Sensible Medicine

Primary articles discussed:

* First myocardial infarction: risk factors, symptoms, and medical therapy

* Oral vs Extended-Release Injectable Naltrexone for Hospitalized Patients With Alcohol Use DisorderA Randomized Clinical Trial

Articles referenced:

* Pharmacotherapy for Alcohol Use Disorder: A Systematic Review and Meta-Analysis

* General health checks in adults for reducing morbidity and mortality from disease: Cochrane systematic r...

No association between preprocedural fasting and witnessed pulmonary aspiration: A systematic review and meta-analysis

Here are a couple of other older articles to give you the history of preprocedural fasting.

Reducing the Risk of Acid Aspirations During Cesarean Section

Fasting from midnight — the history behind the dogma

CT Angiography, Healthy Lifestyle Behaviors, and Preventive Therapy

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Clinical Validation of a Circulating Tumor DNA–Based Blood Test to Screen for Colorectal Cancer

If you want a deeper dive into cancer screening, we have covered the topic a lot on Sensible Medicine. There is a video debate Vinay, John, and Adam had about colon cancer screening. We also posted two follow-up articles for that deb...

We are beginning a new series today. John and Adam will discuss a couple of articles we found interesting. Please let us know your thoughts. This week:

Phase 3 Trial of Semaglutide in Metabolic Dysfunction–Associated Steatohepatitis

Tiotropium Initiation and Dementia Risk in Chronic Obstructive Pulmonary Disease

This is a long one! 83 minutes. This is the second podcast in which we answer questions from a our “ask us anything” post. We recorded this one before our most recent podcast — kind of like Abbey Road and Let it Be — so we were still graced by Vinay’s presence. In fact, we recorded it in his studio.

We still have about a half dozen questions to answer; we will cover those on an upcoming podcast. Enjoy.

John and Adam discuss our hopes for Vinay’s tenure at the FDA and how we intend to keep Sensible Medicine a vibrant place on Substack, a place where we will continue to showcase a range of ideas and opinions about all things bio-medicine. We also answer some of the questions from our recent “ask us anything” post.

FH is a 66-year-old woman who comes in for an urgent visit because she has been feeling woozy for two days. She is very anxious, almost distraught, because she thinks these symptoms are the same as the ones that her sister had before she died of a hemorrhagic stroke.

Sensible Medicine is a reader-supported publication. If you appreciate our work, consider becoming a free or paid subscriber.

A few years ago, a team building exercise w...

Professor Jeffrey Flier is a distinguished service professor and Higginson Professor of Physiology and Medicine at Harvard Medical School. He is the former dean of Harvard Medical School.

We talked about the recent (and sudden) change in NIH funding. First a note on Professor Flier. He is not a normal medical school dean. He is active online. He speaks candidly, often critically. He and Vinay wrote together in STAT news during the ...

I recently recorded a conversation with Michael Easter from the TWO/PERCENT, a Substack and podcast. Michael offers “practical, accurate, and useful health, performance, and mindset information,” and in a space where there is a lot of drive, I find him remarkably thoughtful.

Our conversation is on the podcast feed. Below are my notes for our conversation with links to many of the things we discussed.

Adam Cifu, MD

Sensible Medicine is...

I have long followed the work of Dr. Margaret McCartney. She is a general practitioner in Glasgow, Scotland, writer, public speaker, and now PhD.

She is a fierce advocate for evidence-based medicine. She holds highly skeptical views of screening for disease—which, to my surprise is quite common in the UK.

Her recently finished PhD sought empirical evidence regarding declaration of conflicts of interest in the UK. Here is a link to ...

I had the pleasure of being interviewed by Michael Easter. Michael is behind the TWO/PERCENT Substack where he offers “practical, accurate, and useful health, performance, and mindset information.” I’ve listened to, and read, a bunch of Michael’s content. Not only is it enjoyable but it seems, well, sensible. Our conversation was inspired by my Coming Out Against the Healthy Lifestyle post.

I hope you enjoy our conversation and may...