NB Hot Topics Podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this edition, we look at three new pieces of research.First, in the BMJ, a paper exploring whether a GP-led psychological intervention can help PTSD symptoms in our patients after ICU. Could this also be successful for other forms of trauma?Second, in the Lancet, research looking at whether semaglutide can improve walking distance in patients with diabetes and intermittent claudication.Finally, in the BJGP, can a practice-led physical activity intervention improve symptoms in survivors of cancer? Will anyone actually want to do it? The answer, and who, may surprise you.ReferencesPoor by Katriona O'SullivanBMJ PTSD paperLancet GLP1ra and PADBJGP Physical activity and cancer survivorsMoving Medicinewww.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode, we are joined by Dr Stephen Bradley, lead author of a new paper published in the BJGP looking at rates of CXR use in general practice and how this influences lung cancer stage at diagnosis and mortality. He discusses the findings of his research and how this might influence our practice. In other research, we look at a new paper in the BMJ on orthostatic HYPERtension - yes, you read that correctly - does treatment help, and does it really matter in the first place? And from the Lancet, research looking at the role of urodynamic studies in women with refractory overactive bladder - does it improve outcomes, or should it be stopped?ReferencesBMJ Orthostatic hypertension and BP treatmentBMJ OH editorialLancet Refractory overactive bladder & urodynamic studiesBJGP CXR in GP & lung cancer staging and mortalitywww.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode, we look at three new papers with practice-changing consequences. Firstly, can treating partners of women with bacterial vaginosis prevent recurrence? Secondly, can semaglutide be effective in alcohol misuse? Finally, is tirzepatide an effective treatment for pre-diabetes in people with obesity (take a guess...!)?ReferencesNEJM Male partner treatment for BVJAMA Psychiatry GLP1a & alcoholNEJM Tirzepatide for Pre-diabeteswww.nbmedical.com/podcast

Welcome to the Hot Topics podcast with Dr Neal Tucker. This is the fourth in our series of special podcasts where we talk to interesting and influential people from the world of general practice.In this interview, we talk to Dr Helen Salisbury, GP & BMJ columnist. A working GP for more than 20 years, Helen has also reached the wider medical community through her regular column in the BMJ. A fierce advocate for general practice, we talk about her career, how general practice has changed over the past 20 years, what writing for the BMJ involves, her work with the BMA and vision for general practice in the future.www.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. This week we look at three new pieces of research. First, we have a paper in the BMJ exploring arterial thrombosis risk with modern hormonal contraceptives including newer treatments such as the combined patch and ring. Second, we have a BJGP paper looking at which type of safety net advice is the most effective. Finally, a new paper in JAMA Internal Medicine collates trials on anti-virals for influenza. Can any of them provide genuine benefit? And don't forget our NB Plus offer - £25 discount on an annual subscription until the 17th of February.ResourcesBMJBJGPJAMAHealthier Together patient infowww.nbmedical.com/podcast

Welcome to the Hot Topics podcast with Dr Neal Tucker. This is the third in our series of special podcasts where we talk to interesting and influential people from the world of general practice.In this interview, we talk to Dr Euan Lawson, GP and editor of the BJGP. The journal will be familiar to all clinicians in general practice and has gone from strength to strength over the past few years. We talk about his career and how he became editor, discuss the world of research including the most influential papers published during his tenure, consider the importance of inclusion health in the changing face of GP, and discuss his vision for the future.And remember our recent NB Clinic in Inclusion Health can be watched on demand here.www.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. A belated Happy New Year! In our round-up of new research, we look at three papers. Firstly, what have been the effects of increased hybrid working in general practice, particularly with the introduction of digital tools and triage? Secondly, do patient decisions aids help patients with choices on anticoagulation in AF and does this help us? Finally, can appendicitis be safely treated with antibiotics and could we be doing this in general practice soon? ReferencesBJGP Hybrid working in general practiceBMJ Patient decision aids in AFLancet Appendicectomy vs antibiotics in kidswww.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker.It's Christmas time and that means a song to get you in the festive spirit. We'll be back with the regular podcast in the New Year. Happy holidays everyone!Nealwww.nbmedical.com/podcastwww.nbmedical.com/podcast

