Questioning Medicine

Questioning Medicine
  • 4.9 (75)
  • MEDICINE
  • UPDATED MONTHLY

Join Andrew on a medical rollercoaster as we ask a medical question and answer it based on recent published papers.  

  1. 1D AGO

    421. Scabies and DUKE criteria

    Stavropoulou E, et al. Reassessing the 2023 International Society for Cardiovascular Infectious Diseases Duke clinical criteria for infective endocarditis: Impact of excluding fever and updating diagnostic definitions. Clin Infect Dis 2025 Dec 31; [e-pub]. DOI: 10.1093/cid/ciaf737.    Big takeaways About 35% of patients truly had IE. Fever showed up in 80% of patients both with and without IE, so it did not help distinguish them. Dropping fever from the criteria actually made them better:   Sensitivity improved: 77% (no-fever) vs 74% (standard). Specificity improved a lot: 80% vs 49%. "Possible IE" shrank from 39% to 17%, meaning fewer gray-zone cases. Only 0.4% of patients without IE were incorrectly labeled as having IE.  Both are widely used and both can work for regular (non-crusted) scabies.   The SCRATCH trial: who won? In the SCRATCH trial from France, researchers treated about 1000 people in 300 households with confirmed scabies. Each household was randomized to:   Whole-body 5% permethrin cream on days 0 and 10, or Oral ivermectin (weight-based) on days 0 and 10. They then checked who was cured at day 28.   Here's what they found: Household cure rates Permethrin: 88% cured Ivermectin: 72% cured Translation: For every 6 households treated with permethrin instead of ivermectin, one extra household was fully cured (NNT  6).   Index (main) patient cure rates Permethrin: 92% Ivermectin: 77% That's one extra person cured for about every 7 treated with permethrin instead of ivermectin (NNT  7).   Side effect Skin irritation-type reactions: 14% with permethrin vs 10% with ivermectin. So permethrin wins on cure, with a small trade-off in local skin reactions.

    12 min

  2. FEB 5

    420. Frail and CODE LVO PLUS antibiotics don't help viral illness

    we look at CODE LVO and what does being frail even mean?????vaccines may not help baby and antibiotics still don't help viral illness

    20 min

  3. JAN 20

    CME song --Check the Lytes

    CME song --Check the Lytes

    3 min

  4. JAN 20

    CME - sodium, potassium, calcium

    CME - sodium, potassium, calcium

    43 min

  5. 12/15/2025

    418. Beta Blockers Post MI, PSA, Youtube,

    10.1016/j.jaip.2025.07.005.40675327 All of the videos were found to be useful or very useful, 99% were of moderate or high reliability, and 99% had moderate to excellent educational quality  Prostate-specific antigen levels among participants receiving annual testing. JAMA Oncol 2025 Nov; 11:1341 10.1001/jamaoncol.2025.3386.40965920 PSA levels at or above 4.0 ng/mL fell below that threshold on the next annual test 30% of the time. 10.1016/S2665-9913(25)00250-4. During 10 years of follow-up, patients in the PKA and TKA groups did not differ significantly in pain, function, or quality of lifehttps://www.nejm.org/doi/full/10.1056/NEJMoa2508026?query=TOC Among patients who underwent CABG for an acute coronary syndrome, ticagrelor plus aspirin did not result in a lower incidence of death, myocardial infarction, stroke,  https://www.nejm.org/doi/full/10.1056/NEJMoa2509907?query=TOC In this trial, a high-dose inactivated influenza vaccine did not result in a significantly lower incidence of hospitalization for influenza or pneumonia than a standard dose among older adults.    https://www.nejm.org/doi/full/10.1056/NEJMoa2509834?query=TOC Among community-dwelling adults 65 to 79 years of age, there appeared to be fewer hospitalizations for influenza or pneumonia with high-dose inactivated influenza vaccine than with the standard dose but the NNT is like 1500!   https://pmc.ncbi.nlm.nih.gov/articles/PMC12594118/ Afib should not be screened even if the authors say yes   https://pubmed.ncbi.nlm.nih.gov/40997143/ defines the US cost-effectiveness threshold as $120 000 per quality-adjusted life year gained,    https://pubmed.ncbi.nlm.nih.gov/40481660/ In CKD, electronic letter nudges for patients or primary care practices did not differ from no letters for prescriptions of guideline-recommended RASis or SGLT2is at 6 months.     https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S0140673625015922?returnurl=https:%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0140673625015922%3Fshowall%3Dtrue&referrer=https:%2F%2Fclinician.nejm.org%2F β-blocker therapy on clinical outcomes in patients with myocardial infarction and mildly reduced (40–49%)    https://www.nejm.org/doi/10.1056/NEJMoa2512686#ap2&uccLastUpdatedDate=2025-12-12%2005%3A34%3A29.658%20%2B0000&rememberMe=false In this meta-analysis including individual-patient data from five randomized trials, beta-blocker therapy did not reduce the incidence of death from any cause, myocardial infarction, or heart failure in patients with an LVEF of at least 50% after myocardial infarction without other indications for beta-blockers.

    41 min

  6. 12/03/2025

    417. Aspirin, Pre-diabetes, Menopause, Type 1 Diabetes, HPV Vaccine and more!!!!

    Wolfe R, Broder JC, Zhou Z, et al. Aspirin, cardiovascular events, and major bleeding in older adults: extended follow-up of the ASPREE trial. Eur Heart J. 12 Aug 2025. [Epub ahead of print]. https://pubmed.ncbi.nlm.nih.gov/40796244/   Donocan LE et al. Closed-loop insulin delivery in type 1 diabetes in pregnancy: The CIRCUIT randomized clinical trial. JAMA 2025 Oct 24; [e-pub]. (https://doi.org/10.1001/jama.2025.19578)   https://jamanetwork.com/journals/jama/fullarticle/2822766   https://onlinelibrary.wiley.com/doi/full/10.1002/art.24894?msockid=3f10fb6c3d086e4c32e2ede23c9e6fbc   https://pubmed.ncbi.nlm.nih.gov/41118187/   https://pubmed.ncbi.nlm.nih.gov/41115754/     https://pubmed.ncbi.nlm.nih.gov/41138956/

    34 min

  7. 11/17/2025

    416. Car Seats, Beta-Blockers after a Heart Attack, Oral Semaglutide, High-Dose influenza vaccine

    Beta-Blockers after Myocardial Infarction without Reduced Ejection Fraction - https://www.nejm.org/doi/full/10.1056/NEJMoa2504735?query=WB     McGuire DK et al. Oral semaglutide and cardiovascular outcomes in high-risk type 2 diabetes. N Engl J Med 2025 Mar 29; [e-pub]. (https://doi.org/10.1056/NEJMoa2501006)   Interactive Virtual Presence to Remotely Assist Parents With Car Seat Installation https://pubmed.ncbi.nlm.nih.gov/41077424/     Effectiveness of high-dose influenza vaccine against hospitalisations in older adults (FLUNITY-HD): an individual-level pooled analysis  https://pubmed.ncbi.nlm.nih.gov/41115437/

    23 min

  8. 11/12/2025

    415. Do Air Filters Lower Blood Pressure?

    https://pubmed.ncbi.nlm.nih.gov/40767818/This is a great example for students and residents to look and see that the abstract does not always match what the paper actually says

    10 min
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Join Andrew on a medical rollercoaster as we ask a medical question and answer it based on recent published papers.  

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  • Creator
    Questioning Medicine
  • Years Active
    2014 - 2026
  • Episodes
    338
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