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Beyond Journal Club Podcast from Core IM

Evaluating new trials and their place in the literature

Should your patients be reaching for albuterol when their asthma flares up? Some of us may have been treating asthma exacerbations incorrectly for many years… What is the right approach? Tune in to the fifth episode of Beyond Journal Club, a...

The MANDALA Trial: What is the Best Rescue Medication for Asthma?

How do you counsel patients eligible for the RSV vaccines? What do the results of the RENOIR and AReSVi trials tell us and how do they compare? How should we interpret vaccine trials in the first place? Tune in to the...

The RENOIR and AReSVi Trials: RSV & What Makes Vaccine Trials Different?

In community-acquired pneumonia, can steroids improve mortality? Past studies of steroids in CAP have been conflicting, with some showing a mortality benefit and others showing no difference. How does the CAPE COD trial change how we think about patients hospitalized with...

The CAPE COD Trial: Do Steroids Have a Role in Community-Acquired Pneumonia?

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 treatment effect heterogeneity. Differences in the effectiveness of treatments across participants in a clinical trial is important to understand when deciding how to apply clinical trial results to clinical practice. ...

How Treatment Effect Heterogeneity Works

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

From Pages To Practice

From Pages to Practice

Each fall and winter, pediatric emergency rooms fill with infants in distress due to respiratory syncytial virus (RSV). Estimates of global disease burden suggest that one in every 28 deaths in children aged 28 days to 6 months is attributable to...

Nirsevimab for a More HARMONIE-ous RSV Season in Infants

Testosterone plays a critical role in men’s skeletal health, increasing bone mineral density throughout adulthood and maintaining it as they age. Men who undergo androgen deprivation therapy to reduce testosterone levels have decreased bone mineral density and increased risk of fracture....

Testosterone and Fracture Risk

Postexposure prophylaxis is not a new concept in medicine. The administration of antibiotic or antiviral therapy after close contact with a person who may be infectious is the current standard of care for many diseases including bacterial meningitis, human immunodeficiency virus...

PEPpered with Disappointment: The dPEP Trial

Type 1 diabetes mellitus (T1DM) is a chronic disease that is primarily diagnosed in childhood and marked by the autoimmune destruction of pancreatic insulin-producing β-cells. Histopathologic studies in the 1960s showed that by the time the disease becomes clinically apparent, fewer...

PROTECTing β-Cell Function in Children with Type 1 Diabetes Mellitus

Patients with cancer often question whether the risks and adverse effects associated with a specific treatment outweigh the benefits. This decision is highly personal and dependent on individual values and goals. Many patients value independence and quality of life over cancer...

Foregoing Radiotherapy after Breast Conserving Surgery

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

NEJM Quick Takes

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New research findings summarized in a short video

For patients with STEMI and multivessel disease, the benefit of fractional flow reserve–guided complete revascularization, as compared with culprit-lesion-only PCI, is unclear. New research findings are summarized in a short video.

FFR-Guided Complete PCI for STEMI

SGLT2 inhibitors improve cardiovascular outcomes in high-risk patients with diabetes, chronic kidney disease, or heart failure, but their effects after acute myocardial infarction are unknown. New research findings are summarized in a short video.

Empagliflozin after Acute Myocardial Infarction

Most moderate-to-late–preterm infants need nutritional support pending the sufficient availability and intake of mother’s breast milk, but evidence for the best nutrition strategy is lacking. New research findings are summarized in a short video.

Nutritional Support for Preterm Infants

Adjuvant pembrolizumab was approved for patients with renal-cell carcinoma on the basis of improvements in disease-free survival observed in the KEYNOTE-564 trial. Data on overall survival are needed. New research findings are summarized in a short video.

Adjuvant Pembrolizumab and Survival in Renal-Cell Carcinoma

Cardiogenic shock in ST-segment elevation myocardial infarction is associated with high mortality. The effects of circulatory support with a microaxial flow pump have been uncertain in this setting. New research findings are summarized in a short video.

Microaxial Flow Pump for STEMI and Cardiogenic Shock

Contemporary clinical trials examining the efficacy and safety of long-term beta-blocker therapy in patients with acute myocardial infarction and preserved ejection fraction are lacking. New research findings are summarized in a short video.

Beta-Blockers after MI and Preserved Ejection Fraction

For patients with type 2 diabetes, there are no approved treatments that specifically target obesity-related heart failure with preserved ejection fraction. New research findings are summarized in a short video.

Semaglutide, Heart Failure, and Diabetes

Whether early minimally invasive surgical removal of an intracerebral hemorrhage improves functional outcomes is unknown. New research findings are summarized in a short video.

Early Minimally Invasive Removal of Intracerebral Hemorrhage

Among patients with resected ALK-positive NSCLC, standard adjuvant platinumbased chemotherapy is associated with only modestly improved survival and a high risk of adverse events. Alectinib might improve outcomes. New research findings are summarized in a short video. ...

Alectinib in Resected ALK-Positive NSCLC

Nirmatrelvir plus ritonavir reduced the risk of Covid-19–related hospitalization or death in unvaccinated, high-risk adults, but whether it can reduce symptom duration in a broader group is unknown. New research findings are summarized in a short video.

Nirmatrelvir for Outpatients with Covid-19

Previous trials have shown that omission of axillary-lymph-node dissection does not appear to affect important outcomes. New research findings extend those findings and are summarized in a short video.

Omitting Axillary Dissection in Breast Cancer

Lixisenatide, a glucagon-like peptide-1 receptor agonist used to treat type 2 diabetes, is under study as a potential treatment for Parkinson’s disease. New research findings are summarized in a short video.