Welcome to the Hot Topics podcast with Dr Neal Tucker. This is the second in a series of special podcasts where we talk to interesting and influential people in general practice.In this interview we talk to Dr Katie Bramall-Stainer, GP and chair of the BMA GPC England, who is currently leading much of UK general practice through 'collective action'. We talk about her career and how she came to her current role, about the BMA collective action in England and what impact this is achieving, and what is the end goal for general practice in England. www.nbmedical.com/podcastReferencesBMA GP Collective action sitewww.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this edition, we look at three new research papers.Firstly, can eating chocolate actually reduce our chance of type 2 diabetes? Sounds too good to be true... Secondly, could a blood test predict your 30-year cardiovascular risk? Finally, how does general practice access going digital affect minoritised ethnic populations? Look out next week for the second of our special interviews. We talk to Dr Katie Bramall-Stainer, chair of the GPC in England, about what does she hope general practice will look like in the future and the effects of collective action in England.ReferencesBMJ Chocolate vs diabetesNEJM 30 year CVD risk predictionBJGP Digitalising GP access and minoritised ethnic populationswww.nbmedical.com/podcast

Welcome to the Hot Topics podcast with Dr Neal Tucker. This is the first in a series of special podcasts where we talk to the movers and shakers of general practice. We will talk to people in GP politics, leadership, media and research and discuss how their careers evolved, how they see current general practice and how they may be influencing the future of the specialism. We start with Dr Claire Fuller, GP and current primary care medical director for NHS England. Hugely influential, you will probably know her as the author of the Fuller Stocktake report. We discuss how she came to the job, what this report found, and how it is impacting general practice in England. www.nbmedical.com/podcast

Welcome to the latest Hot Topics Podcast from NB Medical with Dr Neal Tucker. In this episode, we look at two new papers on the drugs de jour: GLP1 receptor agonists and SGLT2 inhibitors. Can the former reduce pain in knee osteoarthritis and can the latter prevent recurrent renal stones? Our third paper is a consensus paper published in the BJGP on optimising PSA testing for the early detection of prostate cancer in asymptomatic men. Sponsored by Prostate Cancer UK, Neal is joined by Dr Alex Norman, a GP, and Dr Oliver Hulson, a consultant radiologist who undertakes prostate biopsy, to discuss the outcomes of this paper and the latest research in this area. For further information from Prostate Cancer UK including educational resources and webinars see the links below.ReferencesNEJM Semaglutide & knee OABMJ SGLT2i & renal stonesBJGP Consensus Paper on PSA Testing in Asymptomatic MenNB Podcast on role of DRE in identifying prostate cancerPCUK Prostate Cancer Education for Health ProfessionalsPCUK Consensus Paper Webinarwww.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode, we have three exciting new papers. Firstly, in the BMJ a network meta-analysis on acute migraine treatments - can the new GEPANTs drugs beat existing therapies? Secondly, a paper in NEJM does screening for prostate cancer using MRI actually help? Finally in the BJGP can first contact physio be better than a GP appointment? Listen on! ReferencesBMJ Acute migraine therapiesNEJM Prostate cancer screening with MRIBJGP First contact physio in GPwww.nbmedical.com/podcast

Welcome to Season 6 of the Hot Topics podcast with Dr Neal Tucker. The summer holidays are over and it's back to work so time for a new podcast. In this episode, we look at research on whether SGLT2i might prevent dementia, on if it is safer to de-escalate sooner rather than later from dual anti-platelet therapy post-MI, and how effective is the new RSV vaccine at preventing hospitalisation in older people.ReferencesBMJ - SGLT2i & dementiaLancet - De-escalation of DAPT post-MIJAMA - RSV Vaccination Efficacy in Older Peoplewww.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. Have you ever walked into a pharmacy and wondered whether those nasal sprays suggesting they can stop the common cold actually do anything? Ahead of the inevitable coughs and colds of the autumn, the Lancet Respiratory provides some answers and they won't be the ones you think... Still, right now it's the summer and time to get outside and active - especially if you have recurrent back pain. We look at a paper in the Lancet exploring whether just simply walking can be the problem. Finally, from the BJGP we examine a paper looking at what being a "full-time GP" means and how, sometimes, definitions can be REALLY important. ResourcesBJGP Trends in Full-Time Working in GPLancet Effectiveness of Walking for Back PainLancet Resp Nasal Sprays for URTIswww.nbmedical.com/podcast

