Primary Care Pod

We're back!

Fun, quick episode this week.    https://pubmed.ncbi.nlm.nih.gov/33934725/   Non-fatal senior pickleball and tennis-related injuries treated in United States emergency departments, 2010-2019   Harold Weiss 1, Jacob Dougherty 2, Charles DiMaggio 3

Today's episode is a very complicated topic without clear cut benefits. Expert opinions and modeling data to address a dangerous and serious topic. Let's look at 2 sources: a new study from the Annals of Internal Medicine and an expert opinion from Uptodate.   https://www.uptodate.com/contents/selecting-adult-patients-with-lower-extremity-deep-venous-thrombosis-and-pulmonary-embolism-for-indefinite-anticoagulation?search=unprovoked%20dvt§ionRank=1&usage_type=default&anchor=H648618&source=machineLearning&selectedTitle=1~150&display_rank=1#H648618   vs.   https://pubmed.ncbi.nlm.nih.gov/37364263/ Indefinite Anticoagulant Therapy for First Unprovoked Venous Thromboembolism : A Cost-Effectiveness Study Faizan Khan 1, Doug Coyle 2, Kednapa Thavorn 3, Sasha van Katwyk 4, Tobias Tritschler 5, Brian Hutton 6, Grégoire Le Gal 7, Marc A Rodger 8, Dean A Fergusson 9

Time restricted eating vs. caloric restriction. Is there a winner in this 1:1:1 12-month trial from Chicago?   https://pubmed.ncbi.nlm.nih.gov/37364268/ Time-Restricted Eating Without Calorie Counting for Weight Loss in a Racially Diverse Population : A Randomized Controlled Trial Shuhao Lin 1, Sofia Cienfuegos 1, Mark Ezpeleta 1, Kelsey Gabel 1, Vasiliki Pavlou 1, Andrea Mulas 1, Kaitie Chakos 1, Mara McStay 1, Jackie Wu 1, Lisa Tussing-Humphreys 2, Shaina J Alexandria 3, Julienne Sanchez 4, Terry Unterman 5, Krista A Varady 1

Talking about 2 studies released last month:   1. Giving it to 3rd trimester moms and seeing what happens in newborns: https://pubmed.ncbi.nlm.nih.gov/37018474/   2. Giving it to 60+ yo adults and seeing what happens: https://pubmed.ncbi.nlm.nih.gov/37018468/   What happens when I review these? Listen to find out!   Helpful table (Not sure if this will reproduce well or not):   NNT Vaccine Efficacy Severe LRI     first 90 d 142 81% In 6 mo 75 69% ADULTS 1428 85%       non-severe LRI     first 90 d 111 57 6mo 55 51% ADULTS 769 66%       Any URI     ADULTS 500 62%  

Hey everyone, on today's episode we are talking about a recent JAMA article on Heterogeneity in Blood Pressure Response to various blood pressure medicines and the idea of individualizing antihypertensive algorithms.   https://jamanetwork.com/journals/jama/article-abstract/2803518

Today's episode we look at a study of 60+ year olds who have poorly controlled depression.  Is it better to add on medications? Switch medications? Does it matter?    Study link: https://pubmed.ncbi.nlm.nih.gov/36867173/

Bempedoic Acid aka Nexletol has a new trial in NEJM that shows MACE reduction in very high risk patients (mostly secondary but some primary prevention).  NNT? NNH? Other trials on Bempedoic acid? Tune in and find out.    

Interesting study today that looks at High dose ICS inhalers possibly have worse outcomes in patients than medium dose ICS inhalers, leading to more exacerbations and need for antibiotics. Plausible? Let's discuss!

We take a Pre-operative study from the Annals of Surgery and talk about perioperative risk management for patients with low serum creatinine.

Minor changes, but enough that it's probably useful for an update!

Fun episode today!

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Let's review a clinical trial of medical cannabis use in chronic pain patients with the goal of reducing daily MME dose.

Interesting Study out of the Netherlands on different typing speeds in clinical practice by age, gender, medical role, and specialty.    Take home - You aren't as fast as a typer as you think!