Lixisenatide in Early Parkinson’s Disease

Many patients have the triad of chronic kidney disease, diabetes, and hypertension. Trials examining implementation of guideline-directed care to reduce morbidity among these patients are lacking. New research findings are summarized in a short video.

Hospitalization Rate in Chronic Kidney Disease

In patients with HR-positive, HER2-negative early breast cancer, the efficacy and safety of ribociclib plus adjuvant endocrine therapy versus endocrine therapy alone are unknown. New research findings are summarized in a short video.

Ribociclib in Early Breast Cancer

Many patients with paroxysmal nocturnal hemoglobinuria have persistent anemia despite standard treatment. The efficacy and safety of the complement inhibitor iptacopan in PNH are unclear. New research findings are summarized in a short video.

Iptacopan for Paroxysmal Nocturnal Hemoglobinuria

Many people with food allergies are allergic to multiple foods, but there is no FDA-approved treatment for multiple food allergies. New research findings on omalizumab for children and adolescents with multiple food allergies are summarized in a short video. ...

Omalizumab for Multiple Food Allergies

For patients with the rare inflammatory disorder eosinophilic granulomatosis with polyangiitis, a head-to-head trial comparing benralizumab and mepolizumab is lacking. New research findings are summarized in a short video.

Benralizumab versus Mepolizumab for EGPA

Among patients with advanced urothelial cancer, 5-year survival with firstline platinum-based chemotherapy is relatively low. Enfortumab vedotin plus pembrolizumab may improve outcomes. New research findings are summarized in a short video.

Enfortumab Vedotin–Pembrolizumab in Advanced Urothelial Cancer

Radical hysterectomy remains the standard of care for early-stage, low-risk cervical cancer, but simple hysterectomy could be a safe option. New research findings are summarized in a short video.

Simple Hysterectomy for Low-Risk Cervical Cancer

Patients with primary biliary cholangitis who are treated with the only approved first-line therapy commonly have persistently elevated levels of alkaline phosphatase, bilirubin, or both. New research findings are summarized in a short video.

Seladelpar in Primary Biliary Cholangitis

Curbside Consults Podcast

A deep dive with clinician experts and educators

In this episode of Curbside Consults, Dr. Andrew Dwyer, Director of Psychometrics at the American Board of Pediatrics (ABP), joins Mridula Nadamuni, former editorial fellow, to discuss the process of creating and administering pediatric board examinations. ...

How the Pediatric Boards Are Made with Dr. Andrew Dwyer

In this episode of Curbside Consults, Dr. Adriann Begay, member of the Navajo Nation, shares her journey into medicine. Dr. Begay is Tábaahi (Edge of the Water clan) and born for Bít’ahnii (Folded Arms People clan). Her maternal grandparents are Ta’néészahnii...

Global Health, GLocal Health, and the Indian Health Service with Dr. Adriann Begay

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

Clinical Spotlight

Exploring controversies in clinical research

Its effects include sedation not reversed by naloxone, as well as hypotension and bradycardia; extensive skin wounds are associated with xylazine-adulterated fentanyl.

Xylazine: An Increasingly Frequent Adulterant in Fentanyl Street Drugs

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?

Research Summaries

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Research summaries with expert commentaries

A case series describes 23 patients with presumed hepatotoxicity from these substances.

Characteristics of Drug-Induced Liver Injury from Anabolic Steroids and Selective Androgen-Receptor Modulators

In a randomized trial, octreotide was highly effective, and serious adverse events were rare.

Long-Acting Octreotide Reduces Bleeding in Patients with Gastrointestinal Angiodysplasia

The American College of Gastroenterology published new guidelines for this condition.

Managing Acute Pancreatitis

An IgA-tTG titer greater than 10 times the upper limit of normal has a very high positive predictive value.

More About Serologic Diagnosis of Celiac Disease

Genetic predisposition might explain some of the variability in response to exercise.

Why Do Some People Develop Obesity Despite High Levels of Physical Activity?

Wearable monitors were reasonably accurate at measuring heart rate during rest in NSR but much less accurate in atrial fibrillation or exercise.

Accuracy of Wearable Monitors for Assessment of Heart Rate During Rest and Exercise

In a Mayo Clinic study, HCM incidence has increased during the past several decades.

How Common Is Hypertrophic Cardiomyopathy?

A new review provides practical help with difficult choices.

Antibiotics in End-of-Life Care

An 11-year observational study showed a roughly threefold higher risk for death in steroid users than in nonusers.

High Mortality Is Associated with Anabolic Steroid Use

Remote therapy might be more convenient without sacrificing improvements in pain and function.

In-Person and Remote Physical Therapy Are Equally Effective for Chronic Knee Pain

In a randomized trial, combination treatment was not superior to treatment with levothyroxine alone.

Combination T4/T3 Treatment for Hypothyroidism?

In patients with angina and no obstructive coronary disease, positive stress tests were highly predictive of CMD.

“False-Positive” Stress Tests in Patients with Coronary Microvascular Dysfunction

These treatments are recommended “conditionally” for certain groups of patients with Clostridioides difficile colitis.

Using Fecal Microbiota–Based Therapies

Checking vital signs and deploying rapid response teams are paramount to identifying and responding to critically ill hospitalized patients.

Managing Patient Deterioration Outside of the ICU

A new guideline carefully separates validated treatments from those with weak or insufficient evidence and recommends a screening tool for primary care.

Managing Post-Traumatic Stress Disorder

In a placebo-controlled trial, this treatment was ineffective.

Lidocaine Patch for Chronic Nonspecific Neck Pain?

Outcomes at 2 years favored surgery over collagenase injections and needle fasciotomy.