Primary Care Update
By Mark Ebell
Four healthily skeptical primary care physicians discuss the latest in primary care medicine. Join Essential Evidence Editor Mark Ebell MD, Rush University's Kate Rowland MD, MSU Professor of Medicine Gary Ferenchick MD, and POEMs co-founder Henry Barry MD, MS for this fast-paced weekly update on evidence-based primary care.
Episode 112: buckle fractures, tirzepatide for obesity, and stroke risk with severe carotid stenosis
This week, Henry, Gary and Mark discuss: managing children with torus (buckle) fractures of the distal radius, tirzepatide for treating obesity in adults without T2DM, and stroke risk in patients with asymptomatic severe carotid artery stenosis. Kate couldn't join us this week, but check out her thoughtful essay in the journal Family Medicine
September 14, 2022
Episode 110: pharmacogenomics, functional abdominal pain in kids, vitamin D and fractures, and a T2DM guideline
This episode, Henry, Kate, Mark and their colleague Gary Ferenchick from MSU discuss: pharmacogenomic-guided antidepressant therapy, non-drug interventions for children with functional abdominal pain, Vitamin D and fracture risk in the elderly, and NICE guideline for persons with T2DM.
September 03, 2022
Primary Care Update: Remembering John Hickner, MD, MS
Our mentor, colleague, fellow podcaster, and dear friend John Hickner died peacefully at home on August 22nd at age 72. As we grieve, we want to share some stories about John that exemplify why he was the kindest, most thoughtful, and most decent person we have had the privilege to know.
September 02, 2022
Episode 109: motivational interviewing for weight loss, urate lowering in gout, and screening for anal cancer.
This week Kate, Henry and Mark discuss motivational interviewing for weight loss, intensive vs standard urate lowering in persons with gout, and screening high risk persons for anal cancer.
August 17, 2022
Episode 108: LDL and mortality, cost-effectiveness of Alzheimer drugs, and surgery for ortho problems
This week, Kate, Henry and Mark discuss how much statins lower mortality, the cost-effectiveness of the new crop of Alzheimer's drugs, and whether surgery is helpful for a range of orthopedic conditions.
August 03, 2022
Episode 107: TENS for renal colic, secondary HTN in kids, and evaluating chest pain
This week, Kate, Mark and Henry will discuss secondary hypertension in children, TENS for persons with renal colic, and CTA vs angiography in persons with suspected stable CAD.
July 20, 2022
Episode 106: hMKPX (OK, monkeypox), screening for afib, and aducanumab for Alzheimer dementia
John has the week off, so Kate, Mark and Henry plow forward rudderless and talk about monkeypox (sorry, WHO, we're not calling it hMKPX, buy a vowel), screening for atrial fibrillation, and our new candidate for worst drug ever: aducanumab for Alzheimer dementia.
July 06, 2022
Episode 105: coronary calcium CT, what happens to prediabetics, an RCT of ketamine, and 1 vs 2 antidepressants
This week, Kate, Mark, Henry and John discuss the added value of coronary calcium scores, the natural history of prediabetes in older adults, using ketamine in suicidal persons, and whether antidepressant combination or monotherapy is better in severe or refractory depression.
June 22, 2022
Episode 104: stress urinary incontinence, thyroid meds, Achilles tendon rupture, and HEPA for COPD
Kate, John, Henry and Mark (he set his alarm this time) are back to talk about a new treatment for female stress urinary incontinence, air cleaners for preventing COPD exacerbations in smokers, surgery vs non-operative management of Achilles tendon rupture, and whether switching among levothyroxine generics is a problem.
June 08, 2022
Episode 103: rosacea treatment, Dr. Google, and vitamin D and COVID
This week Mark slept in, so Kate, John and Henry talk about British guidelines for treatment of rosacea, what to do when Dr. Google comes to the office, and Vitamin D and COVID.
May 26, 2022
Episode 102: Prevention of preterm delivery, statins during pregnancy, and aromatherapy for postmenopausal symptoms
This week, Kate leads us on a special Mother's Day edition focused on women's health. Topics discussed by Kate, John and Henry (Mark is in Würzburg busily pontificating) include prevention of preterm delivery, statins during pregnancy, and aromatherapy for postmenopausal symptoms.
May 10, 2022
Episode 101: new VTE guidelines, weight loss drugs, and increased CV risk post-COVID
This week Kate, Henry and Mark discuss updated guideline recommendations for treatment of VTE, weight loss drugs, and the increased risk of cardiovascular events following COVID-19 infection. John has the week off.
April 29, 2022
Episode 100: Best of the best of the best!
