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Beyond Journal Club Podcast from Core IM

Evaluating new trials and their place in the literature

What is the difference between semaglutide (Ozempic, Wegovy, Rybelsus) and tirzepatide (Mounjaro) in metabolic outcomes and mechanism? How did we find out diabetes medications can help with weight loss? SURMOUNT-1 asked the question, "Does tirzepatide, a once weekly injectable drug used...

The SURMOUNT-1 Trial: How Did Diabetes Medications Become Weight Loss Meds?

Does adding revascularization by percutaneous coronary intervention (PCI) to optimal medical therapy improve survival and heart failure hospitalizations in patients with severe ischemic left ventricular systolic dysfunction? Some evidence suggests that patients with low ejection fraction benefit from revascularization by PCI....

The REVIVED Trial: Does PCI Save Lives in Heart Failure and CAD?

Stats, Stat!

Stats

This Stats, STAT! animated video explores the concept of statistical power and explains how clinical investigators determine how many participants to enroll in a randomized trial.

How Statistical Power Works

A common challenge in clinical research is determining the time to occurrence of a given event. This animated video explores the concept of censoring in survival analysis and how investigators deal with ambiguity in the time of an event’s occurrence. ...

How Censoring Works

In the latest edition of Stats, STAT!, Fralick and colleagues explain the statistics behind large language models — used in chat bots like ChatGPT and Bard. While these new tools may seem remarkably intelligent, at their core they just assemble sentences...

Large Language Models

This Stats, STAT! animated video explores two possible approaches to analyzing data in a randomized controlled trial: “Frequentist” versus “Bayesian.”

Bayesian Way

This Stats, STAT! animated video explores common approaches to analyzing data from randomized controlled trials, including intention-to-treat, per-protocol, and as-treated analyses.

Good Intentions to Treat


From Pages To Practice

From Pages to Practice

Sickle cell disease (SCD) is the most common monogenic disorder caused by a point mutation in the HBB gene, which encodes β-hemoglobin. The resulting substitution of valine for glutamic acid modifies the erythrocyte morphology such that it is predisposed...

Progress in Sickle Cell Disease Gene Therapies

If you have ever looked at a pediatric chest radiograph, you may recall seeing a large thymic shadow overlying the mediastinum. That shadow disappears with age as the thymus atrophies and involutes. Children born with an absent or hypoplastic thymus, such...

Don’t Underestimate the Health Consequences of Thymus Removal in Adults

Patients with major depressive disorder (MDD) often require multiple medications trials to achieve remission. Treatment-resistant depression (TRD) — defined as lack of response to two or more medication trials — affects up to 30% of patients with MDD. Patients with...

Escaping Treatment-Resistant Depression with Esketamine

Glucagon-like peptide 1 (GLP-1) receptor agonists are gaining attention for the management of type 2 diabetes and obesity. These drugs have multifactorial effects that include stimulating glucose-dependent insulin secretion, delaying gastric emptying, and inhibiting postprandial glucagon secretion. Consequently, GLP-1 receptor agonists...

Promising Results for GLP-1 Receptor Agonists in Obesity-Related HFpEF

A 40-year-old man with bipolar I disorder who is currently on a mood stabilizer is feeling better after a recent depressive episode. During the episode, he was treated with an adjunctive antidepressant. Now that his depression is in remission, you are...

Duration of Adjunctive Antidepressants After Remission of Depression in Bipolar I Disorder

Ms. Apple is a 74-year-old woman with a history of overweight but otherwise very active and still working as a part-time schoolteacher. At a primary care visit, she explains that she is concerned about memory loss because her mother developed dementia...

Diet for Prevention of Cognitive Decline in Older Adults

Mr. Wang is a 73-year-old male with a history of atrial fibrillation (AF) and diabetes who presented with left-sided weakness. Head imaging showed an ischemic stroke affecting the superficial cortical branch of the right middle cerebral artery. When should he restart...

Early Anticoagulation After Stroke Due to Atrial Fibrillation Prevents Recurrent Ischemic Events

Men who receive a diagnosis of low- or intermediate-risk clinically localized prostate cancer can live for decades. Each treatment option is associated with different effects on quality of life and sexual, urinary, and bowel function. To compare the effectiveness of these...