Kicking 2023 year off with a topic on Motivational Interviewing, and what I'm focusing on to help patients make healthy choices and beneficial lifestyle changes for this year.

Thanks to Dr. Leah Prestbo, you the MVP.

Today we discuss a recent study looking at intra-articular steroid injections for knee arthritis vs. IM steroid injections in the glute.  Non-inferior???

Apparently, the relationship between HDL and coronary artery disease is much more complicated than previously thought. Low HDL doesn't matter if you are black? Let's read about a November 2022 study from JACC.

Last decade, data has pointed us to prescribe BP meds at night, new study says, maybe it doesn't matter?

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SHOCKING! DRAMA! Not really, so let's dig into the details from NEJM October article on colonoscopy RCT in Europe.

I HAVE NOTHING TO PUT IN HERE, JUST LISTEN OK.

Works!  How Well? Well, pretty good. Let's get more details!

1. New classifications for your documentation - HFrEF, HFmrEF, HFpEf, HFiEF 2. Medications for HFrEF, HFmrEF 3. Medications for HFpEF. 4. MEMORIZE ALL THE ACRONYMS

Not smoking cessation, but SITTING CESSATION? How a British RCT showed that PCPs can improved hours of sedentary sitting per day, and make changes to patient's overall wellbeing and ? health?  Let's discuss!

WELCOME BACK.   Let's talk about a recent study last month on treatment options for painful neuropathy in diabetes. Monotherapy or dual therapy? Is More Better? Is this practice changing? Do I like typing questions in here? Find out in this episode!

Let's talk about cfDNA and how a new test is soon to be coming to a PCP office near you to screen healthy patients for all cancers in a single blood test.

On today's episode: Standard opening and joke, but with a new sponsorship from Panacea Financial!   Pod Episode is on an interesting study from last month on management of hyperkalemia with patients on ACE/ARBs that I thought was super interesting and very relevant to primary care.  Hope you agree!

Let's talk and review research (and future treatments of LpA) on today's episode of the PCP.

*sigh* Alzheimer's disease is awful.    Let's talk about management, or at least how best to handle it.

We're back!   Let's talk what to do with Warfarin/coumadin, DOACs, antiplatelets/aspirin at the time of EGDs and Colonoscopy based on the most recent guidelines in the spring

Let's review an important topic for Primary Care - COPD! Because it's actually easier than we make it out to be, and can be managed by PCPs in the clinic.  Let's review the 2020 GOLD recommendations.

Let's have a talk based on a very recent meta-analysis from the BMJ about PCSK9 and ezetimibe use in prevention of ASCVD/MACEvents.

TITLE.     POEM FROM AFP   IS GOOD TO REVIEW.   BYE.  

Fun article to discuss today, does it matter whether you wear a white coat to patients?

PPIs are usually great.  PPIs sometimes need to go away. Let's talk about De-prescribing PPIs from a new guideline update from the AGA. OK

Very confusing study and very confusing popular media reporting on the topic, all leads to good topic to talk about in podcast form.

We're back! New pod episode!

You suck at documenting. Let's talk why and focus on how to get better.

Today we go back to Practice Efficiency and look at clinic documentation!  Something we can ALL get better about.  I have thoughts. ALL THE THOUGHTS.

New update! Goodbye Pneumovax 23. Hello PCV 20.  Prevnar is back, baby?

Just a short, fun episode on human physiology and space travel. Probably not clinically relevant but maaaaaaaaaybe one day? Nah, probably not.  

Hey! New study! Is it better to increase a current medication to max dose or start new medication? We know the answer in general population, but let's talk about elderly specific patients.

I like alliteration. Today is about a possible new PE protocol we can follow to rule out false positive D-Dimers by adjusting its threshold based on some variables. BUT, this can be confusing. And hard to remember. Are adding more and more complex algorithms actually worth it?

Hey everyone, simple and quick review of acne treatment today. Tune in and review!

New study! Short course, low dose Amox NON INFERIOR to traditional care. Game changer? IDK probably, let's discuss.

New study highlights what artificial sweeteners are actually doing metabolically, neurologically, and impacting people's ability to lose weight.

Hey everyone   On this episode, we review the recent AFP article on outpatient alcohol withdrawal management.