

Host: Matt Birnholz, MD

Host: Michael Greenberg, MD

Host Dr. Matt Birnholz talks with Dr. James Watson, winner of the 1962 Nobel Prize for the discovery of the structure of DNA. They discuss Dr. Watson's current and most pressing interest in cancer research, and its biochemical causes. Also, blogger and physician technologist Dr. Joseph Kim joins Drs Michael Greenberg and Matt Birnholz to talk about Apple's new iPad and its potential uses in healthcare. Dr. Kim is the author of several blogs, including Medicine and Technology. And in the Forum, Greenberg and Birnholz discuss the Lancet retraction of the MMR vaccine and autism link research.

Host: Roy Levit, MD

Guest: Allen Verne, MD

What are the advantages to using private practices, as opposed to academic institutions, for testing medications? Dr. Allen Verne, president of the American Retina Foundation and founder of the Bay Area Retina Associates, discusses in-office drug studies he is involved in, including one on diabetic retinopathy and another on photodynamic therapy, and why these studies can be particularly useful in determining the most effective treatments for patients with retinal conditions. Dr. Verne also discusses the process of separating the interests of the pharmaceutical companies sponsoring studies and those participating in the study. What are the financial and time costs to the practices involved in in-office medication studies? Dr. Roy Levit hosts.

Host: Mark Chyna, MD

Tune in to hear news and research from the Infectious Diseases Society of America's 47th Annual Meeting in Philadelphia.

Guest: Thomas Starzl, MD, PhD

Host: Martin Samuels, MD

Now in his 80s, Dr. Thomas E. Starzl is actively pursing his latest research interests and gives no indication of slowing down. He is widely known as the father of transplantation. But what is not widely known is that his early work was in neurophysiology. What made him choose surgery? What was it like when he was doing his pioneering transplantation work? What is he researching now? Host Dr. Martin Samuels and Dr. Thomas Starzl discuss.

Guest: Sanjiv Chopra, MD, FACP

Host: Martin Samuels, MD

How can American learning institutions effectively disseminate medical knowledge around the world? What are some of the attributes of Continuing Medical Education that make it improve patient outcomes? Dr. Sanjiv Chopra, dean for continuing medical education at Harvard Medical School, discusses these topics and others with host Dr. Martin Samuels.

Host: Mark Nolan Hill, MD

Guest: Jeffrey Klausner, MD, MPH

Detection and treatment of HIV in the United States has improved dramatically since the peak of the epidemic here in the 1980s, but there is far more work to be done. HIV transmission is one area of heightened concern, particularly those cases spread by newly infected persons who remain undiagnosed. Though tests are available to diagnose HIV in the acute phase, many experts believe we must improve these tests to really make headway in reducing the incidence of HIV in the United States. Dr. Jeffrey Klausner, a deputy health officer and director of the STD Prevention and Control Services Section at the San Francisco Department of Public Health, joins host Dr. Mark Nolan Hill to lay out the path toward progress in detecting acute cases of HIV infection. Newer, more effective tests are available, but must be adopted around the United States, and as Dr. Klausner looks ahead, a point-of-care rapid exam, though still in development, could eventually change the paradigm for early-stage HIV detection.

Guest: Patrick Schlievert, PhD

Host: Lee Freedman, MD

HIV research has encountered quite a few setbacks, especially with attempts to create an HIV vaccination. But topical microbicides made from glycerol monolaurate, commonly found in some foods and cosmetics, are showing some promise. What mechanisms of microbicides may help successfully prevent infection, including HIV and other sexually transmitted infections? Dr. Patrick Schlievert, professor of microbiology and immunology at the University of Minnesota Medical School, explains the exciting potential of topical microbicides for preventing the transmission of sexually transmitted infections and HIV. How soon might one of these topical microbicides be available, if they are further proved to have efficacy? Dr. Lee Freedman hosts.

Guest: Patricia Donahoe, MD

Host: Martin Samuels, MD

How does one go about crafting a pioneering medical career in practice as well as in research? Joining host Dr. Martin Samuels to discuss these themes in her own career is Dr. Patricia Donahoe, director of Massachusetts General Hospital's pediatric surgical research laboratories and chief emerita of pediatric surgical services.

Guest: Robert Harman

Host: Bruce Japsen

Human stem cell treatments are only just emerging in clinical trials. but man's 'best friend' is already benefitting from pain relief and important treatments that are commercialized. And this work in dogs and cats could one day benefit human patients. Dr. Robert Harman, CEO and founder of Vet-Stem, tells the Chicago Tribune's Bruce Japsen about the latest efforts by a stem cell therapy developer to use fat cells for treatments, a therapy gaining momentum in pets and soon to be moving through clinical trials for humans.