Similarly Low 15-Year Mortality After Monitoring, Surgery, or Radiotherapy for Prostate Cancer

Pulmonary arterial hypertension (PAH) involves the obliteration of the small arterioles of the pulmonary vasculature. PAH is categorized as World Health Organization (WHO) group 1 pulmonary hypertension, based on the presence of elevated pulmonary arterial pressures, normal pulmonary capillary wedge/left heart...

Lung Story Short: A New Therapy for Pulmonary Arterial Hypertension

The perennial question of whether to use glucocorticoids to treat patients with community acquired pneumonia (CAP) continues to consume hours of discussion in intensive care units (ICUs). Pneumonia elicits an inflammatory response in the lung, which left unchecked, can lead to a deleterious decline in pulmonary function and oxygenation. Glucocorticoids...

Should Glucocorticoids Be All the Rage in the Treatment of CAP?

Some anticoagulation decisions in patients with thrombosis are straightforward, thanks to a preponderance of data. First provoked deep-vein thrombosis (DVT)? There’s a guideline for that (no less than 3 months of anticoagulation). Recurrent DVT, pulmonary embolism, or decisions between a direct...

Hydrochlorothiazide or Chlorthalidone for Hypertension?

Venous thromboembolism (VTE) is the most common cause of preventable death in hospitalized medical patients, yet pharmacologic prophylaxis remains underutilized. The Virchow’s triad of venous stasis, vascular injury, and hypercoagulability is key in the assessment of VTE risk. Based on the Padua Score — a validated risk assessment model that...

Broken Bones and Thromboprophylaxis: Is Aspirin Enough?

Opioid use disorder (OUD) continues to be a national crisis in the United States. President Biden has identified battling the opioid crisis as a top priority and the U.S. Department of Health and Human Services (HHS) has awarded $1.6 billion to...

Methadone or Buprenorphine in Mothers and Neonates: A Tale of Two Drugs for OUD

Going with the Flow — Rivaroxaban Prophylaxis in Noncirrhotic Portal Venous Thrombosis

Tuberculosis (TB) is the leading cause of death worldwide from a single infectious agent. TB is caused by the bacillus Mycobacterium tuberculosis , infecting about a quarter of the world’s population. Drug-resistant TB continues to be a threat to public health; in 2019, approximately 465,000 patients worldwide had rifampicin-resistant disease,...

Assessing What’s PRACTECAL in Rifampicin-Resistant Tuberculosis

Eosinophils are granulocytes theorized to have developed in humans to guard against parasitic infections, including nematodes that reside in human intestines. As a result, eosinophils appear to be normal constituents of gastrointestinal tissue, with an increasing gradient... ...

Dupilumab for Eosinophilic Esophagitis: Therapy for a Tough Diagnosis to Swallow?

Mr. Pool is a 64-year-old man with high blood pressure while taking lisinopril, diabetes (HbA1c level, 7.3), obesity (BMI, 32 kg/m2 ), and dysplipidemia while taking statin therapy (elevated triglyceride of 270 mg/dL and low HDL of 33 mg/dL...

Fibrate Therapy Does Not Reduce Cardiovascular Events in Patients with Mild-to-Moderate Hypertriglyceridemia

The pancreas is a notoriously complex endocrine organ and when inflamed can cause a wide range of clinical symptoms, ranging from simple epigastric pain, nausea, and vomiting, all the way to circulatory collapse and acute respiratory distress syndrome (ARDS). As...

Fluid Resuscitation in Pancreatitis

Cigarette smoking is the leading cause of chronic obstructive pulmonary disease (COPD). More than 3 million people worldwide die of COPD each year, accounting for approximately 6% of all deaths. COPD is a heterogenous condition with various phenotypes including emphysema...

Inhalers for Smokers' Cough? Time for a RETHINC

When an area of the myocardium is not moving normally, it is important to realize that all may not be lost. Although ischemia can lead to infarction —or death of the cardiomyocytes— the cells may survive by “hibernating” or suspending the...

