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Program notes: 0:36 HPV vaccines and pregnancy outcomes 1:36 600,000+ births 2:36 What is the mechanism? 3:30 Adult ADHD 4:30 May see underperformance 5:30 Almost always methylphenidate or amphetamine 6:30 Public health significance 7:01 Hospital closures in the U.S. 8:01 Safety net, non-teaching hospitals closed more 9:03 Advance care planning in black and white older adults 10:04 Racially concordant or discordant facilitator 11:08 Self-guided planning 12:10 Not doing a good job offering ACP 13:59 End

Program notes: 0:40 Lean metabolic associated liver disease 1:40 Biopsy confirmed MASLD 2:40 Elastography for diagnosis 3:41 Liver transplant often needed 4:04 HT and thromboembolic disease 5:04 VTE, ischemic stroke and MI 6:04 Oral estrogen increased risk 7:07 LIquid cancer biopsy impact 8:07 Not had cancer compared to routine screening 9:07 Not seeing a positive impact 10:05 Inter-interval breast cancers 10:31 How to manage early septic shock 11:31 Main outcome alive and out of the hospital at day 90 12:30 Both are equally effective 13:20 End

Program notes: 0:33 Statins for older people without CVD 1:34 Followed for six years 2:34 Aged to 70 without CVD 3:00 Improving primary care for folks with chronic conditions 4:00 70,000 respondents 5:00 Long term relationship with a primary care provider 6:00 Continuity and coordination can be delivered at scale 7:09 Treating advanced breast cancer 8:10 Mutation in estrogen receptor 9:12 Targeting specific mutations 10:00 A new target for managing asthma and COPD 11:00 Healthy volunteers and patients with asthma 12:00 Typically treated with immunosuppression 13:05 End

Program notes: 0:40 Structured exercise after cancer 1:40 Moderate evidence 2:40 Improves overall survival 3:41 Improves drug penetration 4:00 Colonoscopy intervals after polyp removal 5:00 Five-year cumulative incidence same as three years 6:03 Covid vaccination and immune checkpoint therapy 7:03 Mortality as primary outcome 8:04 Multiple benefits of vaccination 9:03 Other vaccines of benefit? 9:50 Does sodium bicarbonate help in critical illness and shock 10:50 Metabolic acidosis tx 11:50 Largely futile 12:37 End

Program notes: 0:37 New stroke therapy 1:37 Use of IV for 10 days after stroke 2:37 Present late after a stroke 3:39 Long term outcomes of top-down therapy in Crohn's 4:40 Outcomes up to five years 5:40 Early TNF use from diagnosis improves outcomes 6:42 No real downside 7:38 How much oxygen for 32–35-week neonates? 8:34 Ongoing respiratory support needed? 9:34 Not hypoxic to begin with 9:50 Feeding eggs and peanuts during pregnancy 10:50 Did not impact risk for infant allergy 11:50 One third dropped out 13:03 End

Program notes: 0:33 Vaccines for RSV, flu, and Covid 1:35 Studies available right now 2:33 Reduction of hospital encounters for infants 3:33 Maternal vaccination for RSV 4:34 Gene silencing therapy for cardiomyopathy 5:35 Decreased primary outcome about 20% 6:35 Should we be screening? 7:06 A new protein to pinpoint preeclampsia 8:05 Low levels in first trimester 9:08 Anchors embryo to uterus 10:05 A new therapy for COPD exacerbations 11:05 Phase three trial of monoclonal 12:34 End

Program notes: 0:44 EKG monitoring and syncope 1:45 No difference when monitored 2:45 Why not try monitoring? 3:13 Catheter directed thrombolysis in PE 4:14 Composite of death from any cause 5:14 Assessment for intermediate or high risk 6:16 Treatment not onerous 6:45 Afib ablation versus sham 7:45 Did not improve quality of life 8:45 Preprocedure assessment of psychological state? 9:13 Digital intervention to protect cognitive health 10:13 Verbal reasoning at 12 months 11:13 As long as internet is available 12:15 What happens at five-year follow-up 13:09 End

Program notes: 0:37 CTE and dementia in NFL players 1:37 Post mortem CTE presence and stage 2:35 Past look at brains of players who died 3:35 Lesion is perivascular tau 4:34 Warning on repeated head trauma 5:14 IV iron for anemia before cardiac surgery 6:14 Anemic before surgery? 7:17 Hospice in rural and urban areas 8:18 People 66 years or older who died 9:20 Length of stay shorter, private or nursing homes 10:20 Doesn't limit hospice care 10:33 ADHD and CVD 11:33 About a 30% increase in CVD 12:45 End

Program notes: 0:35 Devices to do CPR versus manual 1:37 About 60% of U.S. population 2:32 8-9% survive with favorable neurologic status 3:15 Ventilated patients and reduction of mucous secretions 4:15 Duration of ventilation unchanged 5:15 Regulate or expectorate 5:40 Boarding ED patients 6:45 Adults admitted to general medicine service 7:45 More common in older patients 8:45 Can initiate inpatient management 9:24 Cold stored platelets versus room temp 10:24 Hemostatic efficiency score 11:30 Historically used in cancer patients 12:45 End

Program notes: 0:38 Polymyalgia rheumatica treatment 1:35 Antibody targets interleukin 17a 2:35 Remission started at 12 weeks and was durable to 52 3:11 Cannabis and hyperemesis syndrome 4:11 Cannabis-related ED visits 5:11 Prior to the new coding didn't link 6:05 Gene inhibition of PCSK-9 7:05 Encased in a nanoparticle 8:11 Three vascular risk factors and dementia 9:11 Stratified by age, sex, apoE status 10:13 13 additional dementia-free years 11:58 End

This week's topics include caffeine's impact on CVD, antihistamines and atopic dermatitis, a community designed diet for heart failure, and e-cigarettes after smoking cessation.

Program notes: 0:44 Novel agent for acute pain 1:44 Post-abdominal surgery and placebo, low and high dose 2:46 Compared to placebo and opioids 3:19 Metabolic associated steatotic liver disease 4:19 Imaging with two techniques and plasma markers 5:19 Imaging and composite scores for staging 6:21 Identifying appropriate candidates for clinical trials 7:00 Alcohol consumption during pregnancy 8:00 Employed, tobacco use, and mental stress predicts 9:01 Never tested medicines for AUD in pregnant women 9:24 Early detection of Alzheimer's disease with circular RNA 10:24 Can it identify those with the disease as well as those at risk 11:24 Almost 95% AUC 12:20 Use with tau, it was even better 13:05 End

This week's topics include GLP1s and AUD, impact of CVD risk calculation, meeting lipid lowering targets, and no luck with a vaccine for gonorrhea.

This week's topics include continuing dual antiplatelet therapy after stenting, amyloid depletion in Alzheimer's, infections in US hospitals, and algorithms for diagnosing PE in people with cancer.

Program notes: 0:40 Online prescribing of GLP1s 1:44 Physician asks a number of questions 2:44 Interaction to approval about five minutes 3:30 Respiratory outbreak mitigation in nursing homes 4:30 Using PCR-based test in the nursing home 5:30 No difference in outbreak number or size 6:35 Avoid 64,000 ED transfers in U.S. 7:32 Residents reap many benefits 8:00 Inhalation treatment for pulmonary fibrosis 9:00 Clinical worsening in fewer patients 10:01 Dual-mobility total hip replacement 11:04 Substantially reduced risk of dislocation 12:05 Substantial number require revision previously 13:15 End