Practical Talks for Family Docs

In episode 602, James and Mike Kolber go over the best available evidence for the benefits and the harms for one of the most commonly used classes of medications – proton pump inhibitors. We find out the benefit numbers are much larger than the harm numbers. Check out the podcast to get all the numbers you need to help people make decisions. Show Notes 1) Tools For Practice Side effects of long-term PPI use: Leaving a bad taste in your mouth? Proton Pump Inhibitors (PPIs): Is Perpetual Prescribing Inevitable? 2) PEIP Conference Edmonton October 17-18, 2025 3) SPARCTool 4) RX files PPI Stopping your Proton Pump Inhibitor or “PPI”

In episode 601, James and Mike invite Jennifer Young back to the podcast to go over all the evidence we have for pregabalin and gabapentin in patients with fibromyalgia. During the discussion we find out how many people actually get a ≥30% reduction in pain compared to placebo. We even look at some information about different doses. All the numbers are revealed by the end of the podcast – and we give tips and suggestions throughout. Check it out. Show Notes 1) Tools For Practice Pharm for Fibro, Round 2: Can gabapentinoids ease the pain? 2) MEME Conference 2025 in Vancouver – May 9/10, 2025

In this episode of In the Clinic, Mike and Jess invite back Dr. Jennifer Young.  The team discusses Benazir Pervez, a 17-year-old female coming in for acne.  

In this episode of In the Clinic, Mike and Jess invite back Dr. Émélie Braschi.  The team discusses Micti Colate, a 70-year-old female coming in for urinary incontinence.

In this episode of In the Clinic, Mike and Jess invite back Dr. Jennifer Young.  The team discusses Annie Ploidy, a 36-year-old female coming in for prenatal screening.

Over 60% of Canadian trans adults rate their mental health as fair-to-poor and are twice as likely to avoid seeking primary care. Avoidance isn't random – it's the predictable outcome of everyday micro-aggressions, systemic barriers, and what psychologists call minority stress. This podcast will name those forces of avoidance and offer trauma-informed counter-moves family physicians can use on the front line to support their 2SLGBTQ+ patients.    Learning objectives:    By the end of this episode, listeners will be able to: 1. Explain the minority‑stress model and its relevance to everyday family practice. 2. Recognise three common clinic‑level micro‑aggressions that fuel avoidance behaviour. 3. Apply trauma‑informed communication skills that transform micro‑aggressions into micro‑affirmations.

Un nouvel épisode du Pharmascope est disponible… Et on s'attaque encore au trouble d'usage d'alcool! Dans cette deuxième partie, Nicolas, Isabelle et une invitée discutent des traitements de maintien du trouble d'usage d'alcool. Les objectifs pour cet épisode sont: Discuter des interventions comportementales dans le traitement de maintien du trouble d'usage d'alcool Discuter de la prise en charge pharmacologique du trouble d'usage d'alcool Comparer les avantages et les inconvénients de chaque classe médicamenteuse en trouble d'usage d'alcool   Ressources pertinentes en lien avec l'épisode Wood E, Bright J, Hsu K, et coll. Canadian guideline for the clinical management of high-risk drinking and alcohol use disorder. CMAJ. 2023 Oct 16;195(40):E1364-E1379. Repères canadiens sur l'alcool et la santé : rapport final. Centre canadien sur les dépendances et l'usage de substances. 2023 Répertoire des ressources en dépendances du MSSS INESSS. Sevrage d'alcool et prévention des rechutes. 2021. Kelly JF, Humphreys K, Ferri M. Alcoholics Anonymous and other 12-step programs for alcohol use disorder. Cochrane Database Syst Rev. 2020 Mar 11;3(3):CD012880. McPheeters M, O'Connor EA, Riley S, et coll. Pharmacotherapy for Alcohol Use Disorder: A Systematic Review and Meta-Analysis. JAMA. 2023 Nov 7;330(17):1653-1665. Rösner S, Hackl-Herrwerth A, Leucht S, et coll. Opioid antagonists for alcohol dependence. Cochrane Database Syst Rev. 2010 Dec 8;(12):CD001867 Rösner S, Hackl-Herrwerth A, Leucht S, et coll. Acamprosate for alcohol dependence. Cochrane Database Syst Rev. 2010 Sep 8;(9):CD004332. Cheng YC, Huang YC, Huang WL. Gabapentinoids for treatment of alcohol use disorder: A systematic review and meta-analysis. Hum Psychopharmacol. 2020 Nov;35(6):1-11. Anton RF, Latham P, Voronin K, et coll. Efficacy of Gabapentin for the Treatment of Alcohol Use Disorder in Patients With Alcohol Withdrawal Symptoms: A Randomized Clinical Trial. JAMA Intern Med. 2020 May 1;180(5):728-736. Blodgett JC, Del Re AC, Maisel NC, Finney JW. A meta-analysis of topiramate's effects for individuals with alcohol use disorders. Alcohol Clin Exp Res. 2014 Jun;38(6):1481-8. Agabio R, Saulle R, Rösner S, Minozzi S. Baclofen for alcohol use disorder. Cochrane Database Syst Rev. 2023 Jan 13;1(1):CD012557.