Guest: Pride Chigwedere, MD, PhD

Host: Cathleen Margolin, PhD

Dr. Pride Chigwedere, an affiliate of the Harvard AIDS Initiative, speaks with host Dr. Cathleen Margolin about the role of government policy in the AIDS epidemic in South Africa. Dr. Chigwedere's research, as published in the Journal of Acquired Immune Deficiency Syndromes, pins fault on these frightening government rules for the loss of more than 3.8 million person-years in the early portion of this decade. How is South Africa now moving toward a state of accountability for this crucial aspect of their overall public health strategy?

Guest: Jerome Groopman, MD

Host: Martin Samuels, MD

Is there any way for clinicians to avoid misdiagnosis and other 'thinking errors'? Host Dr. Martin Samuels discusses this important topic with researcher, physician, and author Dr. Jerome Groopman. Dr. Groopman explores some of the unintended consequences of targeted medical research and 'the Christopher Reeve effect.'

Guest: Dan Roden, MD

Host: Bruce Bloom, DDS, JD

The greatest side effect of medications is that they often don't do what we expect them to do. Dr. Dan Roden, professor in the departments of medicine and pharmacology at Vanderbilt University School of Medicine, talks with Dr. Bruce Bloom about variability in response to drugs. Genetic components are just one of many reasons patients respond differently. Dr. Roden also discusses his specific work with customizing treatment for patients with arrhythmias based upon the disease mechanism.

Guest: Jun Ye, PhD

Host: Larry Kaskel, MD

Diagnosing life threatening diseases and other medical conditions could soon be as easy as breathing. June Ye, a physics professor at the University of Colorado-Boulder and his graduate student, Michael Thorpe, discuss their research on a technique that uses lasers to detect specific chemical compounds in the breath of patients. They explain to host Dr. Larry Kaskel the underlying mechanisms of this technology, which is known as optical frequency comb, and how that it is able to derive health information from the patient's breath. Tune in to hear how this technology, once perfected, will improve the efficiency of diagnosing and monitoring diseases, as well as save patients thousands of dollars on diagnostic testing.

Guest: Grace Kuo, PharmD, MPH

Host: Charles Turck, PharmD, BCPS, BCCCP

In the minds of healthcare professionals, pharmacogenomics often conjures images of cutting-edge medical technology, and even a sense that the word describes the future of medicine moreso than the present. Aside from vague notions, it’s not clear that most of us have a solid grasp of what contemporary pharmacogenomics entails. How might we bridge this gap in our knowledge? Dr. Grace Kuo, associate professor of clinical pharmacy and director of the Pharmacogenomics Education Program at the University of California, San Diego (UCSD) Skaggs School of Pharmacy and Pharmaceutical Sciences, explains the genesis and foremost goals of this program with host Dr. Charles Turck. How should we think about 21st-century pharmacogenomics, in terms of what it may hold for our patients and our practices?

Host: Todd Mahr, MD

Guest: Steven Weinstein, MD

Clinical trials are essential to the safe development of medications. How are clinical trials structured, and what are the features of the various clinical trial stages? Dr. Steven Weinstein, clinical professor in the department of pediatrics at the University of California at Irvine, provides an overview of clinical trials with host Dr. Todd Mahr. What are the ethical considerations taken into account during clinical trials?

Host: Ketan Sheth, MD, MBA

Guest: Stanley Fineman, MD, MBA

The role that biomarkers can play in asthma control by effectively measuring lung inflammation is a topic that has begun to get more attention lately in medical journals. Although use of most biomarkers is not clinically pragmatic for physicians yet, guest Dr. Stanley Fineman, clinical associate professor in the Department of Pediatrics at Emory University School of Medicine, predicts that biomarkers will likely play a more significant role in the future. Host Dr. Ketan Sheth asks, what other methods are most effective for monitoring control in asthma?

Guest: W. David Hardy, MD

Host: Maurice Pickard, MD

Dr. David Hardy, director of infectious disease at Cedars-Sinai Medical Center in Los Angeles, emphasizes that we already have methods for prevention of the HIV epidemic, especially among gay men and African-Americans. He tells host Dr. Maurice Pickard that, if implemented, the Centers for Disease Control and Prevention's new recommendation for testing, that does away with exceptionism, would go a long way towards diagnosing the 25 percent of cases in the United States that are not identified.

Guest: W. David Hardy, MD

Host: Maurice Pickard, MD

A new test to differentiate recent from older HIV infections may help experts more accurately track prevention programs. Host Dr. Maurice Pickard is joined by Dr. David Hardy, director of infectious disease at Cedars-Sinai Medical Center in Los Angeles. Dr. Hardy talks about new statistics from the CDC indicating significant increase in the diagnosis of HIV and AIDS in young men and African-Americans.

