Coronavirus Disease 2019 (COVID-19) Update: PCR Testing and Shortages
The lack of availability of COVID-19 testing has interfered with the ability to contain the spread of disease. Omai Garner, PhD, laboratory director for Clinical Microbiology in the UCLA health system, explains how PCR testing for COVID-19 works and why testing is in short supply.
27 Mar 2020
Update on Coronavirus: March 6, 2020, by NIAID’s Anthony Fauci, MD
Coronovirus (the virus SARS-CoV-2) continues to spread throughout the world. In recent weeks, there has been an increasing number of cases and deaths in the US. As concern about the virus increases, there is an increasing need for accurate information about the disease and how much concern we should have. Anthony Fauci, MD, is the director of the National Institute for Allergy and Infectious Diseases (NIAID) and has been the main spokesperson for the US government about coronavirus. Dr Fauci spoke with JAMA Editor in Chief Howard Bauchner, MD, about where we are as of today with the SARS-CoV-2 epidemic. JAMA Coronavirus Resource Center
9 Mar 2020
The Effect of the COVID-19 Pandemic on Clinic Operations
Seattle has been a focal point for the US in the coronavirus pandemic. Doug Paauw, MD, professor of medicine at the University of Washington, in Seattle, describes the UW primary care clinic experience as this pandemic evolved. Major lessons learned included accommodating for significant numbers of staff not available to work in the clinic because of school closures, change in workflow because of shortages of personal protective equipment, physicians having to accommodate very large numbers of patient queries via telephone, email, or electronic health record, and the importance of the rapid development of local ability to test for SARS-CoV-2 independent of public health agencies.
13 Mar 2020
The 2020 Influenza Epidemic—More Serious Than Coronavirus in the US
Although coronavirus disease 2019 (COVID-19) dominates the news in early 2020, it affects few people in the US. In contrast, at the same time the US is experiencing a severe influenza epidemic, which has caused an estimated 250 000 hospitalizations and 14 000 deaths. Timothy Uyeki, MD, lead for the CDC’s 2019 novel coronavirus response team and Chief Medical Officer of CDC’s influenza division, discusses influenza in the US, how it compares to coronavirus, and what both patients and clinicians should know about this year’s flu season. CDC's Influenza site CDC's Weekly U.S. Influenza Surveillance Report HealthMap Vaccine Finder
18 Feb 2020
Most Popular Podcasts
Coronavirus (COVID-19) Update: Lessons Learned From The 2003 SARS Outbreak
In 2003, Toronto was the North American center for Severe Acute Respiratory Syndrome (SARS). The disease spread through the city’s hospitals before anyone knew what was happening. Dr Allison McGeer was a clinician caring for SARS patients and ultimately was infected herself. She describes her experience as a patient and provider and reviews lessons learned that might help others manage their regional COVID-19 outbreaks. Related: Supporting the Health Care Workforce During the COVID-19 Global Epidemic
25 Mar 2020
Coronavirus (COVID-19) Update: Early Safety Signals Around Ibuprofen and Renin-Angiotensin Inhibitors
Emerging information about how SARS-CoV-2 virus infects cells has led to speculation that NSAIDs and ACE inhibitors/angiotensin receptor blockers (ARBs) may worsen clinical disease. Infectious disease physician Carlos del Rio, MD, of Emory University explains the concerns and their clinical implications.
20 Mar 2020
Coronavirus (COVID-19) Update: Chloroquine/Hydroxychloroquine and Azithromycin
Chloroquine was shown in 2004 to be active in vitro against SARS coronavirus but is of unproven efficacy and safety in patients infected with SARS-CoV-2. The drug's potential benefits and risks for COVID-19 patients, without and with azithromycin, is discussed by Dr. David Juurlink, head of the Division of Clinical Pharmacology and Toxicology at Sunnybrook Health Sciences Centre in Toronto.
24 Mar 2020
More than 6 million people worldwide have Parkinson disease. Even though it is classically associated with tremors, the disease has many manifestations and is very treatable for most patients. Michael S. Okun, MD, from the Department of Neurology at the University of Florida, Gainesville, discusses the pathophysiology, clinical presentation, diagnosis, and treatment of Parkinson disease. Related article: Parkinson Disease AMA Manual of Style
11 Feb 2020
Nonalcoholic Steatohepatitis: The Primary Care Perspective
Nonalcoholic steatohepatitis (NASH) is becoming more frequent as the population becomes more obese. This is not a benign problem, and NASH can ultimately lead to cirrhosis and liver failure. It is thought that NASH will ultimately become the most common cause for liver transplant. NASH is usually diagnosed as an incidental finding, but once found requires careful monitoring and patient counseling. Lisa N. Kransdorf, MD, MPH, from UCLA Health in California, discusses the diagnosis and management of NASH from a primary care clinician's perspective.
