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Faltando pouco para terminar a segunda temporada do Podcast POEMs da BVS/APS, neste episódio 14 eu vou comentar sobre uma revisão da Cochrane publicada em junho de 2019, falando sobre o uso de probióticos para prevenção de otite média aguda em crianças. Tanto o uso dos probióticos, quanto o estudo da otite média em crianças são temas importantes para a prática do médico em atenção primária. Junto com essa revisão, eu vou iniciar uma pequena série de 3 episódios sobre causalidade em epidemiologia, pois na nossa busca diária de respostas a dúvidas clínicas, compreender como se relacionam causas e efeitos é essencial. Artigo disponível em: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012941.pub2/full?highlightAbstract=antibiotic%7Cprevent%7Cantibiot%7Cprevention

Neste episódio da segunda temporada, o tema é antibiótico na prevenção de exacerbações em pessoas com DPOC. Foi publicado em janeiro de 2021 na biblioteca Cochrane, com metanálise em rede como metodologia principal. Além dos resultados deste estudo, vou comentar sobre como esse tipo de metanálise é realizado e com qual finalidade. Artigo disponível em https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013198.pub2/full?highlightAbstract=antibiotic%7Cprevent%7Cantibiot%7Cprevention

Neste 5º episódio da segunda temporada, vou falar sobre uma revisão sistemática da Cochrane publicada em setembro de 2021, sobre um tema bem importante em várias regiões do Brasil, principalmente região norte e em populações indígenas: Uso de medicação em massa para reduzir a prevalência da doença. Junto a esta revisão, vou falar um pouco sobre ensaios clínicos comunitários, ou em clusters. O que eles têm de diferente dos trials usuais? Como vivem? O que comem? Brincadeiras à parte, é um tipo de delineamento onde é possível avaliar intervenções com foco no nível comunitário. Acesso ao artigo em https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008846.pub3/full?highlightAbstract=malaria%7Cmalari

What does the body of evidence have to say on the topic of ergonomics? Plus: should a maker of vaping products have bought out an entire issue of an academic journal to publish its studies, and we answer questions from our listeners about osteoporosis and COVID contrarians.   Block 1: Ergonomics: carpal tunnel syndrome and ergonomic keyboards (2:09)   Block 2: Ergonomics: work breaks, arm supports, workplace interventions, standing desks, and computer glasses (11:27)   Block 3: The controversy over Juul e-cigarettes and academic publishing (28:42)   Block 4: Is this paper proof that strontium works for osteoporosis? (41:07) What's with MDs and PhDs becoming COVID contrarians? (45:33)     * Jingle by Joseph Hackl * Theme music: “Fall of the Ocean Queen“ by Joseph Hackl. * Assistant researcher: Nicholas Koziris   To contribute to The Body of Evidence, go to our Patreon page at: http://www.patreon.com/thebodyofevidence/.   To make a one-time donation to our show, you can now use PayPal! https://www.paypal.com/donate?hosted_button_id=9QZET78JZWCZE   Patrons get a bonus show on Patreon called “Digressions”! Check it out!     References:   1) Cochrane review on ergonomic keyboards for carpal tunnel syndrome: https://www.cochrane.org/CD009600/NEUROMUSC_ergonomic-positioning-or-equipment-for-carpal-tunnel-syndrome   2) Cochrane review on various interventions for reducing neck pain: https://www.cochrane.org/CD008570/OCCHEALTH_ergonomic-interventions-preventing-work-related-musculoskeletal-disorders-upper-limb-and-neck-among   3) Cochrane review on various interventions for reducing neck pain: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008570.pub3/full?highlightAbstract=ergonomic%7Cergonom   4) Cochrane review on various interventions for reducing neck pain: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012886.pub2/full?highlightAbstract=ergonomic%7Cergonom   5) Cochrane review on ergonomics in dentistry practices: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011261.pub2/full?highlightAbstract=ergonomic%7Cergonom   6) Cochrane review on workplace interventions: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010912.pub5/full?highlightAbstract=ergonomic%7Cergonom   7) Sydney Morning Herald article on the lack of science in ergonomics: https://www.smh.com.au/lifestyle/health-and-wellness/a-difficult-position-experts-question-whether-ergonomics-holds-up-20180910-p502w5.html   8) Our previous episodes on vaping: https://bodyofevidence.ca/005-e-cigarettes, https://bodyofevidence.ca/052-baldness-and-vaping, and https://bodyofevidence.ca/056-drinking-water-and-olivier-bernard   9) Philadelphia Inquirer article on the Juul controversy: https://www.inquirer.com/health/juul-pro-vaping-research-seeks-to-influence-fda-regulation-e-cigarettes-20210710.html   10) The paper on strontium for osteoporosis: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5310667/  