This week, Kate, Mark, Henry and John pick their 4 favorite POEMs from the first 99 episodes. We'll dig into aspirin, beer before wine or vice versa, chronotherapy for hypertension, and asthma diagnosis. And thanks for being our audience for 100 episodes! Keep listening, and spread the word to friends and colleagues.
April 11, 2022
Episode 99: NSAIDS for back pain, masks in schools, fluoride, and antipsychotics
Join family physicians Kate Rowland, Mark Ebell and John Hickner this week as they discuss the best NSAID for acute low back pain, a study on masks in schools to reduce COVID incidence, antipsychotics, and the benefits of fluoride varnish and supplements in kids.
March 16, 2022
Episode 98: COVID, pain management without opioids, irritable bowel, and communicating risk
A diverse set of POEMs from Kate, John, Henry and Mark: CDC COVID mitigation and vaccination updates, non-opioid post-op pain management, a guideline for managing persons with IBS, and the challenges of communicating risk with words
March 04, 2022
Episode 97: acne, hypoglycemia in the nursing home, DAPT or aspirin after stroke, and lockdowns
This week our skeptics discuss the best topical acne treatments, hypoglycemia in nursing home residents, the best antiplatelet therapy after minor stroke or TIA, and whether lockdowns reduced COVID-19 mortality.
February 16, 2022
Episode 96: medication safety, midodrine for syncope, empagliflozin for heart failure, and peppermint oil for IBS
This week Kate, Henry, Mark and John are all over the map, with 4 new studies on the safety of Janus Kinase inhibitors, midodrine for recurrent vasovagal syncope, empagliflozin for heart failure (not DM) and peppermint oil for irritable bowel syndrome.
February 02, 2022
Episode 95: measuring temps, implantable monitors, procalcitonin in primary care, and HPV based cancer screening
This week Kate, Mark, Henry and John talk about measuring temps in kids, implantable monitors to diagnose afib, procalcitonin in primary care, and HPV based cervical cancer screening
January 19, 2022
Episode 94: overcoming vaccine hesitancy, fluvoxamine and Paxlovid for COVID-19, and tighter BP control in elders
This week family physicians Kate, John, Henry and Mark discuss best practices for vaccine uptake, fluvoxamine for outpatients with COVID, Paxlovid for outpatients with COVID, and the benefits and harms of lowering BP in older persons.
January 05, 2022
Episode 93: holiday death rates, ear wax, amoxicillin for kids, and vaccines and the omicron variant
This week, family physicians Kate, John, Henry and Mark will discuss whether mortality really increases over the holidays, the best way to prep patients for ear wax removal, whether high dose amoxicillin is effective for kids with lower respiratory infection, and how effective vaccines are against omicron. Plus a special Christmas quiz!
December 22, 2021
Episode 92: urinary incontinence, forearm fractures in kids, COVID testing in schools, and a novel hypertension strategy
This week on Primary Care Update we talk about group PT visits for urinary incontinence in women older than 60, managing uncomplicated forearm fractures in children, a COVID testing strategy for keeping kids in school, and a quadpill for treating hypertension
December 09, 2021
Episode 91: iron for anemic infants, IL-6 antagonists and inhaled steroids for COVID, and PRP for Achilles tendinopathy
This week Kate, Henry, John and Mark discuss whether iron supplementation provides real benefits for anemic infants, IL6 antagonists for COVID, inhaled corticosteroids for COVID, and platelet rich plasma for Achilles tendinopathy.
November 24, 2021
Episode 90: music therapy, lung CA screening, VTE prophylaxis, and a pain guideline
This week, Kate, John, Mark and Henry discuss music to improve sleep and cognition in older adults, lung cancer screening in an organized health system, a comparison of 2 agents for VTE prophylaxis after total knee arthroplasty, and a new pain guideline with a surprising recommendation.
November 20, 2021
Episode 89: pumpkin seeds, placebo for post-op pain, muscle relaxants, and depression screening
This week, join Kate, John, Henry and Mark for a discussion of pumpkin seed oil for BPH symptoms, open label placebo for post-op pain, muscle relaxants for low back pain, and the implications of universal depression screening.
October 28, 2021
Episode 88: influenza, stroke prevention, a novel telemedicine use, and T2DM overtreatment
Join Kate, Henry, John and Mark as they discuss antivirals in children hospitalized with influenza, DAPT for secondary stroke prevention, the safety and effectiveness of no-test medical abortions, and harms of overtreating older persons with T2DM.