Welcome to a new episode of the Hot Topics Podcast from NB Medical with Dr Neal Tucker. Today is election results day but we're not talking about politics, we're focusing on the research. We look at a paper in the latest BJGP which looks at which factors influence a patient's decision to discontinue anti-depressants, explore a paper in the Lancet on whether a symptom-clinic led by GPs can improve outcomes for patients with multiple and persistent symptoms, and discuss trends in cardiovascular disease in the UK over the past 20 years, published in the BMJ this week. ReferencesNB Blog on Discontinuation of AntidepressantsBJGP Discontinuation of antidepressantsLancet Symptom clinicBMJ CVD trendswww.nbmedical.com/podcast

Welcome to the Hot Topics Podcast from NB Medical with Dr Neal Tucker. It's election time but we're going to put aside politics and focus on the latest medical research! In this episode, we look at an important BJGP paper highlighting the rates of follow-up after a significant asthma attack, a paper in the Journal of Infection showing the high rates of second antibiotic prescription in ongoing cough, and a RCT in JAMA examining if, as suggested by observational data, aspirin can truly prevent recurrence or metastasis of breast cancer.ReferencesBJGP Post-hospitalisation asthma management in primary careBJGP  Editorial Asthma Deaths in ChildrenJ of Infection Repeat Antibiotics for CougheCancer Aspirin for CancerJAMA Aspiring & Breast Cancer Recurrencewww.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode we think about the GP workforce courtesy of four papers in this month's BJGP - does more GPs boost life expectancy (of the patients...)? do PCNs help health inequalities? is practice-based continuity as good as individual continuity? For a more directly clinical update, we look at new research in the BMJ on which is the best oral option in T2DM after metformin. Can the SGLT2 inhibitors prove their worth?ReferencesBJGP Does the shortage of GPs matter?BJGP PCNs, deprivation and fundingBJGP Continuity in GPBJGP Continuity in Norwegian GPBMJ Best drug after metformin in T2DMwww.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. To DRE or not to DRE? This is the question and the main event in this episode. We have a fantastic interview with Amy Rylance, Head of Improving Care at Prostate Cancer UK, and Sam Merriel, GP and academic clinical lecturer, discussing their recent Clinical Practice paper in the BJGP: Is the digital rectal exam any good as a prostate cancer screening test? In other research, we have two papers with a common theme. Firstly, a paper in the BMJ looking at long-term outcomes after diagnosis with atrial fibrillation, and secondly, a paper in the BJGP examining the role of BNP testing as a marker for future cardiovascular disease in patients with a new diagnosis of hypertension. Both show that while these conditions make us think of stroke and MI, we also should be thinking about heart failure. ResourcesBJGP Clinical Practice paper on DRE for prostate cancer screeningProstate Cancer UK Patient Risk CheckerEuropean Urology Oncology Journal Performance of DRE in PCa ScreeningNEJM 2004 Prevalence of PCa in men with a PSA

Welcome back to the Hot Topics podcast from NB Medical with host Dr Neal Tucker. In this episode, we start by thinking about the news. Firstly, the overwhelming consensus from GPs in England to not support the imposed contract. Secondly, the ongoing discussion around physician associates in general practice, where we touch on an interesting report from South Mississippi around the costs and other outcomes of non-doctor-led primary care. Thirdly, NHS patient satisfaction - is important to take note but why does staff satisfaction never hit the headlines?In research, we look at two papers. First, the rate of familial hypercholesterolaemia coded in practices - how far are we away from what we should expect? And in those with a diagnosis, how good are we at optimally treating them? Second, a paper on which interventions might help people maintain their independence. After an estimated £1.15 billion pounds of research in this area, what does this new systematic review and network meta-analysis tell us?ReferencesAMA Report on PA/NA from South MississippiNHS Staff Survery ResultsBJGP Familial Hypercholesterolaemia rates in GPNICE Guideline FHSimon Broome Diagnostic Criteria for FHBMJ Community Interventions to Maintain Independencewww.nbmedical.com/podcast

Welcome back to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode we think about another year of imposed GP contract on practices in England, the BMA response and where it may lead. In research, we have three fascinating new papers. Firstly, a paper examining how to maintain weight loss after a low-calorie diet – is structured exercise, liraglutide or both better than usual care? Secondly, in the BMJ a systematic review exploring whether exercise should be considered a genuine treatment for depression. And finally, in the NEJM, a study looking at the link between microplastics in carotid arterial plaques and subsequent risk of cardiac vascular events (hint: it's not good news…).ReferencesBMA GP Contract Changes 2024/25Pulse EditorialLancet Discovery Science paper on weight loss maintenanceWeight maintenance author interviewBMJ Exercise and DepressionNEJM Micro/nanoplastics in your arteriesNEJM Microplastics editorialwww.nbmedical.com/podcast