We are joined by Paediatric Consultant Dr Christos Zipitis to discuss a great overview of infant feeding issues. It was fabulous to go over definitions, presentations and management of colic, gastro oesophageal reflux and reflux disease, lactose intolerance and cow's milk protein allergy. We later touch on the resource ICON designed to help parents cope with crying babies. Thoroughly worthwhile learning for all the general practice team.  ___ The GP Infant Feeding Network (UK): https://gpifn.org.uk/infant-feeding/ Milk Allergy in Primary Care (MAP) Guideline 2019: https://gpifn.org.uk/imap/ GP Online, Feeding Problems in infants (2015): https://www.gponline.com/feeding-problems-infants/paediatrics/paediatrics/article/1377305 Medicines for Children Leaflets: https://www.medicinesforchildren.org.uk NICE guidelines Food allergy in the under 19s: https://www.nice.org.uk/guidance/cg116 NICE Guidelines Gastro-oesophageal Reflux in children and young people, diagnosis and management: https://www.nice.org.uk/guidance/ng1/chapter/introduction Thickeners and bowel obstruction discussion reference: Parmar RS et al. Bezoar and bowel obstruction associated with the use of anti-gatro-oesophageal reflux medication in neonates. Infant. 2015; 11(3): 94-5. https://www.infantjournal.co.uk/pdf/inf_063_str.pdf Discussion on potential side effects of Proton Pump Inhibitors for babies: Cochrane review (2014): Pharmacological treatment of children with gastro‐oesophageal reflux  (see PPI section re possible increased risk of respiratory infections) https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008550.pub2/full?highlightAbstract=inhibitors%7Cside%7Ceffects%7Cinhibitor%7Ceffect%7Cpump%7Cproton Long-term PPI use and association with gastric cancer: Ka Shing Cheung and Wei K Leung. Long-term use of PPIs and risk of gastric cancer: a review of the current evidence. Therapeutic Advances in Gastroenterology. 2019; 12: 1-11 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6415482/ ICON: Resource for parents about how to cope with crying babies: https://iconcope.org/ ___ We welcome any feedback you might have, our survey takes 1-2 minutes: pckb.org/feedback or contact us on Twitter @PCKBpodcast ___ This podcast has been made with the support of Greater Manchester Health and Social Care Partnership, GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions.  The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