October 17, 2021
Episode 87: COVID boosters, ivermectin, and pregnancy outcomes with COVID infection
Kate, Mark, John and Henry discuss the value of three doses of mRNA vaccine for immunocompromised people, Ivermectin for treating persons with COVID-19, the benefits of boosters based on Israeli data, and pregnancy outcomes of women with COVID-19 infection.
September 30, 2021
Episode 86: dexamethasone post-op, topical terbinafine for toenails, thromboprophylaxis, and vaccine adverse events
This week Kate, Mark, Henry and John (he's back!) discuss dexamethasone after major non-cardiac surgery, topical terbinafine for onychomycosis, thromboprophylaxis during knee replacement, and mRNA COVID vaccine adverse events
September 15, 2021
Episode 85: aspirin and antidepressant doses, how low to go with BP, and eye drops for migraine
This week, Kate, Henry and Mark discuss comparative efficacy of aspirin doses, blood pressure lowering and health outcomes, dosing of antidepressants, timolol eye drops for acute migraine treatment
September 03, 2021
Episode 84: adenotonsillectomy in kids with OSA, DAPT vs ASA for stroke prevention, and ovarian cancer screening
This week Kate, Henry and Mark give John the week off and discuss outcomes after adenotonsillectomy in children with OSA, the effectiveness and safety of DAPT vs ASA for secondary stroke prevention, and the final results of the largest trial of screening for ovarian cancer using CA-125 and ultrasound.
August 19, 2021
Episode 83: TIA risk score, US for frractures, CDC delta variant report, and harms of MRI
This week, Kate, Henry, Mark and John will discuss the Canadian TIA score, ultrasound for diagnosing upper extremity fractures in children, a summary of the leaked CDC report on breakthrough cases and the delta variant, and how MRI reports can cause harm
August 03, 2021
Episode 82: PCR stool tests in kids, duration of antibiotics for CAP in kids, and an UGI bleed guideline
This week, we give John the episode off, so Kate, Mark and Henry will discuss rapid stool tests in children with community acquired diarrhea, a guideline for managing patients with acute UGI bleeding, and the best duration of antibiotics for ambulatory kids with community-acquired pneumonia
July 22, 2021
Episode 81: LDL targets, guided antiplatelet therapy, CRC screening, and myocarditis after mRNA vax
This week, we will discuss LDL targets after stroke, guided antiplatelet therapy after PCI, updated CRC screening recommendation from the USPSTF, and the risk of myocarditis after mRNA-based COVID vaccination. For CME credit go to IAFP.com and click on the online education link, and then find our podcast.
July 08, 2021
Episode 80: Cannabis, PRP for plantar fasciitis, epidural steroids, and COVID mortality and race
This week, Kate, Mark, John and henry will discuss cannabis use in patients with rheumatologic disorders, platelet-rich plasma injections for persons with plantar fasciitis, epidural steroid injections for sciatica, and COVID mortality and race.
June 24, 2021
Episode 79: caffeine in pregnancy, DM and cancer, ruling out MI, and COVID reinfection
This week we tackle caffeine in pregnancy, new onset diabetes and cancer risk; a clinical prediction tool to help rule out acute myocardial infarction and a report on the frequency of COVID reinfection.
June 11, 2021
Episode 78: PCN allergy, US guided injections, IBS, and prediabetes prognosis
This week, Kate, Mark, Henry and John will discuss penicillin allergy, US-guided steroid injections, psychological therapies for patients with IBS and the natural history of “prediabetes”. Plus the quiz from Kate.
May 27, 2021
Episode 77: deprescribing antibiotics, BP screening recommendations, vit D and fish oil to prevent AF, and steroids for wheeze preschoolers.
This week, Kate, Mark, John and Henry discuss a proven strategy to decrease antibiotic prescribing, learn about updated USPSTF recommendations for blood pressure screening, whether vitamin D and fish oil for prevent A fib, and the value of oral steroids for wheezy preschoolers age 2 to 5.
May 13, 2021
Episode 76: inhaled steroids work for early COVID, new opiate rules, managing metatarsal fracture, and mRNA vaccines in pregnancy
We are really excited to introduce our new co-host, Dr. Kate Rowland, an Associate Professor in the Department of Family Medicine at Rush University in Chicago. We have been teaching with Kate for a long time in our in-person courses, and it's great to have her on board for the podcast. This week we talk about a new study from Oxford University finding a clear benefit for inhaled steroids in patients newly diagnosed with COVID-19. Kate discusses changes (good ones!) in regulations around MAT, Henry has good news about managing 5th metatarsal fractures, and John closes with data on the safety of mRNA vaccines in pregnancy. And the quiz!