To PCI or Not to PCI — a Revascularization Question

NEJM Quick Takes

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New research findings summarized in a short video

Preventive inhaled antibiotics may reduce the incidence of ventilator-associated pneumonia. New research findings are summarized in a short video.

Inhaled Amikacin to Curb Ventilator-Associated Pneumonia

Amivantamab is approved as second-line therapy for NSCLC with EGFR exon 20 insertions. Preliminary data showed safety and antitumor activity of amivantamab when combined with chemotherapy. New research findings are summarized in a short video.

Combination Therapy in NSCLC with EGFR Exon 20 Insertions

Guidelines recommend administration of thyroid hormone to brain-dead hemodynamically unstable, potential organ donors. Evidence for this approach in heart donation is lacking. New research findings are summarized in a short video.

Levothyroxine and Heart Donation

The PARTNER 3 trial previously found transcatheter aortic-valve replacement to be superior to surgical valve replacement with respect to cardiovascular events at 1 and 2 years. New research findings at 5 years are summarized in a short video. ...

TAVR or Surgery in Low-Risk Patients at Five Years

Osimertinib is the preferred first-line treatment in patients with EGFR-mutated advanced non–small-cell lung cancer. Whether adding chemotherapy to osimertinib could improve outcomes is unclear. New research findings are summarized in a short video.

Osimertinib with Chemotherapy in EGFR-Mutated NSCLC

Treatment options are limited for advanced or metastatic urothelial cancer that progresses after standard therapies. Erdafitinib might improve survival after progression during treatment with PD-1 or PD-L1 inhibitors. New research findings are summarized in a short video.

Erdafitinib in Advanced or Metastatic Urothelial Carcinoma

The RET kinase inhibitor selpercatinib previously showed promise for treating RET-mutant medullary thyroid cancer in nonrandomized studies. New research findings from a randomized trial of selpercatinib are summarized in a short video.

Selpercatinib in RET-Mutant Medullary Thyroid Cancer

For the diagnostic evaluation of arginine vasopressin deficiency, a head-to-head trial comparing arginine-stimulated and hypertonic saline–stimulated copeptin is lacking. New research findings are summarized in a short video.

Stimulated Copeptin to Diagnose AVP Deficiency

Selpercatinib showed promise in treating RET fusion–positive non–small-cell lung cancer in nonrandomized studies, but evidence is lacking regarding its efficacy relative to available therapies. New research findings are summarized in a short video.

First-Line Selpercatinib in RET Fusion–Positive NSCLC

Anti-Aβ antibody treatments for Alzheimer’s disease have had mixed results. New research findings for gantenerumab, a monoclonal antibody with high affinity for aggregated amyloid, are summarized in a short video.

Gantenerumab in Early Alzheimer’s Disease

Nursing home residents are at high risk for infection and infection-related hospitalization. Universal decolonization might provide a benefit over routine care. New research findings are summarized in a short video.

Nursing Home Decolonization for Infection Prevention

Local injections of botulinum toxin are frequently used to treat head tremor, yet randomized trials assessing the effects have been limited. New research findings are summarized in a short video.

Botulinum Toxin for Head Tremor

In patients with advanced urothelial carcinoma, durable responses to first-line cisplatin-based chemotherapy are uncommon. The addition of nivolumab to chemotherapy might improve outcomes. New research findings are summarized in a short video.

Nivolumab plus Chemotherapy in Advanced Urothelial Carcinoma

In patients with medically refractory paroxysmal atrial fibrillation, the safety and efficacy of pulsed field ablation as compared with conventional thermal ablation is unknown. New research findings are summarized in a short video.

Pulsed Field Ablation for Paroxysmal Atrial Fibrillation

Small-intestinal angiodysplasia is the most common cause of small-intestinal bleeding. Effective and safe oral treatments are needed for recurrent bleeding in these patients. New research findings are summarized in a short video.

Thalidomide for Recurrent Bleeding Due to SIA

For patients with resectable non–small-cell lung cancer, the most appropriate treatment is unclear. New research findings comparing perioperative durvalumab plus neoadjuvant chemotherapy with neoadjuvant chemotherapy alone are summarized in a short video.

