Caroline R. Richardson, MD

It's a bit off-cycle, but you never know who might be looking and when... Brown has a new T32 postdoctoral fellowship in child health equity! Applications are open now and will be reviewed on a rolling basis. More details can be found in the link below:

today.brown.edu/announcement...

How states can mitigate Trump’s Medicaid cuts – and set their health care systems on a better path States are unlikely to fully neutralize the Medicaid cuts — but they have tools to scuttle the Trump administration's efforts.

"Although states cannot fully neutralize the impending Medicaid cuts, they have tools to scuttle the Trump administration’s efforts."

Hayden Rooke-Ley, senior fellow in CAHPR, writes in @statnews.com that states can mitigate Medicaid cuts—if they act boldly. www.statnews.com/2025/07/24/m...

Comparing Very Low-Carbohydrate vs DASH Diets for Overweight or Obese Adults With Hypertension and Prediabetes or Type 2 Diabetes: A Randomized Trial PURPOSE Adults with a triple multimorbidity (hypertension, prediabetes or type 2 diabetes, and overweight or obesity), are at increased risk of serious health complications, but experts disagree on which dietary patterns and support strategies should be recommended. METHODS We randomized 94 adults from southeast Michigan with this triple multimorbidity using a 2 × 2 diet-by-support factorial design, comparing a very low-carbohydrate (VLC) diet vs a Dietary Approaches to Stop Hypertension (DASH) diet, as well as comparing results with and without multicomponent extra support (mindful eating, positive emotion regulation, social support, and cooking). RESULTS Using intention-to-treat analyses, compared with the DASH diet, the VLC diet led to greater improvement in estimated mean systolic blood pressure (−9.77 mm Hg vs −5.18 mm Hg; P = .046), greater improvement in glycated hemoglobin (−0.35% vs −0.14%; P = .034), and greater improvement in weight (−19.14 lb vs −10.34 lb; P = .0003). The addition of extra support did not have a statistically significant effect on outcomes. CONCLUSIONS For adults with hypertension, prediabetes or type 2 diabetes, and overweight or obesity, the VLC diet resulted in greater improvements in systolic blood pressure, glycemic control, and weight over a 4-month period compared with the DASH diet. These findings suggest that larger trials with longer follow-up are warranted to determine whether the VLC diet might be more beneficial for disease management than the DASH diet for these high-risk adults.

Not as well as a low carb diet works www.annfammed.org/content/21/3...

Soft?

She saw family in Lebanon. Now this Brown Medicine doctor is being held at Logan for deportation. Dr. Rasha Alawieh flew into Logan Airport Thursday after visiting family in Lebanon. She's being detained now at Logan without legal counsel.

They're trying to deport my colleague from the med school and holding her without counsel. She was coming back from a visit to her family. If there are ways to help I'll let you know. www.providencejournal.com/story/news/l...

Dictionary of Lost Words by Pip Williams, Intermezzo by Sally Rooney

Battle, not war. In Samoa, after the anti-vax policy yielded predictable results with 83 deaths attributed to measles, the vaccine rate in Samoa increased from 34% in 2018 to 94% at the end of 2019.

In Rhode Island -

NIH FUNDING:
$256M

JOBS SUPPORTED:
2212

ECONOMIC ACTIVITY SUPPORTED:
$502M

www.unitedformedicalresearch.org/nih-in-your-...

We are not far away from your spouse’s cancer trial stopping, your parent’s Alzheimer’s clinical trial evaporating, your teen’s mental health intervention disappearing. It’s easy to attack universities, but the recent actions from the White House will stop cutting edge medical research very quickly.

Check out Episode 4 of the Annals of Family Medicine Podcast where Jade Wexler and Dr. Elizabeth Toll discuss their recently published paper "A Qualitative Study of Primary Care Physicians’ Approaches to Caring for Adult Adopted Patients"

Listen now: www.annfammed.org/content/anna...

New Year. New Issue. The January/February 2025 issue of Annals of Family Medicine is available now!

Check out this video preview for an exclusive glimpse into our latest issue & newest research in #PrimaryCare

www.annfammed.org/content/23/1...

Trump Administration Halts H.I.V. Drug Distribution in Poor Countries PEPFAR’s computer systems also are being taken offline, a sign that the program may not return, as Republican critics had hoped.

Over 20 years, the US spent $120 billion (approx equivalent to 2 months of current military spending) to help save more than 25 million lives worldwide.
PEPFAR should not be partisan. It was started by George W Bush.
This is absurd, unnecessary cruelty.
www.nytimes.com/2025/01/27/h...

Every week, I check the CDC's Mortality and Morbidity Weekly Report. This week for the first time in its 60 years it was not published on schedule. American healthcare workers all over the country are less informed about health crises that affect their patients. CDC led reports matter a 🧵

You can see all the notes that were proposed, and those that were approved by the community (attached and visible to everyone) if you want to get a sense of it. Check out the Community Notes Monitor created by researchers at Michigan. csmr.umich.edu/projects/cn/

So, you may ask, why do I get so angry about the new liberal spin on RFK Jr, as in, "he gets some things right, so let's collaborate on those" or "we have to work with him because he has a huge following we need to reach"? Because I've seen this movie before. 1/

Other than after hours shifts, that’s a wrap for 2024 in our family med clinic. It is an honour to take care of patients throughout their lives. Saw patients this week who were kids when I met them, now at university. You hear a lot about what’s broken in health care. These are the joys of our work.

For most people, creatinine will not return to baseline at 3 months unless they stop the SGLT2i, so for many, the 3 month check will still meet criteria for CKD and it will still not be due to actual kidney damage. What then?

Question for medsky: If you have a patient with diabetes whose kidney function is normal but their A1c is high and you put them on an SGLT2 inhibitor and their A1c drops to 6.8 but you recheck their creatinine and it dropped to 55, do you now add a diagnosis of CKD?

#MedSky #MedicareForAll

Flyer for a diabetology fellowship at Brown in Rhode Island with QR code for application.

Join us in Rhode Island for a one year clinical fellowship in diabetology.

🩺❤️
Have questions about the family doctor shortage?

Want to hear me and co-guest, Dr. Laura Sang, try and answer?

Send your questions in here and listen to CBC Radio One’s “Just Asking” at 2pm (pacific).

www.cbc.ca/radio/just-a...

This original research study highlights patients who saw their own family physician for after-hours care were 10% less likely to visit the ER within a week, suggesting that continuity of care may improve outcomes, reduce ER visits & lower health care costs.

www.annfammed.org/content/22/6...