Welcome back to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode, we think about the pay offer for practices in England, a new King's Fund report on the under-funding of primary care for three decades, and the introduction of Pharmacy First. In new research, we have two papers. First, in the BMJ, can an online combined exercise and psychological programme improve quality of life for patients struggling after hospitalisation with covid? Second, in JAMA, can serum urate levels help predict future flares of gout and guide us on who might benefit the most from urate-lowering therapyReferencesKings Fund Report on Primary CareBMJ Post-covid-19 syndrome and online programmeJAMA Serum urate and recurrent goutwww.nbmedical.com/podcast

Welcome back to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode, we consider the current state of general practice in the UK and what lessons the countries can learn from each other. We examine a new paper in the BJGP on how patients feel about general practice in Scotland since the introduction of the 2018 GP contract. Is it meeting patient and policymaker goals? In other research, we see what lessons a new paper in JAMA on weight loss and cancer association can tell us about a seemingly obvious connection, and from the NEJM what effect testosterone replacement for hypogonadism has on men's fracture risk.ReferencesBJGP Patient experiences of Scottish GP paperBJGP Family physician's moral distress when managing health inequalitiesJAMA Cancer diagnoses after weight lossNEJM Testosterone replacement for hypogonadism and fracture riskwww.nbmedical.com/podcast

Welcome to the Christmas Hot Topics Podcast from NB Medical with Dr Neal Tucker. It's time for a bit of light-hearted festive fun so if you've finished signing all your scripts for Christmas then join us for a discussion with Dr Stephen Bradley and Dr Alice Harper about “Great Expectations: GPs estimations of time required to deliver BMJ's 10minute consultations”.This new paper explores how long it REALLY takes to do everything that's recommended in clinical guidance. If you've ever felt like there just isn't enough time in your general practice day, this might explain it, and you are not the only one.Merry Christmas everyone, see you in the New Year. NealReferencesGreat Expectations: GPs estimations of time required to deliver BMJ's 10minute consultationsThe Health Foundation: Identifying Operational Failures in General PracticeBMJ Guidelines should consider clinicians time needed to treatwww.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode, we talk to Prof Hazel Everitt, a GP and lead author of a recent Lancet paper exploring whether amitriptyline is effective for IBS, and where it might fit in to general practice management.We also look at research in the Lancet on treating hand osteoarthritis with methotrexate - what's the rationale and does it work? - plus a BMJ paper on using a patient information leaflet to improve lower urinary tract symptoms in men. Are PILS better than pills? ResourcesLancet ATLANTIS paper on IBS & amitriptylineATLANTIS trial website with patient informationGut journal CBT for IBS National Institute for Health and Care Research - how to get involvedNIHR Local research groups - how to get involvedLancet Methotrexate for hand OA with synovitisBMJ Leaflets for LUTSwww.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. The highlight of this episode is our interview with Prof Miriam Santer, lead author of recent research in the BMJ exploring the effectiveness of spironolactone for acne in women. Does it work? Is it a treatment for general practice? And if so, is it safe, what monitoring is required, and where does it fit with current acne pathways?In the news, we think about the current issues around physician associates in general practice. In research we have two papers on diabetes: first, in the Lancet, is a new once-weekly insulin injection as effective as a daily treatment for type 1 diabetes; and second, in JAMA, is the additional tirzepatide better than prandial insulin in addition to glargine for managing type 2 diabetes? ReferencesEczema Care OnlineBMJ Spiro for acneLancet Once weekly insulin vs daily insulin in T1DMJAMA Tirzepatide vs prandial insulin in T2DMwww.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode we talk to Dr Jessica Watson, lead author of the Why Test study, published in the BJGP exploring the use of blood tests in general practice and how often they make a difference - positive or negative.In other research we look at a BMJ paper comparing rosuvastatin and atorvastatin for secondary prevention, and in the Lancet, the PATHFINDER study, exploring the role of multi-cancer early detection blood tests - will this be useful for diagnosing cancers earlier?Plus the usual news, views, and a song about vaccinations.www.nbmedical.com/podcast ReferencesBJGP Why Test StudyPACT - primary care academic collaborative websiteBMJ Rosuva vs Atorva for secondary preventionLancet PATHFINDER MCED studyLancet EditorialRCGP Manifesto Seven Steps To Rebuild General Practice and Save the NHSwww.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr. Neal Tucker. As we celebrate 25 years of NB Medical and the Hot Topics course, in this podcast we chat with co-founder Dr Simon Curtis about the changes in general practice and medical education since its inception, we discuss three of the most influential research papers over the era, and what the future may hold for GPs. In research, we examine two new papers. The first in the NEJM is on semaglutide for patients with heart failure and preserved ejection fraction. Can it help improve symptoms and quality of life? Could it improve mortality? The second paper from the Lancet looks at a practice nurse-delivered insomnia intervention using sleep restriction therapy. Could this be a useful, cost-effective option for helping people struggling to sleep? ReferencesNEMJ Semaglutide + HFPEF with obesityLancet Nurse-led Insomnia intervention www.nbmedical.com/podcast