Perioperative Chemoimmunotherapy in Lung Cancer

For pregnant persons with type 1 diabetes, improved maternal glucose levels are tied to better outcomes, but whether a hybrid closed-loop system could improve glycemic control is unknown. New research findings are summarized in a short video.

Automated Insulin in Pregnant Patients with Type 1 Diabetes

Appropriate treatment for patients with transthyretin amyloidosis (ATTR amyloidosis) — a progressive, debilitating, and fatal disease — is unclear. New research findings comparing patisiran to placebo are summarized in a short video.

Patisiran for Transthyretin Cardiac Amyloidosis

Prurigo nodularis is a chronic, debilitating skin disease characterized by severe itching and widespread nodular lesions. Nemolizumab is under study as a potential treatment option. New research findings are summarized in a short video.

Nemolizumab for Prurigo Nodularis

Patients frequently have biochemical recurrence after prostate cancer treatment. The hormonal therapy enzalutamide is under study as a potential treatment for these patients. New research findings are summarized in a short video.

Enzalutamide for Biochemically Recurrent Prostate Cancer

Curbside Consults Podcast

A deep dive with clinician experts and educators

On this episode of Curbside Consults, we discuss current approaches, adverse effects, and management of complications associated with immune checkpoint inhibitors (ICIs). We are joined by Dr. Kerry Reynolds, Clinical Director of Inpatient Oncology at Massachusetts General Hospital and Director of...

Immune Checkpoint Inhibitors with Dr. Kerry Reynolds

In this episode of Curbside Consults, we examine the 2022 scientific statement from the American Heart Association on the management of acute coronary syndrome in the older adult population. We are joined by Dr. Abdulla Damluji, the lead author on the...

Management of Acute Coronary Syndrome in Older Adults with Dr. Abdulla Damluji

In this episode of Curbside Consults, Jaclyn Albin, MD and Milette Siler, RD share their passion for food as medicine and talk about their experiences at The Culinary Medicine Program at UT Southwestern Medical Center. Jaclyn believes food as medicine delivers...

Culinary Medicine with Dr. Jaclyn Albin and Milette Siler, RD

In this episode of Curbside Consults, we examine the Endocrine Society’s 2022 Clinical Practice Guideline on management of hyperglycemia in hospitalized adults in non-critical care settings. We are joined by Dr. Mary Korytkowski, Emeritus Professor of Medicine at the University of...

Management of Hyperglycemia in Hospitalized Adults with Dr. Mary Korytkowski

In this episode of Curbside Consults, we examine the American College of Chest Physicians recent clinical practice guideline on Perioperative Management of Antithrombotic Therapy. We are joined by Dr. James Douketis, Chair in Thromboembolic Disease at McMaster University and the first...

American College of Chest Physicians Clinical Practice Guideline on Perioperative Management of Antithrombotic Therapy with Dr. James Douketis

In this episode of Curbside Consults, we examine the 2022 revision of the clinical practice guideline on the management of hyperbilirubinemia in the newborn infant by the American Academy of Pediatrics (AAP). We are joined by two authors of the revised...

Management of Hyperbilirubinemia in the Newborn Infant with Drs. Alex Kemper and Tom Newman

In this episode of Curbside Consults, we discuss aerospace medicine with two physicians who are double boarded in internal and aerospace medicine and are also NASA astronauts. Dr. Auñón-Chancellor recently served as Flight Engineer on the International Space Station for Expeditions...

Space Medicine with Drs. Serena Auñón-Chancellor and Michael Barratt

In this episode of Curbside Consults, we examine an update on management of opiate use disorder in hospitalized adults by the SHM (Society of Hospital Medicine). We are joined by Dr. Susan Calcaterra, Associate Professor of Medicine, Director of the Addiction...

Management of Opiate Use Disorder in Hospitalized Adults with Dr. Susan Calcaterra

In this episode of Curbside Consults, we examine the American Thoracic Society Clinical Practice Guideline (CPG) on Sarcoidosis. We are joined by one of its co-authors, Dr. Kevin Wilson, Chief of Guidelines and Documents at the American Thoracic Society and Professor...