Un nouvel épisode du Pharmascope est disponible et on s'attaque cette fois au trouble d'usage d'alcool. Dans cette première partie, Nicolas, Isabelle et une nouvelle invitée discutent du dépistage et de l'évaluation de cette maladie sous diagnostiquée, en plus de réviser la prise en charge du sevrage alcoolique. Les objectifs pour cet épisode sont: Procéder au dépistage du trouble d'usage d'alcool Diagnostiquer un trouble d'usage d'alcool Discuter des bénéfices et des désavantages associés aux principaux traitements pharmacologiques du sevrage alcoolique   Ressources pertinentes en lien avec l'épisode Lignes directrices canadiennes récentes en trouble d'usage d'alcool Wood E, Bright J, Hsu K, et coll. Canadian guideline for the clinical management of high-risk drinking and alcohol use disorder. CMAJ. 2023 Oct 16;195(40):E1364-E1379. Repères canadiens sur l'alcool et la santé : rapport final. Centre canadien sur les dépendances et l'usage de substances. 2023 Guide canadien sur les risques associés à l'usage d'alcool Coalition canadienne pour la santé mentale des personnes pagées. Lignes directrices sur le trouble lié à l'utilisation de l'alcool chez les personnes âgées. 2023. Guide de l'INESSS sur la prise en charge du trouble d'utilisation d'alcool INESSS. Sevrage d'alcool et prévention des rechutes. 2021. US Preventive Services Task Force; Curry SJ, Krist AH, Owens DK, et coll. Screening and Behavioral Counseling Interventions to Reduce Unhealthy Alcohol Use in Adolescents and Adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2018 Nov 13;320(18):1899-1909. Mitchell AJ, Bird V, Rizzo M, et coll. Accuracy of one or two simple questions to identify alcohol-use disorder in primary care: a meta-analysis. Br J Gen Pract. 2014 Jul;64(624):e408-18. Bush K, Kivlahan DR, McDonell MB, et coll. The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. Arch Intern Med. 1998 Sep 14;158(16):1789-95. Maldonado JR, Sher Y, Das S, et coll. Prospective Validation Study of the Prediction of Alcohol Withdrawal Severity Scale (PAWSS) in Medically Ill Inpatients: A New Scale for the Prediction of Complicated Alcohol Withdrawal Syndrome. Alcohol Alcohol. 2015 Sep;50(5):509-18. Kaner EF, Beyer FR, Muirhead C, et coll. Effectiveness of brief alcohol interventions in primary care populations. Cochrane Database Syst Rev. 2018 Feb 24;2(2):CD004148. Amato L, Minozzi S, Vecchi S, Davoli M. Benzodiazepines for alcohol withdrawal. Cochrane Database Syst Rev. 2010 Mar 17;(3):CD005063. Daeppen JB, Gache P, Landry U, et coll. Symptom-triggered vs fixed-schedule doses of benzodiazepine for alcohol withdrawal: a randomized treatment trial. Arch Intern Med. 2002 May 27;162(10):1117-21. Elholm B, Larsen K, Hornnes N, Zierau F, Becker U. Alcohol withdrawal syndrome: symptom-triggered versus fixed-schedule treatment in an outpatient setting. Alcohol Alcohol. 2011 May-Jun;46(3):318-23. Minozzi S, Amato L, Vecchi S, Davoli M. Anticonvulsants for alcohol withdrawal. Cochrane Database Syst Rev. 2010 Mar 17;(3):CD005064. Airagnes G, Valter R, Ducoutumany G, Vansteene C, Trabut JB, Gorwood P, Dubertret C, Matta J, Charles-Nelson A, Limosin F. Magnesium in the treatment of alcohol withdrawal syndrome: a multicenter randomized controlled trial. Alcohol Alcohol. 2023 May 9;58(3):329-335.