Welcome to Season 5 of the Hot Topics podcast from NB Medical with Dr Neal Tucker. Despite celebrating our 25th birthday (don't forget to check out our NB Plus birthday special here) the world of medical news and research never stops. In this episode we look at research in the BJGP about the motivations behind being a GP, whether adding NSAIDs may improve efficacy of emergency contraception, and whether we should be worried about cancer in patients with reflux.www.nbmedical.comReferencesBJGP Mapping GP MotivationsLancet Levonorgestrel + piroxicam for ECBMJ Non-erosive reflux and oesophageal cancer riskwww.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker.  Wondering where the sunshine is? Then this song is for you. Have a good summer everyone and the podcast will be back in September. In the meantime have a look at www.nbmedical.com for our latest courses - we have live webinars for the new Hot Topics course, our new Paediatrics and Child Health course, our updated dermatology course and much more in September.www.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker.  School's out for summer but general practice never stops. This week we look at the medical news story of the week: donanemab for Alzheimer's disease - can this monoclonal antibody revolutionise dementia care? Also in research, prevention is better than a cure, so can a Mediterranean-DASH diet keep cognitive decline at bay? For you weekend warriors out there, is cramming exercise into the weekend as good as exercising throughout the week. A new paper in JAMA answers this question. And is there ANY role for opioids in acute back pain? A new Australian study goes strong to see if there is benefit with this common problem.Don't forget to check out all our upcoming courses including the new Hot Topics course in September and much more on www.nbmedical.com. ReferencesJAMA DonanemabNEJM MIND diet for dementia preventionJAMA Weekend warriors and CVD riskLancet Opioids for Low back and neck pain

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker.  NHS Long Term Workforce Plan is all over the news today. In this episode we have a look at some of the key statements, seeing what is positive for general practice, what is wishful thinking, and what could be even worse.In research we look at new observational data from Denmark, published in the BMJ, finding an association between HRT and dementia; also a study examining the effectiveness of an intra-pulmonary artery device for identifying earlier deterioration of heart failure; and two papers in the NEJM on more weight loss medications for obesity. ReferencesNHS Long term workforce planBMJ HRT & dementiaLancet HF deviceNEJM Retatrutide & Orforglipron

Welcome to a new Hot Topics podcast from NB Medical with Dr Neal Tucker. In Just One More Thing we are joined by Dr. Jim Moore, chair of the Primary Care Cardiovascular Society, where we discuss cholesterol lowering therapies, new ways to treat heart failure, and how we may meet government targets for blood pressure control - can and should it all be done in general practice?In news, is it good news as GPs are primed to solve the obesity crisis with semaglutide? And in research we look at a BMJ paper hoping to radically change how we monitor patients taking methotrexate, and in JAMA a new paper looks at strategies for helping patients stop opioids for chronic pain.ResourcesPrimary Care Cardiovascular Society websiteBMJ Methotrexate monitoring JAMA Chronic opioid withdrawalMy Opioid ManagerPodcast Transcript

Welcome back to the Hot Topics podcast.  In this episode we reflect on the Prime Ministers Primary Care Recovery Plan, then move on to more useful things like research.  We have new papers in the BJGP on who may be more likely to develop fatigue after mild covid and the NEJM on using a peanut patch to desensitive toddlers at risk of anaphylaxis. We also have the next in our series of Just One More Thing - this time we chat about allergy with Dr Matt Doyle, GP and chair of the primary care committee of the British Society of Allergy and Clinical Immunology. ReferencesBSACI websitePrime Ministers Primary Care Recovery PlanBJGP Post-covid fatigueNEJM Peanut allergy patch