What are Jellyfish anyway?? How do they eat and move around? How do they reproduce? Are they animals? Plants? Fungi? Or somewhere in the middle? Find out the answers to all these questions and more in our latest release.   Sam's (Incredibly Comprehensive) show notes for Arthritis   Arthritis and weatherJena, A., Olenski, A., Molitor, D. and Miller, N., 2017. Association between rainfall and diagnoses ofjoint or back pain: retrospective claims analysis. BMJ, [online] p.j5326. Available at:. Robert H. Shmerling, M., 2020. Does Weather Affect Arthritis Pain? - Harvard Health Blog. [online]Harvard Health Blog. Available at: [Accessed 16 August 2020]. Savage, E., McCormick, D., McDonald, S., Moore, O., Stevenson, M. and Cairns, A., 2014. Doesrheumatoid arthritis disease activity correlate with weather conditions?. Rheumatology International,[online] 35(5), pp.887-890. Available at: . Steffens, D., Maher, C., Li, Q., Ferreira, M., Pereira, L., Koes, B. and Latimer, J., 2014. Effect ofWeather on Back Pain: Results From a Case-Crossover Study. Arthritis Care & Research, [online]66(12), pp.1867-1872. Available at: . Timmermans, E., Schaap, L., Herbolsheimer, F., Dennison, E., Maggi, S., Pedersen, N., Castell, M.,Denkinger, M., Edwards, M., Limongi, F., Sánchez-Martínez, M., Siviero, P., Queipo, R., Peter, R., vander Pas, S. and Deeg, D., 2015. The Influence of Weather Conditions on Joint Pain in Older Peoplewith Osteoarthritis: Results from the European Project on OSteoArthritis. The Journal ofRheumatology, [online] 42(10), pp.1885-1892. Available at:. Verges, J., Montell, E., Tomas, E., Cumelles, G., Castaneda, G., Marti, N. and Moller, I., 2004. Weatherconditions can influence rheumatic diseases. Cochrane Central Register of Controlled Trials, [online]2005(Issue 4). Available at: [Accessed16 August 2020]. Living With Arthritis. 2020. Weather And Arthritis Pain - Living With Arthritis. [online] Available at: [Accessed 16 August 2020].       BONUS - https://www.youtube.com/watch?v=uGog0Jo26iQ

This week Matt walks us through the frequently discussed Placebo effect and Levi debunks detox diets.   PLACEBO EFFECT“Placebo effect studies are susceptible to response bias and to other types of biases”-JCEhttps://www.jclinepi.com/article/S0895-4356(11)00049-7/fulltext   “Is the Placebo powerless?”-New England JoMedhttps://www.nejm.org/doi/full/10.1056/NEJM200105243442106   “A Comprehensive Review of the Placebo Effect”-Annual Review of Psychology https://www.annualreviews.org/doi/10.1146/annurev.psych.59.113006.095941   “Placebo interventions for all clinical conditions”-Cochrane Library https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003974.pub3/full?highlightAbstract=placeb%7Cplacebo%7Ceffect   “Howard Fields, MD, PhD, The Placebo Effect Part 1: Defining the Placebo Response” video https://youtu.be/oWPtIR-0Q_A   “Bad Science”-Dr Ben Goldacrehttps://www.goodreads.com/book/show/3272165-bad-science   “Bad Pharma”-Dr Ben Goldacre https://www.goodreads.com/book/show/15795155-bad-pharma DETOX DIETS   Detox diets for toxin elimination and weight management: a critical review of the evidence https://onlinelibrary.wiley.com/doi/full/10.1111/jhn.12286   How Does the liver work? https://www.ncbi.nlm.nih.gov/books/NBK279393/   The Truth about toxins https://www.rush.edu/health-wellness/discover-health/truth-about-toxins   7-day detox; a Naturopath approved plan https://www.bodyandsoul.com.au/diet/diets/the-7day-detox-plan/news-story/cfb1850be6010553eba661bb9cbcb938   Do Detox Diets Work? https://www.healthline.com/nutrition/detox-diets-101