Un nouvel épisode du Pharmascope est maintenant disponible! Dans de ce 138ème épisode, Nicolas, Isabelle et Olivier discutent d'un problème pas reposant : le syndrome des jambes sans repos. Les objectifs pour cet épisode sont : Expliquer la présentation clinique, les critères diagnostics et les facteurs de risque du syndrome des jambes sans repos Conseiller des mesures non-pharmacologiques pour aider les personnes avec un syndrome des jambes sans repos Discuter des bénéfices et des désavantages associés aux principaux traitements pharmacologiques du syndrome des jambes sans repos   Ressources pertinentes en lien avec l'épisode Manconi M, Garcia-Borreguero D, Schormair B, Videnovic A, Berger K, Ferri R, Dauvilliers Y. Restless legs syndrome. Nat Rev Dis Primers. 2021 Nov 3;7(1):80. Trotti LM, Becker LA. Iron for the treatment of restless legs syndrome. Cochrane Database Syst Rev. 2019 Jan 4;1(1):CD007834. Earley CJ, García-Borreguero D, Falone M, Winkelman JW. Clinical Efficacy and Safety of Intravenous Ferric Carboxymaltose for Treatment of Restless Legs Syndrome: A Multicenter, Randomized, Placebo-controlled Clinical Trial. Sleep. 2024 Apr 16:zsae095. Short V, Allen R, Earley CJ, Bahrain H, Rineer S, Kashi K, Gerb J, Auerbach M. A randomized double-blind pilot study to evaluate the efficacy, safety, and tolerability of intravenous iron versus oral iron for the treatment of restless legs syndrome in patients with iron deficiency anemia. Am J Hematol. 2024 Jun;99(6):1077-1083. Wilt TJ, MacDonald R, Ouellette J, Khawaja IS, Rutks I, Butler M, Fink HA. Pharmacologic therapy for primary restless legs syndrome: a systematic review and meta-analysis. JAMA Intern Med. 2013 Apr 8;173(7):496-505. Allen RP, Chen C, Garcia-Borreguero D, Polo O, DuBrava S, Miceli J, Knapp L, Winkelman JW. Comparison of pregabalin with pramipexole for restless legs syndrome. N Engl J Med. 2014 Feb 13;370(7):621-31. Trenkwalder C, Benes H, Grote L, Happe S, Högl B, Mathis J, Saletu-Zyhlarz GM, Kohnen R; CALDIR Study Group. Cabergoline compared to levodopa in the treatment of patients with severe restless legs syndrome: results from a multi-center, randomized, active controlled trial. Mov Disord. 2007 Apr 15;22(5):696-703. Trenkwalder C, Beneš H, Grote L, García-Borreguero D, Högl B, Hopp M, Bosse B, Oksche A, Reimer K, Winkelmann J, Allen RP, Kohnen R; RELOXYN Study Group. Prolonged release oxycodone-naloxone for treatment of severe restless legs syndrome after failure of previous treatment: a double-blind, randomised, placebo-controlled trial with an open-label extension. Lancet Neurol. 2013 Dec;12(12):1141-50. Carlos K, Prado GF, Teixeira CD, Conti C, de Oliveira MM, Prado LB, Carvalho LB. Benzodiazepines for restless legs syndrome. Cochrane Database Syst Rev. 2017 Mar 20;3(3):CD006939. Jadidi A, Rezaei Ashtiani A, Khanmohamadi Hezaveh A, Aghaepour SM. Therapeutic effects of magnesium and vitamin B6 in alleviating the symptoms of restless legs syndrome: a randomized controlled clinical trial. BMC Complement Med Ther. 2022 Dec 31;23(1):1. Wali SO, Abaalkhail B, Alhejaili F, Pandi-Perumal SR. Efficacy of vitamin D replacement therapy in restless legs syndrome: a randomized control trial. Sleep Breath. 2019 Jun;23(2):595-601.