Guest: Lorie Chaiten, JD

Host: Lauren Streicher, MD

For the past 25 years, the U.S. government has funded abstinence-only sex education in public schools. Still, 47 percent of high school students report having had sexual intercourse and 70 percent are sexually active by age 19. Lorie Chaiten, director of the Reproductive Rights Project for the Roger Baldwin Foundation of the ACLU of Illinois, talks with host Dr. Lauren Streicher about the implications for young people's sexual health when they are denied access to complete and accurate science-based information.

Guest: Robert Bailey, PhD, MPH

Host: Larry Kaskel, MD

New research reveals that male circumcision could reduce HIV infection rates by up to 60 percent, which could prevent 5.7 million new cases and 3 million deaths over 20 years in sub-Saharan Africa. Dr. Robert Bailey, professor of epidemiology at the University of Illinois, Chicago, School of Public Health, discusses his research findings with host Dr. Larry Kaskel, highlighting HIV infection rates in areas of Africa where the male population is circumcised, and explaining the mechanism by which HIV infection may occur in uncircumcised men.

Guest: James Crowe, MD

Host: Mark Nolan Hill, MD

Preparing for the future by studying the past: With researchers now able to resurrect antibodies to the 1918 influenza pandemic from elderly survivors, how does the technology used to do this potentially lead us to antibodies for other viruses? Can we be sure this immunity is not generated by recent exposure to similar strains? Dr. James Crowe, Jr., professor of microbiology and immunology, and director of the Vanderbilt Program for Vaccine Sciences at Vanderbilt University School of Medicine, and one of the researchers leading this expansive project, explains how we are beginning to learn more about where viruses, including HIV, are most susceptible to being controlled and destroyed. Dr. Mark Nolan Hill hosts.

Host: Mark Nolan Hill, MD

Guest: James Crowe, MD

Ninety-plus years after the 1918 influenza pandemic, we are just beginning to understand the naturally occurring adaptive immunity of those who were in contact with this devastating virus. As researchers probe survivors of the flu pandemic, all of whom are approaching or have attained centenarian status, what are we learning about their long-lasting immunity to this virus? Can we explain why these people survived this expansive outbreak, just as relatives and friends around them perished? Dr. James Crowe, Jr., professor of microbiology and immunology, and director of the Vanderbilt Program for Vaccine Sciences at Vanderbilt University School of Medicine, and one of the researchers leading this expansive project, shares some of the tricks that his team has used to make these antibodies in this fascinating discussion with Dr. Mark Nolan Hill.

Guest: James Crowe, MD

Host: Mark Nolan Hill, MD

First published in 2005, the story of how we've come to understand the complete sequence of the 1918 pandemic influenza virus begins years ago, in a remote Alaskan village, and continues today in research across the country. What are we learning about a virus that has taken many decades to comprehend? Dr. James Crowe, Jr., professor of microbiology and immunology, and director of the Vanderbilt Program for Vaccine Sciences at Vanderbilt University School of Medicine, and one of the researchers leading this expansive project, tells host Dr. Mark Nolan Hill that antibody recognition may actually bear a strong resemblance to cognitive memory. What does Dr. Crowe mean by this? Do we know how the immune system would respond if survivors were infected with this influenza virus?

Guest: Bruce Walker, MD

Host: Leslie P. Lundt, MD

Chronic viral infections can manifest in two different ways: one group, such as Epstein-Barr virus, are immunologically contained after the acute infection. The other group, including HIV, lead to persistent viremia and progressive clinical disease. Are there patients who are able to escape the latter without antiviral medications? The director of the Center for AIDS Research at Harvard Medical School, Dr. Bruce Walker, joins host Dr. Leslie Lundt to discuss these so-called "elite controllers."

Guest: Anthony S. Fauci, MD

Host: Maurice Pickard, MD

Dr. Anthony Fauci, director of National Institute of Allergy and Infectious Diseases at the National Institutes of Health discusses the sentiments and mood after the XVII International Conference on AIDS at Mexico City. He emphasizes the need for societies and individuals to implement effective and multifaceted treatment and preventive programs, advance human rights, and invest in AIDS and health care systems. Can therapies that are already at our disposal help stop this pandemic? Hosted by Dr. Maurice Pickard.

Guest: Anthony S. Fauci, MD

Host: Maurice Pickard, MD

Dr. Anthony Fauci, director of National Institute of Allergy and Infectious Diseases at the National Institutes of Health speaks about the daunting challenges 25 years after the discovery of HIV as the pandemic continues to rage worldwide. In particular he describes the factors that have not made it possible to develop a vaccine despite our success in the past with this intervention in other viral illnesses. Hosted by Dr. Maurice Pickard.

Guest: Ronald Hall II, PharmD

Host: Charles Turck, PharmD, BCPS, BCCCP

A drug that's been around for decades, vancoymcin is the medicine of choice for treating MRSA infections. While intravenous dosing recommendations are usually weight-based, vancomycin is often prescribed using a flat-dose strategy. Given the growing obesity epidemic in our country, it's worthwhile to ask whether we're underdosing our patients when we write for vancomycin using the conventional flat-dose. Dr. Ronald Hall II joins host Dr. Charles Turck to evaluate vancomycin dosing by weight.

