Important:
Information contained in the following UpToDate Talk podcasts was current at the time of initial release. However, this content is not maintained or updated. For current clinical recommendations, please always consult UpToDate Online. Please note that we are no longer producing new clinical podcasts.
UpToDate faculty discuss important changes to the practice of medicine based 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.
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.
This is the complete archive for the UpToDate Clinical Talk Podcasts.
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.


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


Segment on investigational gene editing in human embryos to prevent disease (Dr. Benjamin Raby):
- Ma H, Marti-Gutierrez N, Park SW, et al. Correction of a pathogenic gene mutation in human embryos. Nature 2017; 548:413.
- 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):
- 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.


Segment on prevention of HIV infection (Dr. Mayer):
- 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):
- Golwala H, Bajaj NS, Arora G, Arora P. Implantable Cardioverter-Defibrillator for Nonischemic Cardiomyopathy: An Updated Meta-Analysis. Circulation 2017; 135:201.
- 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.
- 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.
- 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.


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