Un nouvel épisode du Pharmascope est maintenant disponible! Dans de ce 136ème épisode, Nicolas, Isabelle et un invité discutent de la prophylaxie pré-exposition au VIH dans diverses situations à risque.  Les objectifs pour cet épisode sont : Résumer et comparer les modalités de prise en charge de la PrEP Identifier les patients pouvant bénéficier de la PrEP Discuter des avantages et des risques associés à la prise de la PrEP   Ressources pertinentes en lien avec l'épisode Baril JG et coll. La prophylaxie préexposition au virus de l'immunodéficience humaine : Guide pour les professionnels de la santé du Québec. Ministère de la santé et des services sociaux. Janvier 2019. Disponible, en ligne. US Public Health Services.Preexposure Prophylaxis for the Prevention of HIV Infection in the United States – 2021 Update. A Clinical Practice Guideline. 2021. Disponible, en ligne. Grant RM et coll; iPrEx Study Team. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010;363:2587-99. Grant RM et coll; iPrEx study team. Uptake of pre-exposure prophylaxis, sexual practices, and HIV incidence in men and transgender women who have sex with men: a cohort study. Lancet Infect Dis. 2014;14:820-9. McCormack S et coll. Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial. Lancet. 2016;387:53-60. Molina JM et coll; ANRS IPERGAY Study Group. On-Demand Preexposure Prophylaxis in Men at High Risk for HIV-1 Infection. N Engl J Med. 2015;373:2237-46. Baeten JM et coll; Partners PrEP Study Team. Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. N Engl J Med. 2012;367:399-410. Choopanya K et coll; Bangkok Tenofovir Study Group. Antiretroviral prophylaxis for HIV infection in injecting drug users in Bangkok, Thailand (the Bangkok Tenofovir Study): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet. 2013;381:2083-90.

In episode 600, James and Mike invite Jamie Falk back to the podcast again and we talk about if exercise helps movement in Parkinson's disease. You might be surprised by the size of the effect so have a listen and get all the evidence and numbers you need. Show Notes Tools For Practice Exercise for Parkinson's Disease: More movement = Better movement? MEME Conference 2025 In Vancouver – May 9/10, 1025

In episode 599, James and Mike invite Roni Kraut to the podcast for the first time to talk about a common problem that has a simple answer. What route and/or duration of antifungals is needed when treating uncomplicated vulvovaginal candidiasis in non-pregnant women. Tune in to find out all the simple details. Show Notes Tools For Practice A single dose for treating yeast infections: Is it really this simple? MEME Conference 2025 Vancouver – May 9/10, 1025

In episode 598, James and Mike continue to talk with David Gardner about the issue of insomnia. We discuss his latest, very cool, Your Answers When Needing Sleep (YAWNS NB) randomized clinical trial. YAWNS was a pragmatic, open-label, minimum-contact, RCT where people with long-term use of benzodiazepines and current or past insomnia were randomly allocated to different mailed behavior change interventions or no intervention. They found that in people who got the intervention more of them stopped or reduced the dose of their benzodiazepines and more improved their sleep. Tune in for the numbers for this simple intervention. Show Notes The YAWNS NB trial Booklets: order booklets via the Resource Centre Sleepwell, a research and knowledge translation program based out of Dalhousie University in Halifax, includes tools, resources, and recommendations for patients, the public, and health care professionals. Some features and resources to explore are: Sleepwell stories (patient and health care professional video and written accounts) Clinicians – short videos on how to use get what you need from the website for patient care, and CBT-I training options Sleepwell recommends – vetted reviews and recommendations for self-help CBT-I programs Sleeping pills – content to motivate and facilitate safely ending long-term use of sedatives Tools – sleep diary, online sleep calculator (with guidance for time-in-bed restriction therapy), behaviour change tools (CBTi vs. Sleeping Pills) Zopiclone's residual effects on actual driving performance in a standardized test: a pooled analysis of age and sex effects in 4 placebo-controlled studies Clin Ther 2014 Jan 1;36(1):141-50. doi: 10.1016/j.clinthera.2013.11.00 Audio Player      

In this episode of In the Clinic, Mike and Jess invite back Dr. Émélie Braschi. The team discusses Mr. Ramakanta, a 75-year-old man who is having trouble sleeping at night and difficulty breathing in the day time.