April 29, 2021
Episode 75: Duration of symptoms with mild and severe COVID, and true rate of vaccine anaphylaxis
This week, Mark reports the first study looking at the duration of symptoms with mild COVID in healthcare workers (more than you think) compared to those without COVID. Then Henry looks at the same thing in hospitalized COVID patients compared to those with other respiratory infections in the US and UK, and John tells us the true rate of anaphylaxis with vaccines.
April 15, 2021
Episode 74: More flozins and tides, Lyme disease, and something new for acute migraine
This week we discuss a huge and really important meta-analysis of SGLT-2 inhibitors (flozins) and GLP-1 agonists (tides). Also, a good guideline on Lyme disease diagnosis and treatment, and a novel approach to treating migraine.
April 02, 2021
Episode 73: low-carb diets for T2DM, chronic back pain, and reinfection with COVID
This week: low-carb diets for patients with T2DM, managing patients with chronic back pain, and reinfection rates in patients with COVID. Plus the quiz, and a reality TV recommendation.
March 20, 2021
Episode 72: Flozins and tides, new med for migraine, and antidepressants for back pain and DJD
This week, Mark, Henry and guest POET Kate Rowland from Rush Medical College discuss: newer agents to treat diabetes, a new medication for migraine prevention, and antidepressants for pain in patients with back pain or DJD.
March 04, 2021
Episode 71: thromboprophylaxis for COVID inpatients, colchicine for outpatients with COVID, and COVID variant mortality
This week, we will discuss a potpourri of COVID studies: a large propensity score matched study of thromboprophylaxis in hospitalized patients, novel use of colchicine for COVID-19, and mortality associated with mutant SARS-CoV-2 strains.
February 18, 2021
Episode 70: colchicine for heart disease, pregnancy after contraception, and prostate CA screening
This week, we will discuss: a novel use for an old-time drug, pregnancy after contraception, and prostate cancer screening.
February 06, 2021
Episode 69: baricitinib + remdesivir, positive study of convalescent plasma, and long-haulers
Today, and all COVID episode. Does adding baricitinib improve outcomes in patients on remdesivir; convalescent plasma given early in high risk elders; and how common are long-hauler symptoms.
January 22, 2021
Episode 68: lung cancer screening, preventing celiac disease, and a positive convalescent plasma trial
This week, we will discuss screening for lung cancer, preventing celiac disease with early introduction of wheat, and a positive trial of convalescent plasma for COVID in patients with early infection.
January 11, 2021
Episode 67: HPV vaccine, a test for IBD in kids, and household transmission of COVID
This week, we will discuss the HPV vaccine and whether it actually prevents invasive cervical cancer, diagnosing inflammatory bowel disease in children, and COVID infectivity in households and families. Plus a mythbusting quiz and John's recommendation for what NOT to read.
December 23, 2020
Episode 66: repurposed antivirals, banlamivimab for outpatients, and convalescent serum, all for COVID-19
This is an all-COVID-19 week. We discuss the WHO Solidarity trial of remdesivir and other antivirals, banlamivimab for outpatients, and an RCT of convalescent serum.
December 12, 2020
Episode 65: gabapentin for chronic pain, achilles tendons, and aspirin for primary prevention
This week we're joined by special guest Dr. Gary Ferenchick, friend of the pod and professor of Internal Medicine at THE Michigan State University. This week we discuss gabapentin for chronic pelvic pain, cast vs boot (vs surgery) for ruptured achilles tendon, and aspirin for primary prevention.
November 24, 2020
Episode 64: COVID vaccine update, natural immunity, tocilizumab trials, and a fishing story
We cover 6 COVID-19 studies today, focusing on natural and acquired immunity, the tocilizumab trials, and a fishing story. Also the quiz, and you can get free CME at: https://iafp.mclms.net
November 12, 2020
Episode 63: overactive bladder, smoking cessation, and bone density testing
This week we will discuss treatment of overactive bladder syndrome, a smoking cessation guideline and bone density testing. For free CME, go to https://iafp.mclms.net.
November 03, 2020
Episode 62: Tests for COVID, kids with COVID, and vaccines.
Since it has been several weeks since we discussed COVID, this week we will discuss tests for diagnosing it, children and adolescents, whether a vaccine will stop the pandemic, and symptom duration after contracting COVID.
October 21, 2020
Episode 61: Baloxavir, scaphoid fracture, and bariatric surgery
This week, we discuss: influenza prophylaxis, treatment of scaphoid fractures and mortality associated with bariatric surgery. And now you can get free CME (0.5 hour) from the Illinois Academy of Family Physicians for listening. Just go to: iafp.mclms.net, answer a short quiz, and claim your credit.