Do you have TIME to brush your teeth regularly? Are you worried about the fluoride in your toothpaste? How about the fluoride in your drinking water? Wait.....what is time? Is time even real, does anyone know? Maybe time's just a construct of human perception; an illusion created by.....anyway, listen to the episode to find out all the answers these these questions and more.     TIME Physics.org articlehttp://www.physics.org/article-questions.asp?id=77   ‘Time Dilation’ newspaper article  https://www.space.com/33411-astronaut-scott-kelly-relativity-twin-brother-ages.html   Ohio State GPS Explanationhttp://www.astronomy.ohio-state.edu/~pogge/Ast162/Unit5/gps.html   Space.com article on Special Relativityhttps://www.space.com/36273-theory-special-relativity.html   Time Dilation Videohttps://www.youtube.com/watch?v=yuD34tEpRFw ‘Does Time Exist?’https://www.youtube.com/watch?v=R3tbVHlsKhs   WATER FLUORIDATION Story of water fluoridation https://www.nidcr.nih.gov/health-info/fluoride/the-story-of-fluoridation Healthcare Triage fluoride video  https://www.youtube.com/watch?v=6Hml1CL0Idk&t=53s Australian systematic review https://www.ncbi.nlm.nih.gov/pubmed/18584000 Cochrane Fluoride Toothpaste  https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD002278/full?highlightAbstract=water%7Cfluorid%7Cfluoridation Cochrane Water fluoridation for the prevention of dental caries https:// https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010856.pub2/full?highlightAbstract=fluoride%7Cfluorid Book Health Effects of Ingested Fluoride https://books.google.com.au/books?hl=en&lr=&id=CMQd6nkX86EC&oi=fnd&pg=PT21&dq=fluoride+health+effects&ots=kwW4zXZ3hB&sig=2edh7tDHg-FbUno0oh9eHrhjCcg&redir_esc=y#v=onepage&q=fluoride%20health%20effects&f=false  

This week on IdioFacto, we are joined by our first guest, Dr. Sam Laucirica. Matt takes us through Microwaves and Levi and Dr. Sam discuss dietary supplements.   Show notes for Microwaves   ARPANSA Microwaves Article: https://www.arpansa.gov.au/understanding-radiation/radiation-sources/more-radiation-sources/microwave-ovens Engineer Guy (Bill Hammack) video: https://youtu.be/kp33ZprO0Ck Steve Mould CD in Microwave: https://youtu.be/7a_YKVf5Wls (I highly recommend you subscribe to this channel, Steve Mould is one of the best science communicators going around)   Show notes for Supplements   Cochrane Review: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012345.pub3/full?highlightAbstract=pufa%7Cwithdrawn%7Ccardiovascular Multivitamins for CVD prevention and treatment https://www.sciencedirect.com/science/article/pii/S0735109718345601?via%3Dihub Royal jelly https://www.vitacost.com/royal-jelly-5 Casimir Funk https://www.medicinenet.com/script/main/art.asp?articlekey=6002  

In episode 8 of IdioFacto, Levi guides you through the world of GPS and Matt taste-tests Kombucha in search of the truth.   Show notes for GPS   GPS Clock Rollover https://techcrunch.com/2019/04/06/gps-rollover-is-today-heres-why-devices-might-get-wacky/ GPS explanation video https://www.youtube.com/watch?v=FU_pY2sTwTA   Show notes for Kombucha   Dr Axe article: https://draxe.com/7-reasons-drink-kombucha-everyday/ Kombucha: a systematic review of clinical evidence https://www.ncbi.nlm.nih.gov/books/NBK69654/ Healthline article: https://www.healthline.com/nutrition/8-benefits-of-kombucha-tea#section7 Coffee, Decaf Coffee and Tea Diabetes article: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/773949 Bacteria in Kombucha article: https://www.ncbi.nlm.nih.gov/pubmed/24290641 Probiotics systematic review: https://www.ncbi.nlm.nih.gov/pubmed/23981066 Cochrane Review 2009 (Cancer): https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD005004.pub2/full?highlightAbstract=withdrawn%7Ctea%7Cgreen Cochrane Review 2012 (Weight Loss): https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008650.pub2/media/CDSR/CD008650/CD008650_standard.pdf Cochrane Review 2013 (CVD): https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009934.pub2/abstract