24 Mar 2020
Nathan Pritikin and His Diet
Nathan Pritikin was a college dropout who became an entrepreneur. While doing research for the government during World War II, he observed that populations that had extremely limited food availability because of the war had substantially reduced mortality from cardiovascular disease—something unexpected at a time when cardiovascular disease was thought to be due to stress. After the war when food became more available CVD death rates went back up, resulting in Pritikin concluding that CVD was related to diet. Pritikin devised his own very low-fat diet that bears his name and the diet is still in use 65 years later. Related: The Pritikin Diet The Lost Lectures from Nathan Pritikin (drmcdougall.com)
17 Mar 2020
Unprofessional Behavior Leads to Complications
Physicians who act out cause all sorts of problems. Fortunately, only a few clinicians have behavior problems and in the modern era, bad behaviors are not tolerated. Bad behaviors get reported these days and actions are taken against these sorts of clinicians. Clinicians who act out frequently say they are doing so to protect their patients. But are they? William Cooper, MD, MPH, and Gerald B. Hickson, MD, from Vanderbilt University Medical Center in Nashville, Tennessee, discuss a study they published in relating bad behaviors to having more complications of surgical care. Related article: Association of Coworker Reports About Unprofessional Behavior by Surgeons With Surgical Complications in Their Patients
25 Feb 2020
The Diagnosis and Management of Primary Hyperparathyroidism
Hyperparathyroidism is a fairly common disease that causes elevated calcium levels and bone depletion, resulting in fractures and kidney problems. There are medications that can effectively manage hyperparathyroidism, and in some cases surgery is indicated. Michael Yeh, MD, professor and chief of endocrine surgery at UCLA, discusses the management of hyperparathyroidism.
24 Mar 2020
Coronavirus Disease 2019 (COVID-19) Update: How the VA Is Preparing
As COVID-19 spreads, clinicians and health systems are struggling to prepare for a surge of patients. Richard Stone, MD, the US Veterans Health Administration's Executive in Charge, spoke with JAMA about how the VA health system is preparing for this public health emergency.
25 Mar 2020
Testing for Breast Cancer Susceptibility Genes
Breast cancer is a leading cause of death in women. Some women have a cancer susceptibility gene known as BRCA, and women should be tested for BRCA under some circumstances. Carol Mangione, MD, division chief of General Internal Medicine and Health Services Research at UCLA, discusses when testing is appropriate, and Ranjit Manchanda, MD, PhD, from Barts Cancer Institute in London, UK, discusses the cost-effectiveness of BRCA screening for women who have had breast cancer.
11 Feb 2020
Who Was Nathan Pritikin and Why Is There a Diet Named After Him?
This podcast explains the Pritikin diet to patients. Nathan Pritikin was a college dropout who became an entrepreneur. While doing research for the government during World War II, he observed that populations that had extremely limited food availability because of the war had substantially reduced mortality from cardiovascular disease—something unexpected at a time when cardiovascular disease was thought to be due to stress. After the war when food became more available CVD death rates went back up, resulting in Pritikin concluding that CVD was related to diet. Pritikin devised his own very low-fat diet that bears his name and the diet is still in use 65 years later. Related: The Pritikin Diet The Lost Lectures from Nathan Pritikin (drmcdougall.com)
17 Mar 2020
AIDS-Related Chronic Inflammation Leading to Chronic Disease
Great strides have been made in treating HIV, as Anthony Fauci, MD, discusses in this podcast episode. But even substantial viral suppression leaves some virus behind, causing chronic inflammation. Many chronic diseases, including atherosclerotic coronary vascular disease, are worsened by this chronic inflammatory state. Because HIV patients are now living very long lives, they are also developing chronic diseases at a more rapid rate than their non-HIV-infected peers because of this chronic inflammation.
18 Feb 2020
COVID-19 in Seattle: Clinical Features and Managing the Outbreak
Seattle was one of the first US cities to have a COVID-19 outbreak, with a cluster of nursing home-related deaths. However, many people who tested positive for the novel coronavirus never became ill, and in some the clinical illness was indistinguishable from influenza. John Lynch, MD, MPH, an infectious disease physician and medical director for infection prevention and control at the Harborview Medical Center, summarizes his hospital’s experience managing the patients and outbreak.
15 Mar 2020
Coronavirus (COVID-19) Update: Safe Shopping at Stores and Pharmacies
Food and medicine shopping is essential during the COVID-19 pandemic, but requires getting out and standing close to strangers at a time when social distancing and sheltering-in-place are recommended to slow spread of disease. David Aronoff, MD, director of the Division of Infectious Diseases at Vanderbilt University in Nashville, explains how to minimize COVID-19 risk while shopping.
3 Apr 2020
Oral Antibiotics for Appendicitis
A new trial reports that a third of emergency department patients presenting with appendicitis admitted for oral antibiotic treatment had outcomes no different from those admitted for intravenous antibiotic treatment. Paulina Salminen, MD, PhD, professor of surgery at the University of Turku in Finland, discusses the findings. Related Article(s): Effect of Oral Moxifloxacin vs Intravenous Ertapenem Plus Oral Levofloxacin for Treatment of Uncomplicated Acute Appendicitis
11 Jan 2021
Hematuria and Bladder Cancer
Mark Litwin, MD, chair of Urology at the UCLA School of Medicine, discusses the evaluation of hematuria and also the presentation, diagnosis, and treatment of bladder cancer. Related Article(s): Bladder Cancer
17 Nov 2020