Healthy Dialogue

Polypharmacy is a rapidly worsening problem that hits elderly patients particularly hard. As patients grow older, they need more medications but at the same time become less capable of managing the complexity of drug treatments. In order to simplify treatment regimens for older patients, it is necessary to consider the evidence supporting treatment of various conditions and when the evidence is not particularly strong, reduce or eliminate medications accordingly. Diabetes management in the elderly is highlighted in this podcast with specific attention given to deintensifying diabetes treatment in the elderly. Articles discussed in this episode: Polypharmacy in the Aging Patient: Glycemic Control in Older Adults With Type 2 Diabetes: A Review (Kasia J. Lipska, MD, MHS) Evaluation and Treatment of Older Patients With Hypercholesterolemia: A Clinical Review (Timo E. Strandberg, MD, PhD) Trends in Prescription Drug Use Among Adults in the United States From 1999-2012 (Elizabeth D. Kantor, PhD, MPH)

Interview with Lynn Babcock, MD, MS, author of Identifying Children and Adolescents at Risk for Persistent Postconcussion Symptoms

Interview with Michael P. Pignone, MD, MPH, author of Screening for Impaired Visual Acuity in Older Adults: US Preventive Services Task Force Recommendation Statement

Robert O. Bonow, MD, the editor-in-chief of JAMA Cardiology, the JAMA Network’s newest addition, discusses his editorial vision for the journal, as well as his insights on advances in the prevention and treatment of cardiovascular disease.

Interview with Clifford Deutschman, MD, MS, Mervyn Singer, MD and Derek Angus, MD, MPH, authors of The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)

Interview with John G. Laffey, MD, MA, author of Epidemiology, Patterns of Care, and Mortality for Patients With Acute Respiratory Distress Syndrome in Intensive Care Units in 50 Countries

Interview with David C. Grossman, MD, MPH, author of Screening for Autism Spectrum Disorder in Young Children: US Preventive Services Task Force Recommendation Statement

Community acquired pneumonia accounts for 600,000 hospital admissions a year. Many patients with this disease are quite ill and have a very high mortality. To save lives, the appropriate antibiotics should be given in a timely basis, but it is not clear what the best antibiotics are and how long they should be given. In this podcast we interview the author of a JAMA review on community acquired pneumonia, Dr Jonathan Lee, author of Antibiotic Therapy for Adults Hospitalized With Community-Acquired Pneumonia, who performed a systematic review of the literature to determine the best way to treat community acquired pneumonia.

The 2015-2020 US Dietary Guidelines for Americans were recently released. They are intended to provide guidance for health policy officials and clinicians regarding healthy diets and establishing goals for improving nutrition. These are important since bad eating habits are the underlying cause for a great deal of disease in the US and that these guidelines influence the operations of programs such as school lunch assistance, meals on wheels etc. Because these guidelines influence policy, they have been criticized by various investigators and special interest groups. Karen DeSalvo, MD, Acting Assistant Secretary for Health at HHS and author of Dietary Guidelines for Americans responds to some of these criticisms and explains how the guideline was created and what it is intended to do. Implementation of the guidelines dietary advice may be challenging and Deborah Clegg, RD, PhD, Professor of Internal Medicine at UCLA discusses how the various recommendations can be followed.

Interview with Martha Clare Morris, ScD, author of Association of Seafood Consumption, Brain Mercury Level, and APOE ε4 Status With Brain Neuropathology in Older Adults