American Thoracic Society Clinical Practice Guideline on Sarcoidosis with Dr. Kevin Wilson

In this episode of Curbside Consults, we examine an update on sleep-related infant deaths by the American Academy of Pediatrics (AAP). We are joined by Rachel Moon, Harrison Distinguished Teaching Professor of Pediatrics of at the University of Virginia and Chair...

Sleep-Related Infant Deaths with Dr. Rachel Moon

In this episode of Curbside Consults, we are joined by Dr. Cheri Blauwet, Chief Medical Officer at Spaulding Rehabilitation Hospital, Associate Professor of Physical Medicine and Rehabilitation at Harvard Medical School, and retired Paralympian in the sport of competitive wheelchair...

Understanding Disability with Dr. Cheri Blauwet

In this episode of Curbside Consults, we examine the latest guidelines on the diagnosis and management of idiopathic pulmonary fibrosis (IPF) and progressive pulmonary fibrosis (PPF) by the American Thoracic Society (ATS). We are joined by Mary Strek, Professor of Medicine...

Update on Idiopathic and Progressive Pulmonary Fibrosis with Dr. Mary Strek

In this episode of Curbside Consults, we examine the latest standards of medical care published by the American Diabetes Association (ADA). We are joined by Dr. Bob Gabbay, who is Chief Science and Medical Officer at the American Diabetes Association, an...

ADA Standards of Medical Care in Diabetes with Dr. Bob Gabbay

In this episode of Curbside Consults, we examine the latest recommendation statement on the use of aspirin to prevent cardiovascular disease from the United States Preventive Services Task Force (USPSTF). We are joined by Michael Barry, who is Director of the Informed Medical Decisions Program in the Health Decision Sciences...

USPSTF Recommendation Statement on Aspirin Use with Dr. Michael Barry

In this episode of Curbside Consults, we are joined by Dr. Clyde Yancy, Chief of Cardiology at the Feinberg School of Medicine, past chair of the American College of Cardiology/American Heart Association Heart Failure Guidelines Committee, and a senior member of the committee that authored the new 2022 Guideline for...

Guideline for the Management of Heart Failure with Dr. Clyde Yancy

In this episode of Curbside Consults, we examine the latest guidelines from the Centers for Disease Control (CDC) on the treatment of sexually transmitted infections (STIs). We are joined by Dr. Kimberly Workowski, a Professor of Medicine in the Division of Infectious Diseases at Emory, and one of the guideline...

CDC Sexually Transmitted Infections Treatment Guidelines with Dr. Kimberly Workowski

As Editor-In-Chief of the New England Journal of Medicine , Dr. Eric Rubin is an authority on medical publishing, but he didn’t always know this was the job he wanted. In this special episode of Curbside Consults, we explore the highlights...

Pursuing a Career in Medical Publishing: A Conversation with Dr. Eric Rubin

In this episode of Curbside Consults, we examine the latest guidelines on the diagnosis and management of Barrett’s esophagus by the American College of Gastroenterology (ACG). We are joined by Dr. Nick Shaheen, a Professor of Medicine and Chief of Gastroenterology and Hepatology at UNC Chapel Hill, and one of...

Diagnosis and Management of Barrett’s Esophagus with Dr. Nicholas Shaheen

In this episode of Curbside Consults, we examine the latest guidelines on the diagnosis and management of pediatric osteomyelitis by the Infectious Diseases Society of America (IDSA) and Pediatric Infectious Diseases Society (PIDS). We are joined by Dr. Samir Shah, a Professor of Pediatrics at Cincinnati Children’s Hospital, Editor-in-Chief of...

Diagnosis and Management of Pediatric Osteomyelitis with Dr. Samir Shah

In this episode of Curbside Consults, we examine the latest guidelines on the management of Clostridiodes difficile (C. difficile ) infection. This year, updated guidelines were developed by the Infectious Diseases Society of America and Society for Healthcare Epidemiology of America, as well as the American College...

Diagnosis and Treatment of C. difficile Infection with Dr. Jessica Allegretti

Clinical Spotlight

Exploring controversies in clinical research

New randomized trials provide helpful data, but our understanding of this drug's effect remains incomplete.