Welcome to another Hot Topics podcast from NB Medical with Dr Neal Tucker. With general practice becoming an increasingly popular political battleground, we focus on the latest research. In this edition, we look at whether bempedoic acid actually reduces cardiovascular events and death as well as reducing cholesterol. Ever wondered which is more important in causing CVD: inflammation or cholesterol? A new paper in the Lancet examines this in patients already taking statins. We also explore what is best to drink if you (or your patient) have type 2 diabetes. Can coffee and tea actually be good for you?www.nbmedical.com/podcastReferencesNEJM Bempedoic acidLancet Inflammation vs chol in CVDBMJ what to drink in T2DM

Welcome to the latest Hot Topics podcast from NB Medical with Dr Neal Tucker.  In this episode, we have the latest news including how the public view the NHS and what's happening to the GP contract for English practice. In research, we have a fascinating paper in the BMJ exploring what differences have emerged in recorded outcomes between England and Scotland since the latter abolished QOF, an answer on whether coffee is bad for you (or at least your heart in the short term), and a new class of drug to help with vasomotor symptoms in menopause.ResourcesBMJ QOF paperNEJM Caffeine and the HeartLancet Fezolinetant and hto flushesNHSE GP is the best job ever page

Welcome to the Hot Topics Podcast with host, Dr Neal Tucker.  In this bumper edition, we have the next in our Just One More Thing series. We interview Dr Sam Merriel in collaboration with Prostate Cancer UK, talking about what we need to know in the world of prostate cancer. Should we be screening? Do we need to think beyond PSA? Does new technology change our approach? In the news, we look at the latest RCGP data on workload and whether GPs will strike, while in research we have a BJGP paper on why antimicrobial stewardship interventions may not have the impact in real life that they do in trials, a BJGP analysis of nitrofurantoin (and other antibiotic) failure in men with UTI, and a NEJM paper testing whether thiazides help renal stones.References:Free on demand NB Clinic with Prostate Cancer UK, March 2022PCUK Resources for Health Professionals PCUK Resources for Delivering the PCN DESPCUK 30 second Risk Checker for PatientsResearch discussed by Sam Merriel...Lifetime risk of PCa by major ethnic group in England...Family history risk for PCa...Genetic risk scores for PCa in patient with LUTSBJGP Implementing Antimicrobial Stewardship in GPBJGP Nitrofurantoin failure in men with UTINEJM Hydrochlorthiazide and renal stones

Welcome to the Hot Topics podcast with Dr Neal Tucker.  In this episode, we speak to Dr Katherine Hickman, current chair of the Primary Care Respiratory Society, who answers our three Just One More Thing questions on what we need to know about from primary, secondary and future care with asthma. In new research, we discuss a paper on how pharmaceutical companies spend more money promoting less effective drugs, how atropine eye drops in children can delay myopia, and whether cancer risk prediction tools are accurate in cancer survivors with their inherently raised CVD risk. www.nbmedical.com/podcast ReferencesPrimary Care Respiratory Society - if you want to know more!JAMA Drug spending on low clinical benefit drugsJAMA Atropine eye drops in kids to delay or prevent myopiaLancet CVD risk prediction tool accuracy in cancer survivors

Welcome to another HOT TOPICS podcast from NB Medical with Dr Neal Tucker.  In the podcast cast we reflect on the latest commentaries from the political parties and medical organisations on how they can help with the NHS crisis. We can't promise a solution, but we can help you stay up to date with the world of research. This week we have new research in the Lancet examining whether molnupiravir actually helps acute covid, whether dementia can be prevented through a healthy lifestyle even if you have high risk genes, and what patients actually feel about FIT tests and we the way we use them in GP. For our latest courses and much more go to www.nbmedical.comReferencesLancet acute covid treatmentBMJ Dementia and healthy livingBJGP Patients perspective on FIT

Welcome to the latest NB Hot Topics podcast. It's Christmas and no one needs anything too serious. Enjoy the song. Happy holidays everyone! See you in 2023.Neal

Welcome to a new episode of the Hot Topics Podcast from NB Medical with Dr Neal Tucker.  In this podcast, we look at new research in the BMJ on optimal duration to treatment distal DVTs (wait... do we even check for these...?), and the Lancet examines the benefits of high-dose chronic heart failure therapies after acute decompensation. In Just One More Thing... this episode we are joined by Dr Rachel Ainley, head of research and evidence at Crohn's & Colitis UK to find out what's new in Inflammatory Bowel Disease. You'll find links to the RCGP IBD toolkit and C&CUK's awareness campaign below. ReferencesRCGP IBD Toolkit C&CUK Professional ResourcesBMJ Distal DVT paperLancet Post-Acute Heart Failure Dosage

