Primary Care Update

Primary Care Update Episode 27

An episode of Primary Care Update

By Mark Ebell and friends
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.
More places to listen

More places to listen

Primary Care Update Episode 29
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). 
22:12
October 15, 2019
Primary Care Update Episode 28
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). 
23:53
October 3, 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.
29:08
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.
28:56
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).
26:08
September 6, 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).
24:30
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). 
24:29
August 9, 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).
24:19
July 23, 2019
Primary Care Update Episode 22
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).
23:07
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).
25:02
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.
23:44
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.
25:00
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). 
20:54
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.
22:48
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). 
18:38
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). 
24:45
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).
26:41
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.
25:15
March 6, 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).
25:03
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).
31:03
February 8, 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. 
26:30
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).  
28:34
January 4, 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
28:38
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.
26:35
December 5, 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/
22:26
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.
24:03
November 8, 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.
26:29
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.
29:22
October 8, 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.
20:45
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).
38:08
August 24, 2018
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