October 07, 2020
Episode 60: DAPT after stroke, gout, and HRT after 20 years
This week John, Henry and Mark discuss dual antiplatelet therapy after stroke, updated recommendations for management of gout, and long-term follow up of hormone replacement for post menopausal women.
September 18, 2020
Episode 59: Top COVID-19 research studies, part deux
We review 9 more of the top COVID-19 research studies to date, including studies on transmission, treatment, and prognosis.
September 05, 2020
Episode 58: Top COVID studies: 9 of the most important COVID-19 studies
In this episode we summarize 9 top COVID-19 studies in a special episode prepared for the Indiana Academy of Family Physicians.
August 28, 2020
Episode 57: Our (hopefully) last 2 HCQ studies, rehab for COPD, and funny shoes for knee OA
This week, we discuss hopefully the last two studies of hydroxychloroquine for patients with COVID (still doesn't work), pulmonary rehab in patients with COPD, and the use of special footwear in patients with knee DJD.
August 13, 2020
Episode 56: Israeli school outbreak, antibody tests, going nerveless for HTN, and syncope
This week, a COVID-19 outbreak in an Israeli high school, the accuracy of antibody studies, denervation to treat hypertension, and identifying low-risk patients with syncope. Plus the quiz, and a recommendation.
July 31, 2020
Episode 55: COVID-19: vaccines, HCQ for mild illness, and C-19 in kids
This week, an all COVID-19 episode covers 7 new studies in just 24 thrill-packed minutes: 2 phase 2 vaccine trials just out yesterday, outpatient monitoring of patients with COVID-19, hydroxychloroquine in mildly ill patients, and transmission of COVID-19 by children
July 22, 2020
Episode 54: COVID, overactive bladder, and pro/synbiotics post-op
This week we discuss COVID research on how many are asymptomatic and for how long people are infectious , managing overactive bladder symptoms in men, and perioperative probiotics and synbiotics for patients undergoing abdominal surgery.
July 17, 2020
Episode 53: COVID prevalence, treating UTI, migraine prophylaxis, and lab values
2 COVID papers on seroprevalence and total vs confirmed cases, treating UTI with telehealth, migraine prophylaxis for kids, and variation in lab values.
July 02, 2020
Episode 52: COVID-19, 6 studies on steroids, NPI, MIRS in kids, and more
This week, 6 COVID-19 updates: corticosteroids reduce mortality for sickest patients, non-drug approaches to controlling COVID, a review of the multisystem inflammatory syndrome in kids, another study on COVID 19 mortality and race, asymptomatic COVID and a report from the CDC on factors related to hospital and ICU use among patients with COVID-19.
June 17, 2020
Episode 51: Convalescent plasma, patient self-testing, pneumothorax, and colic
This week on Primary Care Update: 2 COVID-19 studies (convalescent plasma RCT and accuracy of patient self-sampling), plus managing pneumothorax, and something that seems to work for infantile colic.
June 08, 2020
Episode 50: Last call for HCQ: we cover 6 COVID-19 studies
A lot to cover: remdesivir updates, the effect of cancer treatment on COVID mortality, hypertensive medications, last call for HCQ, and racial disparities.
June 01, 2020
Episode 49: COVID news, cellulitis diagnosis, and COPD
This week on primary care update: safety of convalescent sera, two social distancing studies, cellulitis diagnosis, and treating COPD exacerbations. Plus a bonus beer POEM.
May 27, 2020
Episode 48: Two COVID-19 studies, OA guideline, and choosing insulins
This week: salivary testing for COVID, COVID immunity, ACR guidelines for managing patients with degenerative joint disease, and the use of old forms of insulin in managing patients with type 2 diabetes.
May 13, 2020
Episode 46: remdesivir trials, fecal shedding, and more
In episode 46 we again cover all things COVID-19: 2 trials of remdesivir, news on viral shedding, COVID mortality, thrombotic events and risk of infection among COVID contacts. You can get all of our research briefs on COVID-19 here: https://www.aafp.org/journals/afp/explore/covid-19-daily-briefs.html
May 04, 2020
Episode 45: 2 COVID studies, IBS and prostate CA screening
This week, 2 new COVID-19 studies (doi:10.1001/jama.2020.6771 and doi: 10.1001/jama.2020.6775), an effective treatment for irritable bowel syndrome (https://www.ncbi.nlm.nih.gov/pubmed/31852769), and trends in prostate cancer screening (https://www.ncbi.nlm.nih.gov/pubmed/31794057).