In episode 597, James and Mike invite David Gardner to talk in depth about the issue of insomnia. We talk about triggers, precipitating factors, acute and chronic insomnia, and chronic use of sleeping pills. We discuss Cognitive Behavioral Therapy for Insomnia (CBT-I) and how his team has developed a comprehensive website, Sleepwell, that provides patients and clinicians with great tools and recommendations for the self-care of chronic insomnia. Mike stays awake for the whole podcast and James only has a brief nap. Show Notes Sleepwell, a research and knowledge translation program based out of Dalhousie University in Halifax, includes tools, resources, and recommendations for patients, the public, and health care professionals. Visit https://mysleepwell.ca/ Some features and resources to explore are: Sleepwell stories (patient and health care professional video and written accounts) Clinicians – short videos on how to use get what you need from the website for patient care, and CBT-I training options Sleepwell recommends – vetted reviews and recommendations for self-help CBT-I programs Sleeping pills – content to motivate and facilitate safely ending long-term use of sedatives Tools – sleep diary, online sleep calculator (with guidance for time-in-bed restriction therapy), behaviour change tools (CBTi vs. Sleeping Pills)

In episode 596, Mike and James talk in a PREMIUM way about three trials that used methotrexate for osteoarthritis and walking for back pain. Nothing miraculous but there seems to be an effect – so have a listen.

In episode 595, Mike and James invite Jennifer Young back to talk about the use of combined oral contraceptives for heavy menstrual bleeding (benign etiology) and see if they improve patient outcomes. They do! Have a listen to get all the numbers and see how they compare to using levonorgestrel-containing intrauterine devices or NSAIDs. Show notes Tools for Practice 1) How to Slow the Flow: Combined oral contraceptives 2) How to Slow the Flow: Tranexamic acid for heavy menstrual bleeding 3) How to Slow the Flow: Levonorgestrel intrauterine systems for heavy menstrual bleeding 4) How to Slow the Flow: NSAIDs for Heavy Menstrual Bleeding

In episode 594, Mike and James invite Samantha Moe back to talk about the use of the RSV vaccine in pregnancy. The only way to have an informed conversation around this vaccine is to know the numbers. If you listen to the whole podcast, you'll get all the numbers available to date. Show notes Tools for Practice 1)Bumpin' Up the Protection? RSV Vaccine in Pregnancy 2) Preventing RSV Infections in Infants 3) Preventing RSV in the elderly

In episode 593, Mike and James invite Samantha Moe back to talk about a newer agent for osteoporosis. So, if you want to know all the evidence for romosozumab, tune in and all will be revealed about the benefits and harms. Show notes 1) Tools for Practice Tony Romo-sozumab: Winning touchdown in osteoporosis or interception for the loss? 2) FRAX site for Canada

In this episode of In the Clinic, Mike and Jess invite back Dr. Émélie Braschi. The team discusses Jay Mal, a 9 year old boy presenting with fatigue and fever.

In this episode of In the Clinic, Mike and Jess invite back Dr. Jennifer Young. The team discusses Brea Salter, a 4-year old girl presenting with wheezing.

In episode 592, Mike and James invite Jennifer Young back to the podcast to review the evidence around the use of antidepressants in the challenging pain condition of fibromyalgia. We find there is an effect but, if you are going to help people make decisions, what you really need to know are the numbers for the benefits and harms around the use of these medications. We give you those, so have a listen. Show notes Tools for Practice Pharm for Fibro: Can antidepressants ease the pain?

In episode 591, Mike and James invite Samantha Moe back to the podcast to review the evidence for using testosterone in older men. We talk about the impact testosterone supplementation has on sexual function, strength, fatigue, cognition, quality of life, and harms. There are 16 systematic reviews so we do have pretty good evidence – have a listen and see what the evidence says about what testosterone supplementation might do or not do. Show notes 1) Tools for Practice Testosterone supplementation for cis-gender men: Let's (andro-)pause for a moment

In this episode of In the Clinic, Mike and Jess invite back Dr. Jennifer Young. The team discusses Sissy Hayes, a 38 year old patient who thinks she has a urinary tract infection. 