Welcome to the new Hot Topics podcast from NB Medical with Dr Neal Tucker.  We're dealing with heavy topics today - the Autumn Statement, how losing continuity is detrimental to patient care, maternal mortality in the UK - but we've tried to keep it light in other ways including our new segment: Just One More Thing In Just One More Thing we interview primary care experts across a range of specialties asking 3 questions: what one thing do we need to know about in general practice regarding your specialty, what one thing do we need to know about that's happening in secondary care, and what is pushing the boundaries of medical care in your field. This week we talk to Dr Sarah Davies about diabetes.In research, we consider the implications of two BJGP papers on correlations between practices and patient continuity, while in the BMJ this week a new paper highlights a significant discrepancy in maternal mortality ratios between 8 European countries. Are there lessons for general practice here?ResourcesBJGP Continuity paper no.1BJGP Continuity paper no.2BJGP EditorialBMJ Maternal Mortality paperBMJ MM Editorial

Welcome to a new NB Hot Topics Podcast with Dr Neal Tucker.  Amongst all the political turmoil, healthcare must go on. In this episode, we look at:The new government report (someone's still working, for better or for worse) on the Future of General PracticeThe implications practices need to be aware of for Patient Record Access starting 1st NovemberNew research on the best time to take BP meds and whether cardiovascular screening using CTs & more is helpful.References:Future of GP ReportLancet TIME studyNEJM CVD Screening in Danish Men

Welcome to the new Hot Topics podcast from NB Medical with Dr Neal Tucker.  After a whirlwind week where general practice has been populistically politicised on all sides, in this episode we stay on safer ground and look at new research. The BMJ highlights the future risk of cardio- and cerebrovascular disease after gestational diabetes, even without overt diabetes, but offers some good news regarding the optimisation of risk factors. JAMA introduces roflumilast for chronic psoriasis, as a cream, not a tablet. And the NEJM explores whether there is a role for bronchodilators in people with COPD who don't have COPD - symptomatic smokers with preserved lung function.ReferencesBest research title of the podcast awardBMJ GDM and CVD riskBMJ GDM and modifiable risk factorsJAMA Roflumilast for psoriasisNEJM Bronchodilators for smoking Sx with preserved lung function

Welcome back to the new series of the Hot Topics podcast from NB Medical with Dr Neal Tucker.  A sober start with the death of the Queen yesterday and reflecting on the pressures of general practice and the profoundly sad story of Gail Milligan. But the progress of medicine never stops and there is research to discuss:Papers in the BMJ on whether artificial sweeteners cause harm, and whether supplementing vitamin D really does reduce respiratory and covid infection risk.A Lancet paper on autoimmune disease and an increase in cardiovascular risk, but in whom and how much?Another Lancet paper on the actual rates of statin-induced muscle pain (a little but not a lot...)And a NEJM on whether hacking diabetes monitors and insulin pumps is a safe thing to do.Plus until the 12th of September, we have our Back to School NB Plus offer which you can find here.ReferencesBMJ SweetenersBMJ Vit DBMJ Cod liver oilLancet autoimmune & CVD riskLancet statins & muscle painNEJM Open-source automated insulin delivery systems

Welcome to a new Hot Topics Podcast from NB Medical with Dr Neal Tucker.  It's the summer holidays! We hope a little pressure is off at your practices and you might even get a break yourself.  In this podcast, we discuss the latest news including whether GPs simply aren't working hard enough and debate a £10 charge for DNAs.In research, we look at new data from JAMA suggesting patients are at increased risk of MI shortly after a flare of gout, a fantastic paper in the BJGP presenting data showing how it may be possible to improve early identification of colorectal cancer based on common symptoms and blood results, and more from the BJGP with qualitative research exploring the barriers to shared decision making in patients with multimorbidity. ReferencesJAMA Gout and acute CVDBJGP Early Identification of CRCBJGP Shared decision making and multimorbidity