April 27, 2020
Episode 44: 6 COVID-19 studies
This week, research updates about COVID-19: the largest trial to date of hydroxychloroquine (https://doi.org/10.1101/2020.04.10.20060558), the first serosurvey results (https://doi.org/10.1101/2020.04.14.20062463), doing telehealth (www.bmj.com/content/368/bmj.m1182), masks (https://doi.org/10.17226/25776), the effect of temperature (https://doi.org/10.1101/2020.04.14.20062463) and viral shedding / infectiousness (https://doi.org/10.1038/s41591-020-0869-5).
April 21, 2020
Episode 43: 2 COVID-19 studies, breast CA prevention, and post-MI tx
This week, a couple of COVID-19 updates, plus POEMs on breast cancer prevention (https://www.ncbi.nlm.nih.gov/pubmed/31839281) and a cool new (old) way to reduce bad things after an MI (https://www.ncbi.nlm.nih.gov/pubmed/31733140).
April 15, 2020
Episode 42: COVID-19 edition
All COVID-19 all the time this week with 6 updates: 2 HCQ studies, the new antibody tests, case fatality rates, whether handwashing really works, and an editorial from NEJM. We'll be doing regular podcasts focused on COVID-19, plus our regular podcasts covering all the rest.
April 07, 2020
Episode 41: COVID-19 briefs, clavicle fractures, and acetaminophen
This week: 3 brief summaries of breaking research on COVID-19 (convalescent sera, hydroxychloroquine, and risk stratification); whether you really need surgery for a mid-clavicular fracture (https://www.ncbi.nlm.nih.gov/pubmed/30835150); and whether acetaminophen does anything (https://www.ncbi.nlm.nih.gov/pubmed/31892511).
March 31, 2020
Episode 40: food allergies, BP tarbets, and CRC screening
This week: preventing food allergies (https://www.ncbi.nlm.nih.gov/pubmed/31633778), choosing the right BP target long-term after stroke (https://www.ncbi.nlm.nih.gov/pubmed/31355878), and improving uptake of colorectal cancer screening (https://www.ncbi.nlm.nih.gov/pubmed/30915656).
March 21, 2020
Episode 39: autism, soccer and dementia, and diagnosing hip OA
This week: the results of screening for autism (https://www.ncbi.nlm.nih.gov/pubmed/31562252), does soccer cause dementia (https://www.ncbi.nlm.nih.gov/pubmed/31633894), and the best way to diagnose hip OA on exam (https://www.ncbi.nlm.nih.gov/pubmed/31846019).
March 01, 2020
Episode 38: Top 20 POEMs of 2019, part 3
We finish our top 20 from 2019: bleeding risk with different DOACs (https://www.ncbi.nlm.nih.gov/pubmed/30512099), whether higher doses of ibuprofen are better than low (https://www.ncbi.nlm.nih.gov/pubmed/31383385), a comparison of Shingrix with Zostavax (https://www.ncbi.nlm.nih.gov/pubmed/30361202), and whether exercise really prevents falls (https://www.ncbi.nlm.nih.gov/pubmed/30592475). Plus, an update on the COVID-19 epidemic.
February 19, 2020
Episode 37: Top 20 POEMs of 2019, Part 2
Part 2 of our review of the top 20 POEMs of 2019. This week infections (ruling out CAP, typical duration of RTI in kids, and 5 vs 10 days for strep throat) and colorectal cancer screening (yield of FIT over 10 years ~ colonoscopy, no need to stop NSAID or anticoagulant, and family history effect on risk).
February 04, 2020
Episode 36: Top 20 POEMs of 2019, Part 1
In part 1 this week, we discuss 10 of 2019's top 20 POEMs. POEMs address hypertension, lipid management, behavioral medicine, and aspirin. This is the best of the best of the best for 2019...enjoy!
January 23, 2020
Episode 35: dapagliflozin for HF, muscle relaxants, and gallstone pancreatitis
This week: Dapagliflozin...for heart failure, not T2DM? (https://www.ncbi.nlm.nih.gov/pubmed/31535829) Do muscle relaxants add anything to NSAIDs for back pain? (https://www.ncbi.nlm.nih.gov/pubmed/30955985) And early vs delayed surgery for gallstone pancreatitis (https://www.ncbi.nlm.nih.gov/pubmed/31268184). Plus the quiz and a recommendation.
January 08, 2020
Episode 34: subclinical hypothyroidism, RA, and preventing CAD and AF
Happy Holidays... we hope our listeners are getting some downtime. This week, we discuss the benifits (or not) of treating subclinical hypothroidism, the benefits (or not) of atorvastatin for patients with rheumatoid arthritis, and the best preventive strategy for patients with coronary artery disease and atrial fibrillation.