Guest: Roy Steigbigel, MD

Host: Mark Nolan Hill, MD

We are getting our first in-depth look at some of the research behind raltegravir, a powerful therapy for multi-drug resistant HIV infection already approved by the FDA. How is this raltegravir data impacting current clinical strategies for attacking the virus in multi-drug resistant patients? Host Dr. Mark Nolan Hill probes this question and much more with Dr. Roy Steigbigel, professor of medicine and pathology, molecular genetics and microbiology, and pharmacological sciences, and founding director of the Comprehensive AIDS Center at the State University of New York at Stony Brook.

Guest: Roy Steigbigel, MD

Host: Mark Nolan Hill, MD

In the quest to find therapies for multi-drug resistant HIV, researchers have zeroed in on raltegravir. The latest data indicates this potent agent provides the highest reported virologic suppression rate among multi-drug resistant patients. Is raltegravir proving more effective than antiretrovirals? Does it carry any prominent side effects? Dr. Roy Steigbigel, professor of medicine and pathology, molecular genetics and microbiology, and pharmacological sciences, and founding director of the Comprehensive AIDS Center at the State University of New York at Stony Brook, details his New England Journal of Medicine research on raltegravir therapy for multi-drug resistant HIV with host Dr. Mark Nolan Hill.

Guest: Sharon Mitchell, PhD

Host: Michael Greenberg, MD

Dr. Sharon Mitchell joins host Dr. Michael Greenberg to detail her role in addressing healthcare for the adult film industry. Known to many as 'Dr. Mitch,' she describes her own transformation from adult film star to sexual health expert and founder of the Adult Industry Medical (AIM) Healthcare Foundation. She'll also give us an idea of the unique healthcare challenges of caring for adult film workers, and how the AIM Foundation is able to cater to the specific needs of these patients.

Host: Lee Freedman, MD

Guest: Babatunde Olowokure, MD, MPH, PhD

Guest: Stephen Karpiak, PhD

Rates of STDs in the over-45 population have increased more than twofold since the year 2000. The trend is pushing healthcare providers to stay current on how best to address issues associated with STD care for the older demographic. Host Dr. Lee Freedman learns more from Dr. Babatunde Olowokure, consultant regional epidemiologist from the United Kingdom's Health Protection Agency, and author of research published in the journal Sexually Transmitted Infections, and Dr. Stephen Karpiak, research director for the AIDS Community Research Initiative of America. What's driving this staggering rise in STDs? What initiatives are underway to boost physician awareness of therapeutic measures for our older patients?

Guest: Maj. Molly Klote, MD

Host: John Armstrong, MD

The current military engagements abroad are bringing new areas of activity to the forefront of Army medicine. The slate of ongoing research includes a focus on trauma pain management. How will this revolutionize the standard of care on the battlefield and beyond? Maj. (Promotable) Dr. Molly Klote, an allergist/immunologist and chief of the Research Review Service at Walter Reed Army Medical Center, shares fascinating insights with host Dr. Armstrong.

Guest: Stephen Lewis

Host: Cathleen Margolin, PhD

Healthcare professionals are deeply concerned about HIV/AIDS and the problems presented across the world by the disease. Our voices often carry some influence with those leaders in policy and politics who possess the power to do more for the afflicted and to take preventive steps for those at risk, but our intentions must be strong and clear. What specific messages should we be sending to our world leaders and the powers that be? How can we do more to make known our views? Host Dr. Cathleen Margolin investigates these questions on advocacy and more with Stephen Lewis, co-director of AIDS-Free World, a former United Nations special envoy for HIV/AIDS in Africa and a former deputy executive director of UNICEF.

Guest: Stephen Lewis

Host: Cathleen Margolin, PhD

Women around the world are more likely to be infected with HIV, in part because of their social and economic vulnerability. The stark lack of empowerment of women in many parts of the world indicates the need for men to help protect their gender counterparts from the scourge of HIV. Stephen Lewis, co-director of AIDS-Free World, a former United Nations special envoy for HIV/AIDS in Africa and former deputy executive director of UNICEF, speaks about our need to address the role of sexual violence in furthering the spread of HIV with host Dr. Cathleen Margolin.

Guest: Stephen Lewis

Host: Cathleen Margolin, PhD

A passionate belief in the power of advocacy fuels AIDS-Free World, an organization working to maintain accountability among those responsible for addressing the challenges of this most devastating disease. Host Dr. Cathleen Margolin speaks with the co-director of AIDS-Free World, Mr. Stephen Lewis, who also is a former United Nations special envoy for HIV/AIDS in Africa and a former deputy executive director of UNICEF.