Welcome to another Hot Topics podcast from NB Medical with Dr Neal Tucker leading you through the latest news and research in general practice.  Of course, we must touch on the demise of Boris Johnson and how he might still be in power if he'd just learned a thing or two from general practice. Meanwhile, in research, we look at prescribing trends in anxiety disorders, whether bariatric surgery can reduce cancer risk in overweight people, and two papers on covid vaccination against Omicron, first on efficacy in kids, second on the relative merits of vaccination vs natural immunity,  plus could a new vaccine for RSV be just around the corner?And with hot weather finally coming to the UK,  time to remind ourselves about the symptoms and signs of heat-related illness in our KISS from NB. References:BJGP Trends in anxiety medications JAMA Bariatric surgery and cancer riskNEJM Covid vaccine in kidsNEJM Covid vaccination vs natural protection vs hybrid immunityNEJM RSV vaccine study

In this new episode of the Hot Topics podcast from NB Medical.  Dr Neal Tucker reflects on a busy week in the politics of UK general practice: "plans for change" from the English health secretary, but the head of primary care for NHSE says partnerships aren't going anywhere. Meanwhile, Panorama highlights the challenges for private companies running NHS GP practices. Where will it all end up? Answers on an e-consult, or email us at hottopics@nbmedical.com.Meanwhile, there is some research! Important new data from the BJGP on the accuracy of the NICE traffic light system for fever in

Welcome to the latest Hot Topics podcast with Dr Neal Tucker.  This week we think about monkeypox. Do we need to worry? What do we need to look out for? Can my pet rat give it to me? Beyond a disease very few of us are likely to ever see, we look at new research on improving mobility in people with frailty and sarcopenia - can exercise classes and nutrition make a real-world difference? We consider a BJGP paper on preventative medicine - why don't we do more, what are the barriers and what really works? Our final piece of research examines whether treating mild hypertension in pregnancy is beneficial or detrimental to mother and baby. Are the NICE guidelines right?ReferencesMonkeypox info UK gov & WHOBMJ Maintaining mobility in older people with frailtyBJGP Prevention in practiceNEJM Treating mild hypertension in pregnancyNICE Guideline on chronic hypertension in pregnancy

In the latest Hot Topics podcast from NB Medical Dr Neal Tucker discusses the latest research important in primary care and interviews two experts in improving asthma care and sustainable healthcare.In new research we examine: The role of self-monitoring of BP in women with hypertension or higher risk of pre-eclampsia - does it provide early detection?Do ezetimibe and PCSK9 inhibitor provide additional real-world benefits over statins alone? Which is best?Can an oral biological agent, baricitinib, provide some hope for patients with severe alopecia?We are also joined by Dr Aarti Bansal and Dr Veena Aggarwal to talk about improving asthma care with a new Asthma Toolkit from Greener Practice and healthcare sustainability in the UK. Why are our asthma outcomes poor? Can simple measures improve care? What is the NHS doing to help primary care reduce its carbon footprint?If you want more join us for our FREE NB Clinic on Tuesday 17th May, 8pm, for Improving Asthma Care and Thinking Green.ResourcesGreener Practice Asthma ToolkitJAMA Self-monitoring of BP in PregnancyBMJ Ezetimibe and PCSK9 inhibitors for Reducing CVD Risk: network meta-analysisBMJ Lipid-lowering medication Rapid Recommendations NEJM Baricitinib for AlopeciaFaculty of Medical Leadership and Management Fellowship webpageBMJ Open Cost of Switching Asthma Inhalers

Welcome to another Hot Topics podcast with Dr Neal Tucker.In this busy edition, we discuss whether national guidelines are affected by bias against race or ethnicity, potentially driving health inequalities. GP and researcher Dr Dipesh Gopal joins us for an interview to examine issues around NICE hypertension guidance. In new research, we have papers on whether a 4th covid vaccine dose actually provides additional protection, how long patients remain at increased risk from acute covid complications after infection, whether breast pain and cancer are linked, how women feel about delayed antibiotics for UTI and what is the optimum dose schedule for iron supplementation in anaemia.Next podcast we'll be interviewing the founder of the Greener Practice network, which has just published a new website - www.greenerpractice.co.uk - full of useful resources to make GP more sustainable and environmentally friendly. Back after Easter.References1. Lancet editorial on Ockenden report2. Kings Fund review of NHS Patient Satisfaction survey 3. BJGP Breast pain and cancer4. BJGP Non-antibiotic treatment of UTI5. BJGP Iron supplementation review6. BMJ Risk of VTE/bleeding post-covid7. NEJM 4th dose covid vaccine8. Greener Practice website