Clinical Podcasts

UpToDate faculty discuss important “What’s New” and “Practice Changing UpDates”, based on recent medical journal articles, in our clinical podcasts. Our contributors are recognized physician leaders in their fields and offer their expertise regarding each update and its impact on clinical practice. Each clinical podcast includes the most current clinical information available as of the release date listed.

Support for UpToDate Talk is provided by UpToDate, Wolters Kluwer. UpToDate is entirely funded by the subscriptions of its users and does not accept advertising or funding unrelated to subscriptions. The opinions in such podcasts are entirely those of the discussants, and these discussants are authors and editors for UpToDate. View the UpToDate conflict of interest policy.

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PFO closure for prevention of recurrent stroke; Cost-effectiveness of triple therapy in RA

Date Released: Dec 13 2017

This episode of UpToDate Talk begins with Dr. Scott Kasner, who outlines three recent NEJM studies investigating the effects of PFO device closure on recurrent stroke risk. The second segment features Dr. James O’Dell, discussing the cost effectiveness of triple therapy in the treatment of rheumatoid arthritis. Dr. Helen Hollingsworth hosts.

Dr. KasnerDr. Scott Kasner is Professor of Neurology and Chief of the Division of Vascular Neurology at the University of Pennsylvania School of Medicine. He is also Director of the Comprehensive Stroke Center at the Hospital of the University of Pennsylvania.
Dr. O'DellDr. James O'Dell is Bruce Professor of Medicine and Chief of the Division of Rheumatology at the University of Nebraska Medical Center.

Segment on PFO closure for prevention of recurrent stroke risk (Dr. Kasner):

  1. Saver JL, Carroll JD, Thaler DE, et al. Long-Term Outcomes of Patent Foramen Ovale Closure or Medical Therapy after Stroke. N Engl J Med 2017; 377:1022.
  2. Søndergaard L, Kasner SE, Rhodes JF, et al. Patent Foramen Ovale Closure or Antiplatelet Therapy for Cryptogenic Stroke. N Engl J Med 2017; 377:1033.
  3. Mas JL, Derumeaux G, Guillon B, et al. Patent Foramen Ovale Closure or Anticoagulation vs. Antiplatelets after Stroke. N Engl J Med 2017; 377:1011.

Segment on cost effectiveness of triple therapy in RA (Dr. O’Dell):

  1. Bansback N, Phibbs CS, Sun H, et al. Triple Therapy Versus Biologic Therapy for Active Rheumatoid Arthritis: A Cost-Effectiveness Analysis. Ann Intern Med. 2017;167(1):8.

Scott E Kasner, MD Grant/Research/Clinical Trial Support: WL Gore and Associates [Stroke (PFO closure)]; Acorda [Stroke (dalfampridine)]; AstraZeneca [Stroke (ticagrelor)]; Bayer [Stroke (rivaroxaban)]; Bristol Meyers Squibb [Stroke]. Consultant/Advisory Boards: Bayer [Stroke]; BMS [Stroke]; Novartis [Stroke]; Merck [Stroke]; Daiichi Sankyo [Stroke]; Boehringer Ingelheim [Stroke]; Abbvie [stroke]; J&J [stroke].

James R O'Dell, MD Disclosure: Consultant/Advisory Boards: AbbVie [Rheumatoid arthritis (TNF inhibitor)]; Lilly [Rheumatoid arthritis (JAK kinase inhibitor)]; BMS [Rheumatoid arthritis (abatacept)]; GlaxoSmithKline [Rheumatoid arthritis (Anti-IL-6)]; Medac [Rheumatoid arthritis (methotrexate)].

Investigational gene editing in human embryos to prevent disease; Tests for the diagnosis of influenza

Date Released: Nov 29 2017

This episode features Dr. Benjamin Raby discussing a recent paper on correcting a pathogenic gene mutation in human embryos, and Dr. Martin Hirsch discussing testing for diagnosing influenza. Dr. Nancy Sokol hosts.

Dr. RabyDr. Benjamin Raby is an Associate Professor of Medicine at the Harvard Medical School, a Pulmonologist and a Researcher in Genetics at the Channing Division of Network Medicine.
Dr. HirschDr. Martin Hirsch is a Professor of Medicine at the Harvard Medical School and Senior Physician in Infectious Diseases at the Massachusetts General Hospital in Boston.

Segment on investigational gene editing in human embryos to prevent disease (Dr. Benjamin Raby):

  1. Ma H, Marti-Gutierrez N, Park SW, et al. Correction of a pathogenic gene mutation in human embryos. Nature 2017; 548:413.
  2. Ormond, KE et al. Human Germline genome editing: ASHG Position statement. Am J Hum Genet 2017; 101:167 4. http://retractionwatch.com/2017/10/05/nature-adds-alert-heavily-debated-...