In episode 590, Mike and James talk in a PREMIUM way about a new trial that looked at the question, does depression screening provide any benefit in primary care? We also go over a case-finding publication on screening for asthma/COPD. At the end we look at, does implementing guideline care improve outcomes for CKD?

In episode 589, Mike and James invite Jennifer Young back to the podcast again to talk about a topic that Mike absolutely loves – Vitamin D for everyone. Tune in to hear about all the latest, and the older, evidence. Do you agree we should remove the question mark from the podcast title? Show notes 1) Tools for Practice Vitamin D and Fracture Prevention: Not what it's cracked up to be?

In episode 588, Mike and James invite Émélie Braschi back to the podcast to discuss another tricky area – insulin in type 2 diabetes and how to use it. Do we need to give it once a day, twice a day or maybe no times a day? Tune in to hear about all the evidence. Show notes 1) Tools for Practice Strategies for initiating insulin in type 2 diabetes

In this episode of In the Clinic, Mike and Jess are joined by Mike Kolber, family physician from Peace River, Alberta. The team discusses Michelle Reblok - a 25 year old patient who presents with stomach problems - and works through the differential diagnosis.  To claim Mainpro+ credits, click here: https://cfpclearn.ca/podcast/in-the-clinic-episode-29-stomach-problems/ 

Mike, Jess and Jennifer follow up with Farrah Lo, a 27 year old patient, who was diagnosed with iron deficiency anemia in an earlier podcast. Today, the team discusses the management of heavy menstrual bleeding.  Did you miss Farrah's original visit? Tune into episode #13: https://open.spotify.com/episode/366me3xA7wkZYEWS9ANynE?si=5a2b105167214a29 To claim your Mainpro+ credit, click here: https://cfpclearn.ca/podcast/in-the-clinic-episode-28-heavy-menstrual-bleeding/ 

In episode 587, Mike and James invite Adrienne Lindblad back to the podcast to go over all the evidence we have for the oral GLP-1 weight loss medications. You know you are going to get lots of questions about these medications so tune in to find out all the numbers around the benefit and potential harms – and cost. Show notes 1) Tools for Practice Mission Slimpossible Part 2: Oral GLP-1 agonists for weight loss

In episode 585, Mike and James invite Émélie Braschi back to the podcast to talk about the tricky issue of how to deal with a potential penicillin allergy. Believe it or not there are a couple of RCTs looking at this issue. These two trials compared oral challenge alone to skin testing followed (if negative) by oral challenge. The results may allow you to change your practice in a good way. Tune in and find out why. Show notes Tools for Practice It's time to challenge penicillin allergy labels!

In episode 585, Mike and James finally get back to being PREMIUM. We review the REDUCE-AMI trial which tried to answer the question – do you need to use a beta-blocker after an MI if there is preserved ejection fraction? We also review a COPD trial that shows integrating respiratory specialists in primary care improves guideline adherence. However, the interesting finding is what happens to the quality-of-life change and hospitalizations. The results of both of these trials may surprise you. Show notes 1) REDUCE-AMI- Beta-Blockers after Myocardial Infarction and Preserved Ejection Fraction N Engl J Med 2024;390:1372-1381 2) Cluster randomised controlled trial of specialist-led integrated COPD care (INTEGR COPD) Thorax 2024;79:209–218

In episode 584, Mike and James invite Tina Korownyk back to the podcast to talk about the evidence for amyloid-targeting monoclonal antibodies in mild cognitive impairment or Alzheimer's dementia. Unfortunately, the evidence shows these medications don't seem to have a clinically important effect and do have some harms. Have a listen as we give you all the numbers so you will be able to properly discuss these medications with your patients. Show notes Tools for Practice Remind me, do medications that target brain amyloid improve my dementia?

