JAMA Clinical Reviews

Dr. Anthony Charles is a Professor of Surgery and Chief of Trauma and Acute Care Surgery at the University of Vermont. He discusses the alarming rise of diverticulitis cases, especially in younger populations. Key insights include the impact of dietary choices on the condition and the essential diagnostic tools like CT scans. The conversation highlights the tailored approach to treatment, potential complications, and the timing for follow-up colonoscopies. Charles emphasizes the need for urgent responses to complications to ensure better patient outcomes.

William Cliby and John Weroha, both experts from the Mayo Clinic, dive into the complexities of ovarian cancer. They discuss the importance of recognizing nonspecific symptoms that often delay diagnosis and the critical role of clinical judgment in early detection. Preventive strategies like surgeries for those with a family history are emphasized, alongside challenges in current screening methods. They also highlight advancements in treatment options, such as PARP inhibitors, which enhance survival rates for patients facing this disease.

In this discussion, Kimmie Ng, Associate Chief of Gastrointestinal Oncology at Dana-Farber Cancer Institute, reveals alarming trends in early-onset gastrointestinal cancers, particularly in patients under 50. She highlights the importance of recognizing modifiable risk factors like obesity and the psychological challenges young patients endure. The conversation also touches on updated screening guidelines for colorectal cancer and the role of Helicobacter pylori in esophagogastric cancers, emphasizing the urgent need for better diagnostic strategies.

John T. Wei, a Professor of Urology at the University of Michigan, joins Mary M. McDermott to dive into the challenges of lower urinary tract symptoms in men over 50. They highlight that about 40% of older men face issues like urinary urgency and frequency, significantly impacting their lives. The discussion covers diagnostic strategies, the effectiveness of pharmacologic treatments, and the importance of patient feedback. Wei also shares insights on behavioral interventions and minimally invasive surgical options for those with benign prostatic hyperplasia.

Carolyn Gould, MD, a specialist from the CDC's Division of Vector-Borne Infectious Diseases, dives into the complexities of West Nile virus, the leading mosquito-borne disease in the U.S. since 1999. She discusses the virus's geography, impact, and diagnostic methods, particularly for vulnerable populations. The podcast highlights long-term effects on survivors and the absence of specific treatments, emphasizing the need for awareness and preventive measures against this pervasive threat.

Suzanne Morin, a Professor of Medicine at McGill University and expert on osteoporosis, joins JAMA Deputy Editor Mary McDermott to discuss this critical health issue. They delve into the alarming statistics, noting that 1 in 3 women and 1 in 5 men over 50 experience osteoporotic fractures. Risk factors and screening are vital, especially for those with prior fractures. Morin also sheds light on treatment options, including medications like bisphosphonates, and the emerging anabolic therapies that could significantly improve outcomes for high-risk patients.

In this engaging discussion, Dr. Rita Kalyani, a Professor of Medicine at Johns Hopkins University and an expert on type 2 diabetes, dives into crucial topics around diagnosis and treatment. She explains essential tests like hemoglobin A1c and fasting plasma glucose, highlighting the challenges in distinguishing type 2 diabetes from other types. The conversation also covers managing diabetes through lifestyle changes and advancements in medications. Plus, the benefits of continuous glucose monitoring are discussed, showcasing its importance in effective diabetes management.

Anand Vaidya, an Associate Professor of Medicine at Brigham and Women's Hospital and Director of the Center for Adrenal Disorders, dives deep into adrenal insufficiency. He discusses the crucial role of cortisol in metabolic function and stress management. Vaidya outlines the symptoms and mechanisms of this condition, highlighting the importance of timely diagnosis through hormone testing. The treatment strategies, especially glucocorticoid therapy, are explored, including how to manage crisis situations effectively with immediate interventions.

Anne P. Cameron and Glenn T. Werneburg, esteemed urologists from the University of Michigan, delve into Foley catheter management. They share insights on evidence-based guidelines for catheter selection and infection prevention. The discussion highlights critical errors that can lead to urethral trauma and emphasizes diagnosing catheter-associated UTIs effectively. They also tackle urinary retention in surgical settings and critique outdated practices like intermittent clamping. Lastly, they address the complications of long-term catheterization and the importance of patient-centered decision-making.

Professor Johannes A. C. Laferton, a leader in mental health and behavioral medicine, joins to discuss the significant impact of patients' treatment expectations on their health outcomes. He shares evidence-based strategies to enhance patient experiences, emphasizing effective communication and building trust. The discussion includes the influence of provider credibility and the importance of setting realistic expectations, particularly in complex treatment scenarios like cardiac surgery. His insights offer valuable tools for clinicians to foster better patient engagement and outcomes.