Antidepressant Effects of the Psychedelic Drug Psilocybin

Two newly approved vaccines for adults 60 or older should be available in autumn 2023.

RSV Vaccines for Older Adults


Similar neurological, immunological, metabolic, and cardiopulmonary abnormalities are present.

Long COVID and Chronic Fatigue Syndrome Share Pathophysiology


According to a new study, we still have a long way to go.

Has Inpatient Care Become Safer?

Protection against mild COVID-19 wanes within a few months, but prevention of severe outcomes lasts longer (except in immunocompromised persons).

Vaccine Effectiveness Against SARS-CoV-2 Variants, Revisited

Research Summaries

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Research summaries with expert commentaries

2023 guidelines for pneumococcal vaccination of adults aged ≥19 years

Updated Guidelines for Use of Pneumococcal Vaccines in Adults


A small-to-moderate initial drop in GFR was not associated with longer-term adverse cardiovascular or kidney outcomes.

SGLT-2 Inhibitors and Acute Declines in Glomerular Filtration Rates


Adverse outcomes were more likely when cystatin C–based estimates were substantially lower than creatinine-based estimates.

How Should We Interpret Differences Between Cystatin C–Based and Creatinine-Based GFR Estimates?


Corticosteroids were associated with lower 30-day all-cause mortality, particularly in patients directly admitted to the ICU.

A Meta-Analysis on Corticosteroids and Community-Acquired Pneumonia


The evidence supports acamprosate and oral naltrexone as first-line treatments.

Comparing Pharmacotherapy Options for Alcohol Use Disorder

Thyrotoxicosis was associated with 39% higher risk for cognitive disorders.

Thyrotoxicosis and Risk for Cognitive Disorders in Older Adults

Correcting serum sodium slowly was associated with longer length of stay and excess mortality.

How Fast Should We Correct Severe Hyponatremia?

Recurrence of venous thromboembolism at 1, 5, and 10 years was common following isolated distal deep venous thrombosis.

VTE Recurrence After Isolated Distal Leg DVT

Updated international guidelines reaffirm support for a restrictive blood transfusion strategy.

Transfusion of Red Blood Cells in Hospitalized Patients

In a randomized trial of initial empirical therapy in patients with suspected infection, the answer was no.

Is Piperacillin-Tazobactam More Likely Than Cefepime to Be Associated with Acute Kidney Injury?

Patients treated with mupirocin were less likely to have positive S. aureus cultures, but numbers of bloodstream infections were similar.

Iodine Is Inferior to Mupirocin for Nasal Decolonization in the Intensive Care Unit

Those who underwent rehabilitation had better exercise capacity and quality of life.

Should Patients with Persistent Dyspnea After Pulmonary Embolism Be Referred for Exercise Therapy?

An early drop of >15% in glomerular filtration rate predicted excess risk for developing end-stage renal disease.

Renal Outcome After an Acute GFR Decline in Response to Antihypertensive Treatment

AF during hospitalization for acute medical illness or noncardiac surgery recurred in one third of patients by 1 year.

Atrial Fibrillation That Occurs Transiently During Hospitalization

But older, mostly vaccinated, patients didn't benefit.

Nirmatrelvir/Ritonavir Benefitted Immunocompromised Patients with COVID-19

Thirty-day readmission rates were two-thirds lower with primary care follow-up.

Postdischarge Primary Care Follow-Up of Emergency General Surgery Patients Might Prevent Some Readmissions

During 30 years of follow-up, women with prior gestational diabetes had 30% higher risk for death than those without such history.

Gestational Diabetes and Early Mortality

Among patients with at least one 30% stenosis, FFR measurements helped predict adverse cardiac events within 3 years.

Prognostic Value of Fractional Flow Reserve Derived from CT Angiography

A 2-day regimen of low-dose colchicine or prednisone had similar short-term efficacy.

Colchicine vs. Prednisone for Acute Pseudogout

Patients with gastroesophageal reflux disease and normal mucosa on initial endoscopy might not require repeat examinations.