Three healthily skeptical primary care physicians discuss the latest in primary care medicine. Join Mark Ebell MD, John Hickner MD, Henry Barry MD, and others for this fast-paced weekly update on evidence-based primary care.
Today Mark, John and Henry talk about: how to rule out (and rule in) pneumonia (https://www.ncbi.nlm.nih.gov/pubmed/30850460); an RCT of e-cigarettes for smoking cessation (https://www.ncbi.nlm.nih.gov/pubmed/30699054); and non-drug treatments for IBS (https://www.ncbi.nlm.nih.gov/pubmed/30177784).
This week, Henry, Mark and John discuss: statins for primary prevention in the elderly (https://www.ncbi.nlm.nih.gov/pubmed/30712900); beer before wine or vice versa (https://www.ncbi.nlm.nih.gov/pubmed/30753321); and the impact on control on school performance in kids with T1DM (https://www.ncbi.nlm.nih.gov/pubmed/30721295). Plus a beer themed quiz.
How long does a new knee or hip last (https://www.ncbi.nlm.nih.gov/pubmed/30782340); does subacromial decompression work for chronic shoulder pain (https://www.ncbi.nlm.nih.gov/pubmed/30728120); fentanyl or ketamine intranasally for extremity injury in kids (https://www.ncbi.nlm.nih.gov/pubmed/30592476); and splint or cast for fibular fracture (https://www.ncbi.nlm.nih.gov/pubmed/30674451).
This week: is it safe to skip breakfast (https://www.ncbi.nlm.nih.gov/pubmed/30700403), reducing fracture risk in women with osteopenia (https://www.ncbi.nlm.nih.gov/pubmed/30575489), drug therapy for anxiety disorder (https://www.ncbi.nlm.nih.gov/pubmed/30712879 ), and antibiotics for serious asthma exacerbations (https://www.ncbi.nlm.nih.gov/pubmed/30688986).
Today we talk about stem cell injections for osteoarthritis (https://www.ncbi.nlm.nih.gov/pubmed/29099618), a rant about mortality outcomes in cancer screening from Mark, omega-3 oils for primary prevention (https://www.ncbi.nlm.nih.gov/pubmed/30415637), and testosterone for depression in men (https://www.ncbi.nlm.nih.gov/pubmed/30427999).
Today we talk about the impact of more primary care physicians in a population on health outcomes; whether or not probiotics, prebiotics, and antibiotics are helpful for irritable bowel; and the impact of SGLT-2 inhibitors like empagliflozin on cardiovascular outcomes in diabetics with heart disease or at very high risk.
Today's topics: what is the safest oral anticoagulant (https://www.ncbi.nlm.nih.gov/pubmed/30512099), new diabetes guidelines (https://www.ncbi.nlm.nih.gov/pubmed/30291106), and the good and the ouch of the new zoster vaccines (https://www.ncbi.nlm.nih.gov/pubmed/30361202).
Today we discuss: vitamin D for pain and headache (https://www.ncbi.nlm.nih.gov/pubmed/25261164); chronic diarrhea guidelines (https://www.ncbi.nlm.nih.gov/pubmed/29653941); lorcaserin and T2DM (https://www.ncbi.nlm.nih.gov/pubmed/30293771); and the results of "screening" MRI (https://www.bmj.com/content/363/bmj.k4577).
Does linagliptin prevent CV events: ttps://www.ncbi.nlm.nih.gov/pubmed/30418475; does Tai Chi prevent falls and fractures: https://www.ncbi.nlm.nih.gov/pubmed/30208396; treatment of endometriosis pain: https://www.ncbi.nlm.nih.gov/pubmed/30396557; and the benefits of sauna: https://www.ncbi.nlm.nih.gov/pubmed/30486813.
This week: how does the yield for FIT testing compare with colonoscopy (https://www.ncbi.nlm.nih.gov/pubmed/29101260); our take on the new ACC/AHA lipid guidelines (https://www.ncbi.nlm.nih.gov/pubmed/30423391); and what works (or doesn't) for subacute cough (https://www.ncbi.nlm.nih.gov/pubmed/30201828).
This week we talk about the results of the 3 ASPREE aspirin trials, whether omega-3 oil prevents CV events, and a new biologic agent for migraine. Pubmed abstract links: ASPREE: https://www.ncbi.nlm.nih.gov/pubmed/30221596 ; omega-3: https://www.ncbi.nlm.nih.gov/pubmed/30146932 ; and migraine: https://www.ncbi.nlm.nih.gov/pubmed/30360965
This week's topics: whether surgery works for shoulder impingement, framing test results positively for patients, vagus nerve stimulation for frequent migraines, and a commentary on shared decision-making. Study links: Impingement: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5734212/ ; Vagus nerve stimulation: https://www.ncbi.nlm.nih.gov/pubmed/29907608 ; and Positive messaging: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1495144/
Mark, John and Henry talk about tamsulosin for helping stones pass (but not all of them), how aspirin and esomoprazole (at the right dose) can reduce mortality in Barrett's esophagus, whether to do HPV only or co-testing in women 30-65 years, and the safety (and effectiveness) of lorcaserin for weight loss.
Mark, John and Henry discuss the new aspiring studies (does it really prevent heart disease), a positive (!) vitamin D trial, and whether procalcitonin can help us avoid antibiotics for patients with lower respiratory infection. Plus, the quiz, and John nerds out about vitamin D. In a good way.
Today's topics: are new basal insulins really any better, the impact of stigmatizing language, the value of adding cytology to HPV testing alone, and the best evidence to date on just how common incidentalomas are with MRI and CT. Plus, the pop quiz, and a segment we call "Preventing Bad Stuff" (today's topic is prostate CA screening).
August 24, 2018
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