Mike, Jess and Émélie follow up with Charlotte McLeod, a 50 year old patient, who originally presented to the clinic with diabetes. Today, the team discusses the management of Charlotte's blood pressure in the context of diabetes. Did you miss Charlotte's original visit? Tune into episode #12: https://open.spotify.com/episode/1F1eZobKKIKTswqYGy9C2c?si=22fa6e6f8a9041e1. To claim your Mainpro+ credit, please click on this link: https://cfpclearn.ca/podcast/in-the-clinic-episode-27-managing-hypertension-in-diabetes/   

Mike, Jess and Émélie discuss Ms. Ottie Stone, a 35 year old patient who presents with dizziness. Today's podcast will discuss the diagnosis and management of benign paroxysmal positional vertigo. To claim your Mainpro+ credit on CFPCLearn, click here: https://cfpclearn.ca/?post_type=podcast&p=13750&preview=true

In episode 583, Mike and James continue to go over the issues associated with using CVD risk calculators. We talk about some of the limitations, how to think about the results and explain the risks and benefits to patients.   Show notes PEER Simplified Cardiovascular Decision Aid Incorporation of Shared Decision-Making in International Cardiovascular Guidelines, 2012-2022 JAMA Network Open. 2023;6(9):e2332793. doi:10.1001/jamanetworkopen.2023.32793 Lipid levels in patients hospitalized with coronary artery disease: an analysis of 136,905 hospitalizations in Get With The Guidelines Am Heart J 2009;157:111-7.e2 Agreement among cardiovascular disease risk calculators Circulation. 2013;127:1948–1956

In episode 582, Mike and James go over the issues associated with using CVD risk calculators. We talk about where the numbers come from, what they mean, what their limitations are, how to think about them and how to use them. So have a listen as it may decrease your risk but it will definitely increase your understanding.   Show notes 1) PEER Simplified Cardiovascular Decision Aid https://decisionaid.ca/cvd/ 2) Incorporation of Shared Decision-Making in International Cardiovascular Guidelines, 2012-2022 JAMA Network Open. 2023;6(9):e2332793. doi:10.1001/jamanetworkopen.2023.32793 3) Lipid levels in patients hospitalized with coronary artery disease: an analysis of 136,905 hospitalizations in Get With The Guidelines Am Heart J 2009;157:111-7.e2 4) Agreement among cardiovascular disease risk calculators Circulation. 2013;127:1948–1956

In episode 581, Mike and James invite Mike Kolber back to the podcast for the umpteenth time – this time we talk about a topic we haven't discussed before – acute diverticulitis. Historically, if a person has diverticulitis they were given antibiotics BUT do they really do anything? We look at all the evidence and the results may surprise you. Show notes Tools for Practice Antibiotics or no antibiotics for acute diverticulitis, that is the question!

In episode 580, Mike and James invite Jennifer Young to talk about the treatment of pityriasis rosea. Believe it or not there are 2 simple treatments that seem to work really quite well. Tune in to hear what works and how well they work. Show notes Tools for Practice (A)dressing the Christmas Tree? Therapies for pityriasis rosea

In episode 579, Mike and James invite Nicholas Dugré back to the podcast to talk about the evidence around the benefits and harms of a new class of medications for the acute treatment of episodic migraines. Ubrogepant is an oral calcitonin gene-related peptide antagonist. In this case, amazing as it may sound, there are triple the number of systematic reviews than there are RCTs. Nonetheless, we go over all the evidence and at the end of the podcast you'll know what the world knows about these agents. Show notes Tools for Practice Oral Calcitonin Gene-related Peptide Antagonists: A painfully long name for the acute treatment of migraines

In episode 578, Mike, James and Jennifer Potter try to answer the question, in patients with dementia, how safe and effective are stimulants, antidepressants, and antipsychotics for treating apathy? We look at the evidence for methylphenidate, antipsychotics, and antidepressants so tune in to find out if any of these treatments have any sort of effect in this very difficult to treat condition. Show notes Tools for Practice Making a difference in indifference? Medications for apathy in dementia

In episode 577, Mike and James invite Jennifer Young to join us to go over all the evidence around how best to close punch biopsies, lacerations and incisions. We go over all the evidence for sutures (absorbable/nonabsorbable), skin glue, and tape. We look at cosmesis, patient satisfaction, and infection rates so have a listen and find out what we found. Show notes Tools for Practice Looking for Closure: Managing simple excisions or wounds efficiently

n episode 576, James, Mike, and Jamie continue to review the evidence for acne treatments. In this podcast, we examine if antibiotics work and we find they do have an effect. Check out the podcast for all the numbers. Show notes Tools for Practice Facing the Evidence in Acne, Part II: Oral Antibiotics Tools for Practice Is less more with isotretinoin and acne? Alberta Medication Costs