This week, Matt discusses Space Elevators and Levi covers Essential Oils Links for SPACE ELEVATORS American Journal of Physics article: https://pdfs.semanticscholar.org/d402/ba5f97884b7398ae2a1ff79136f9c1a03993.pdf British Interplanetary Society article: http://adsabs.harvard.edu/abs/1999JBIS...52..175L NASA article (archived): https://web.archive.org/web/20080919070924/https://science.nasa.gov/headlines/y2000/ast07sep_1.htm Upward Bound: Space Elevators - Isaac Arthur: https://youtu.be/dc8_AuzeYKE Space Elevator - Science Fiction or the Future of Mankind (Kurzgesagt): https://youtu.be/qPQQwqGWktE Links for ESSENTIAL OILS Lavender Oil and Sleep https://www.sciencedirect.com/science/article/abs/pii/S1876382012010700 Essential Oils as antibacterials https://www.sciencedirect.com/science/article/pii/S0168160504001680 Aromatherapy for dementia  - https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003150.pub2/full?highlightAbstract=withdrawn%7Coil%7Cessenti%7Cessential Cochrane Review  - Herbal medicine https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004504.pub4/full?highlightAbstract=withdrawn%7Coil%7Cessenti%7Cessential Aromatherapy in Labour - https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009215/full?highlightAbstract=withdrawn%7Coil%7Cessenti%7Cessential Cochrane review arometherapy during massage for cancer patients - https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009873.pub3/full?highlightAbstract=withdrawn%7Coil%7Cessenti%7Cessential Dr Josh Axe  and Jordan Ruben on essential oils as medicine - https://www.youtube.com/watch?v=iMvWIAZ21KU Government health warning - https://healthywa.wa.gov.au/Articles/A_E/Essential-oils Dr Josh Axe - https://draxe.com/

Katrins Kind wollte mit dem Po zuerst auf die Welt. Katrin beschreibt die Verunsicherung und die Schwierigkeiten ihr Kind spontan zur Welt zu bringen und berichtet, ob dies letzendlich für sie und ihr Kind möglich war. 5|Katrin|Mit dem Po zuerst Katrins Kind wollte mit dem Po zuerst auf die Welt. Katrin beschreibt die Verunsicherung und die Schwierigkeiten ihr Kind spontan zur Welt zu bringen und berichtet, ob dies letzendlich für sie und ihr Kind möglich war. #beckenendlage #mitdempozuerst #falschherumgehtauch #BEL #geburt #PDA #schwanger #geburtshilfe #bensberg #selbstentscheiden #geschichtenuebergeburten #storiesofbirth #birth #breech #podcast #capabilitiesofbirth #geburtserleben NOTES Beckenendlage: 3-4% der Kinder liegen am Ende der Schwangerschaft mit dem Po unten. Viele Kinder drehen sich im Laufe der Schwangerschaft, von Bedeutung ist die Lage ab der 35/36 SSW. Eine Geburt aus BEL ist schwieriger und kann eher zu Komplikationen führen, als wenn das Kind mit dem Kopf unten liegt. Daher kann versucht werden dem Kind anreize zu bieten, sich zu drehen: zum Beispiel durch besondere Positionen der Frau oder durch Moxen. Es kann auch eine äußere Wendung versucht werden, dabei versucht ein Geburtshelfer*in mit den Händen von außen das Kind zu drehen. Derzeit wird davon ausgegangen, dass Komplikationen bei einer vaginalen Geburt und bei einem Kaiserschnitt bei Beckenendlage etwa gleichhäufig auftreten. Ein Problem ist, das viele Geburtshelfer*innen wenig Erfahrung mit einer vaginalen Geburt aus Beckenendlage haben. Es fehlt ihnen also die notwendige Kompetenz um eine Geburt aus Beckenendlage fachgerecht zu begleiten. Es macht daher Sinn sich ein Krankenhaus zu suchen, die viel Erfahrung mit Beckenendlagengeburten haben. Zum Weiterlesen: https://www.klinikum-nuernberg.de/DE/ueber_uns/Fachabteilungen_KN/kliniken/geburtshilfe/Bilder_und_Dokumente/bel-infoblatt.html Quellen: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD000166.pub2/full?highlightAbstract=withdrawn%7Cbreech https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003928.pub3/full?highlightAbstract=withdrawn%7Cbreech https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD000083.pub3/full?highlightAbstract=withdrawn%7Cbreech https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD000084.pub3/full?highlightAbstract=withdrawn%7Cbreech