December 26, 2019
Episode 33: controlling pain, diverticulitis, and when to take BP meds
Happy Holidays! This week we talk about whether adding ibuprofen and codeine improves pain control (https://pubmed.ncbi.nlm.nih.gov/31378383); whether or not a colonoscopy is needed to look for cancer after an episode of diverticultitis (https://pubmed.ncbi.nlm.nih.gov/31260589); and why everyone should take their blood pressure meds at night (https://pubmed.ncbi.nlm.nih.gov/31641769).
December 12, 2019
Episode 32: ticagrelor for CAD, cough and ACEI, and preventing HIV
Our Thanksgiving episode, we even added theme music! Our 3 POEMs this week address whether to add ticagrelor to ASA in CAD (https://www.ncbi.nlm.nih.gov/pubmed/31475798); how often is a cough caused by an ACE inhibitor (https://www.ncbi.nlm.nih.gov/pubmed/29330882); and how effective is HAART at preventing HIV transmission (https://www.ncbi.nlm.nih.gov/pubmed/31056293)?
November 26, 2019
Episode 31: T2DM treatment, T2DM with CVD or CKD, and pre-diabetes
A whole lotta diabetes goin' on: linagliptin ($780) vs glimepiride ($3) for T2DM (https://www.ncbi.nlm.nih.gov/pubmed/31536101); semaglutide in T2DM + vascular/CKD (https://www.ncbi.nlm.nih.gov/pubmed/31185157); and whether we should care about pre-diabetes (https://www.ncbi.nlm.nih.gov/pubmed/31076416).
November 14, 2019
Episode 30: BRCA mutations, Sitz baths, fecal transplant for IBS, and pneumonia guidelines
It's Halloween, and we start with a seasonally appropriate study. That's followed by new recommendations re: BRCA mutations (https://www.ncbi.nlm.nih.gov/pubmed/31429902), Dave Slawson with an Atrium BEAT on the value (?) of Sitz baths, fecal transplant for irritable bowel (https://www.ncbi.nlm.nih.gov/pubmed/30908299), and a quick review of the latest pneumonia guidelines.
November 01, 2019
Episode 29: congestion, decongestants, personal sound amplifiers, and overtreatment of asymptomatic bacteriuria
A busy pod today: what patients mean when they say "congestion" (https://www.ncbi.nlm.nih.gov/pubmed/31145430); Dave Slawson on why decongestants are safer than we thought; are personal sound amplifiers any good (https://www.ncbi.nlm.nih.gov/pubmed/31095263); and ongoing overtreatment of asymptomatic bacteriuria (https://www.ncbi.nlm.nih.gov/pubmed/31449295).
October 15, 2019
Episode 28: 2 hour MI rule out, tramadol safety, and steroids for pneumonia
This week, guest host Dr. Dave Slawson joins Henry and Mark. We discuss rapid (< 2 hr) protocols for ruling out MI (https://www.ncbi.nlm.nih.gov/pubmed/31242362); whether tramadol is as safe as it's cracked up to be (https://www.ncbi.nlm.nih.gov/pubmed/31088782); and steroids for pneumonia (https://www.ncbi.nlm.nih.gov/pubmed/29937237). Plus the quiz, and Mark reviews two clinical prediction rules for PE (PERC and YEARS).
October 03, 2019
Primary Care Update Episode 27
This week, Dr. Dave Slawson, co-inventor of the POEMs concept, joins us to talk about a new project called "Atrium BEATS" (https://www.iambeats.io). Plus, we discuss new studies in how long to continue dual anti-platelet therapy after PCI, whether rimegapant works for migraine, and a possible alternative to ceftriaxone for gonorrhea.
September 22, 2019
Primary Care Update Episode 27
Special guest Dave Slawson, plus 3 POEMs: 1 vs 12 months of DAPT following PCI; rimegepant for migraine; and the best treatment for clinically suspected gonorrhea and chlamydia.
September 20, 2019
Primary Care Update Episode 26
This week: how accurate is clinical gestalt (https://www.ncbi.nlm.nih.gov/pubmed/31208974), canagliflozin and renal outcomes in high risk patients (https://www.ncbi.nlm.nih.gov/pubmed/30990260) and whether oral immunotherapy for peanut allergy is safe and effective (https://www.ncbi.nlm.nih.gov/pubmed/31030987).