Segment on Tests for the diagnosis of influenza (Dr. Martin Hirsch):

  1. Merckx J, Wali R, Schiller I, et al. Diagnostic Accuracy of Novel and Traditional Rapid Tests for Influenza Infection Compared With Reverse Transcriptase Polymerase Chain Reaction: A Systematic Review and Meta-analysis. Ann Intern Med 2017; 167:394.

Benjamin A Raby, MD, MPH Equity Ownership/Stock Options: CureSpark, Inc [General science]. Employment (spouse): Paraxel [Hematology (CRO)] - No relevant conflict on topic.

Martin S Hirsch, MD Nothing to disclose

Prevention of HIV in high risk adolescents; ICDs for treatment of nonischemic cardiomyopathy

Date Released: Nov 15 2017

This episode features Dr. Kenneth Mayer, discussing use of pre-exposure HIV prophylaxis for high-risk adolescents, and Dr. Samuel Lévy, discussing use of an implantable cardioverter defibrillator for the primary prevention of sudden death in patients with nonischemic cardiomyopathy. Dr. Nancy Sokol hosts.

Dr. MayerDr. Kenneth Mayer is Professor of Medicine at Harvard Medical School and Medical Research Director at Fenway Health in Boston.
Dr. LévyDr. Samuel Lévy is Professor of Cardiology at Aix-Marseille University School of Medicine and Hospital Nord, Marseille, France.

Segment on prevention of HIV infection (Dr. Mayer):

  1. Hosek SG, Landovitz RJ, Kapogiannis B, et al. Safety and Feasibility of Antiretroviral Preexposure Prophylaxis for Adolescent Men Who Have Sex With Men Aged 15 to 17 Years in the United States. JAMA Pediatr 2017; 171:1063.

Segment on ICDs for treatment of cardiomyopathy (Dr. Lévy):

  1. Golwala H, Bajaj NS, Arora G, Arora P. Implantable Cardioverter-Defibrillator for Nonischemic Cardiomyopathy: An Updated Meta-Analysis. Circulation 2017; 135:201.
  2. Shun-Shin MJ, Zheng SL, Cole GD, et al. Implantable cardioverter defibrillators for primary prevention of death in left ventricular dysfunction with and without ischaemic heart disease: a meta-analysis of 8567 patients in the 11 trials. Eur Heart J 2017; 38:1738.
  3. Stavrakis S, Asad Z, Reynolds D. Implantable Cardioverter Defibrillators for Primary Prevention of Mortality in Patients With Nonischemic Cardiomyopathy: A Meta-Analysis of Randomized Controlled Trials. J Cardiovasc Electrophysiol 2017; 28:659.
  4. Kolodziejczak M, Andreotti F, Kowalewski M, et al. Implantable Cardioverter-Defibrillators for Primary Prevention in Patients With Ischemic or Nonischemic Cardiomyopathy: A Systematic Review and Meta-analysis. Ann Intern Med 2017; 167:103.

Kenneth H Mayer, MD Grant/Research/Clinical Trial Support: Gilead Sciences [PrEP (Tenofovir-emtricitabine)]; ViiV Healthcare [PrEP (Cabotegravir)].

Samuel Lévy, MD Consultant/Advisory Boards: Cardiome Pharma [Chair of the Safety Committee, Spectrum Study (Vernakalant IV)].

Zika virus prenatal infection and birth outcome; Evaluation for occult cancer in unprovoked VTE

Date Released: Nov 1 2017

This episode features Dr. Karin Nielsen discussing maternal Zika virus and potential factors associated with birth outcomes, and Dr. Jess Mandel discussing screening for occult cancer in patients with unprovoked venous thromboembolism.  Dr. Jennifer Mitty hosts.

Dr. NielsenDr. Karin Nielsen is a Clinical Professor of Pediatrics in the Division of Infectious Diseases at the David Geffen School of Medicine at UCLA and UCLA Mattel Children's Hospital. She is also the Director of the Center for Brazilian Studies at UCLA.
Dr. MandelDr. Jess Mandel is Professor of Clinical Medicine and Vice Chair of Education in the Department of Medicine at the University of California, San Diego. He is also Vice Chief of the Division of Pulmonary Critical Care and Sleep Medicine.

Segment on severity of maternal Zika virus infection and birth outcome (Dr. Karin Nielsen):

  1. Halai UA, Nielsen-Saines K, Moreira ML, et al. Maternal Zika Virus Disease Severity, Virus Load, Prior Dengue Antibodies, and Their Relationship to Birth Outcomes. Clin Infect Dis 2017; 65:877.

Segment on evaluation for occult cancer in unprovoked venous thromboembolism (Dr. Jess Mandel):

  1. van Es N, Le Gal G, Otten HM, et al. Screening for Occult Cancer in Patients With Unprovoked Venous Thromboembolism: A Systematic Review and Meta-analysis of Individual Patient Data. Ann Intern Med 2017; 167:410.

Karin Nielsen, MD, MPH Nothing to disclose

Jess Mandel, MD Nothing to disclose

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