Sensible Medicine

TR is an 88-year-old man who is disabled and in chronic pain from spinal stenosis and knee osteoarthritis. He has multiple other medical issues, including coronary artery disease and COPD.

He has been through years of treatment for his knees and back, including physical therapy, multiple joint injections, and an in-office procedure for spinal stenosis. He has been on multiple regimens of oral pain medications. He is not interested i...

Amoxicillin-Clavulanate vs Amoxicillin for Acute Sinusitis in Adults

* Prespecified Falsification End Points: Can They Validate True Observational Associations?

* Ultrasonography versus Computed Tomography for Suspected Nephrolithiasis

GLP-1 receptor agonist use and cancer risk in obese nondiabetic adults

* Risk for Cancer With Glucagon-Like Peptide-1 Receptor Agonists and Dual Agonists: A Systematic Review and Meta-analysis

Reduced Melanoma After Regular Sunscreen Use: Randomized Trial Follow-Up

GLP-1 Receptor Agonists or SGLT2 Inhibitors and Nonarteritic Anterior Ischemic Optic Neuropathy

* Previously discussed on Fornight XXII: Glucagon-like peptide-1 receptor agonists and risk of substance use disorders among US veterans with type 2 diabetes: cohort study

Oral Nirmatrelvir–Ritonavir for Covid-19 in Higher-Risk Outpatients

* Real-World Effectiveness of Nirmatrelvir–Ritonavir Against Severe Outcomes of COVID-19 in Taiwan: A Nationwide Population-Based Cohort Study

Three Low-Dose Antihypertensive Agents in a Single Pill after Intracerebral Hemorrhage

* Effect of Combination Therapy on Adherence Among US Patients Initiating Therapy for Hypertension: a Cohort Study

RSV Prefusion F Vaccine for Prevention of Hospitalization in Older Adults

Ultrasound-Facilitated, Catheter-Directed Fibrinolysis for Acute Pulmonary Embolism

* Endovascular management of intermediate-risk pulmonary embolism: evidence, outstanding questions, drivers of utilization, and the horizon

* Glucagon-like peptide-1 receptor agonists and risk of substance use disorders among US veterans with type 2 diabetes: cohort study

* Immediate or Deferred Nonculprit-Lesion PCI in Myocardial Infarction

* Andrew’s previous SM post on the subject: How a Meta-Analysis can Mislead—The Story of Complete vs Culprit-only PCI in STEMI

And, a bunch of the other studies we discussed.

* Complete Revascularization with Multivessel PC...

Sodium Correction Rates and Associated Outcomes Among Patients With Severe Hyponatremia: A Retrospective Cohort Study

* A Randomized Trial of Targeted Hyponatremia Correction in Hospitalized Patients

Effect of Neuromuscular Warm-up on Injuries in Female Soccer and Basketball Athletes in Urban Public High Schools

* Why Are So Many Teen Girls Still Tearing Their A.C.L.s?

* Injury prevention programs that include plyometric exercises redu...

Most conversations about “AI in Medicine” bore me. I think this is because either we lack the imagination to consider how AI will change medicine in the next decade, or we are not being specific enough about how small parts of medicine could be productively affected.

Dr. Shantanu Nundy, MD, MBA, is a practicing physician whom I like to think of as a serial innovator. He is currently an advisor on artificial intelligence ...

High-Dose Influenza Vaccine Effectiveness against Hospitalization in Older Adults

* High-Dose Influenza Vaccine to Reduce Hospitalizations

* Efficacy of high-dose versus standard-dose influenza vaccine in older adults

Beta-blockers after myocardial infarction: effects according to sex in the REBOOT trial

Today on the podcast, I am joined by Dr. Jennifer Rusiecki. Dr. Rusiecki is an Associate Professor of Medicine at the University of Chicago. She is the Director of Women’s Health and Gender-Based Care in the internal medicine residency program and the assistant clinic director overseeing gender-based care.

Dr. Rusiecki and I discussed the article appraised in the other post today, and also discussed the issues of screening for...

A Conservative Dialysis Strategy and Kidney Function Recovery in Dialysis-Requiring Acute Kidney Injury: The Liberation From Acute Dialysis (LIBERATE-D) Randomized Clinical Trial

Beta-Blockers after Myocardial Infarction with Normal Ejection Fraction

* Should Evidence Come with an Expiration Date?

No video this week — we had a bit of a computer meltdown — but two interesting articles.

As always, thanks for listening. If you have articles you would like us to cover, please send us a suggestion at sensiblemedicine2022@gmail.com.

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I was shocked at the comments on this post.

Many people, some of them I know to be smart, thought I was nuts for suggesting two middle-aged women who had isolated high LDL-C needn’t take meds because their calculated 10-year risk was less than 3%

What shocked me is that our guidelines suggest treatment with statins when 10-year risk is ≥ 7.5%. You may not know this but clinicians are supposed to consider cholesterol (and BP) ...

Medical Management and Revascularization for Asymptomatic Carotid Stenosis

Vagus nerve-mediated neuroimmune modulation for rheumatoid arthritis: a pivotal randomized controlled trial

We spent quite a bit of time talking about blinding. This is the table on the adequacy of blinding from the supplement. It does seem like blinding was less than perfect.

We try to answer the remainder of your AUA questions. We will be back in the new year with more article discussions!

Here are a few of the things we referenced.

GDMT Bugs Me: A bit of a rant against the standard of care

A Plan to Refocus Primary Care

Sacrificing patient care for prevention: distortion of the role of general practice

The Great Colonoscopy Debate

Arthroscopic Partial Meniscectomy versus Sham Surgery for a Degenerative Meni...

We cover questions from Amy J, Benjamin Hourani, Diana Stiles Friou, Chris Costas, Errol Laurie, Jim Healthy, Elizabeth Fama, Never Dull, Rod Rodriguez, Ellison Burns, David Araujo, and George.

We have more to come!

One nice reference I found while looking into some of the topics:

DMSO Is Not a Cure-All. But the FDA’s Panic Over It Birthed a Myth