September 06, 2019
Primary Care Update Episode 25
This week: baloxavir (Xofluza) for flu (https://www.ncbi.nlm.nih.gov/pubmed/30184455); a new guideline for subclinical hypothyroidism (https://www.ncbi.nlm.nih.gov/pubmed/31088853); and a great review on treating opioid use disorders in primary care (https://www.ncbi.nlm.nih.gov/pubmed/31088885).
August 28, 2019
Primary Care Update Episode 24
This week: as needed steroid + LABA for mild asthma (https://www.ncbi.nlm.nih.gov/pubmed/31112386); platelet rich plasma for rotator cuff injury (https://www.ncbi.nlm.nih.gov/pubmed/31000394); and pioglitazone in high risk diabetics who've had a stroke (https://www.ncbi.nlm.nih.gov/pubmed/30734043).
August 09, 2019
Primary Care Update Episode 23
This week, John, Henry and Mark talk about adding ultrasound to mammography for screening (https://www.ncbi.nlm.nih.gov/pubmed/30882843), routine labs for patients on an antifungal (https://www.ncbi.nlm.nih.gov/pubmed/30347032), and podiatry interventions to prevent falls (https://www.ncbi.nlm.nih.gov/pubmed/30615052).
July 23, 2019
Episode 22: CHD and AF, antidepressant mgmt, and cardioversion for AF
Today we talk about what to do for patients with both coronary heart disease and afib (https://www.ncbi.nlm.nih.gov/pubmed/30883055); a practice changer for the three of us addressing how patient to be with antidepressants (https://www.ncbi.nlm.nih.gov/pubmed/29952277); and whether early or delayed cardioversion is better for afib (https://www.ncbi.nlm.nih.gov/pubmed/30883054).
July 11, 2019
Primary Care Update Episode 21
This week we talk about ruling out serious bacterial infection in young infants (https://www.ncbi.nlm.nih.gov/pubmed/30776077), whether exercise can prevent falls in the elderly (https://www.ncbi.nlm.nih.gov/pubmed/30592475), and whether statins and BP meds prevent cognitive decline (https://www.ncbi.nlm.nih.gov/pubmed/30814321).
June 26, 2019
Primary Care Update Episode 20
This week we cover why you should start using automated BP measurement if you're not already (https://www.ncbi.nlm.nih.gov/pubmed/30715088); ablation vs rhythm control for afib (https://www.ncbi.nlm.nih.gov/pubmed/30874766); and the value of early aerobic exercise after sports concussion (https://www.ncbi.nlm.nih.gov/pubmed/30715132). Plus, the value (?) of self-monitoring blood glucose in non-insulin T2DM.
June 12, 2019
Primary Care Update Episode 19
This week John, Henry and Mark discuss interpretation of FIT tests for CRC screening (https://www.ncbi.nlm.nih.gov/pubmed/30802902); diagnosis of appendicitis (https://www.ncbi.nlm.nih.gov/pubmed/30017693); and treatment of neonatal abstinence syndrome (https://www.ncbi.nlm.nih.gov/pubmed/30667476). Plus, a quiz about metformin.
May 28, 2019
Primary Care Update Episode 18
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).
May 14, 2019
Primary Care Update Episode 17
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.
April 29, 2019
Primary Care Update Episode 16
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).
April 17, 2019
Primary Care Update Episode 15
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).
March 27, 2019
Primary Care Update Episode 14
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).
March 19, 2019
Primary Care Update Episode 13
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.
March 06, 2019
Primary Care Update: Episode 12
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).
February 12, 2019
Primary Care Update - Episode 11
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).
February 08, 2019
Primary Care Update: Episode 10
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.
January 18, 2019
Primary Care Update: Episode 9
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).
January 04, 2019
Primary Care Update: Episode 8, 12/20/18
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
December 20, 2018
Primary Care Update: Episode 7
Topics: fluids to prevent UTI, deprescribing study, antipsychotics for delitium, and the value of ECG and echo for preparticipation physicals.
December 05, 2018
Primary Care Update: Episode 6
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/
November 20, 2018
Primary Care Update: Episode 5
We discuss recent studies on: antibiotics to treat appys, whether gabapentin is any good for back pain, the accuracy of a single BP measurement, and the best approach to smoking cessation.
November 08, 2018
Primary Care Update: Episode 4
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.
October 23, 2018
Primary Care Update: Episode 3
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.
October 08, 2018
Primary Care Update: Episode 2
Today's topics include anticoagulation in patients already taking aspirin, asthma treatment, and getting patients on board with advanced directives. Plus the quiz, and Nerd Alert with Henry.
September 14, 2018
Primary Care Update: Episode 1
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