Primary Care Update
Four healthily skeptical primary care physicians discuss the latest in primary care medicine. Essential Evidence Editor Mark Ebell MD, Rush University's Kate Rowland MD, MSU Professor of Medicine Gary Ferenchick MD, and POEMs co-founder Henry Barry MD, MS provide a fast-paced weekly update on evidence-based primary care.
Episodes
Episode 217: AI therapists, theta-bursts for depression, finerenone for CKD, and GLP-1s causing vision loss.
This week, Henry, Kate, Gary and Mark talk about 4 great new studies: is using an AI chat therapist really that bad for youth, theta-burst stimulation for adults with major depressive disorder, finerenone in adults with CKD but not DM, and GLP-1 agonists and vision loss risk.
Episode 216: low back pain, nasal saline for URI, non-gated CTs for CAC, and statins after 70,
Join our intrepid primary care experts Kate Rowland, Mark Ebell, Henry Barry and Gary Ferenchick as they tell you about 4 new primary care relevant studies: self-management and manipulation for low back pain, nasal saline for treating adults with URIs, non-gated CT scans and coronary calcium measurement, and statins after age seventy. Links:Low back pain: https://pubmed.ncbi.nlm.nih.gov/42223934/
Episode 215: self collected HPV, AI skin cancer app, electroacupuncture for neuralgia, and asymptomatic cardiac plaque
This week, primary care experts Drs. Kate Rowland, Gary Ferenchick, Mark Ebell and Henry Barry discuss 4 new studies: The post-Papanicolau era of HPV self collection, electroacupuncture for post-herpetic neuralgia, AI-based app for melanoma detection, and the onset age of silent atherosclerosis. Links:Self-collected HPV: https://pubmed.ncbi.nlm.nih.gov/42509175/ Electroacupuncture: https://pubmed.
Episode 214: hyperemesis treatment, Ca++ and Vit D, oral PCSK-9, and semaglutide for dementia (?)
Primary care physicians Kate, Mark, Henry and Gary discuss 4 new studies that could change your practice: treatments for hyperemesis gravidarum, calcium and vitamin D to prevent falls and fractures in older adults, the first oral PCSK9 inhibitor, and oral semaglutide to treat dementia .The John Hickner Memorial fund at MSU: https://give.msu.edu/?sid=17374 Hyperemesis gravidarum treatments: https:/
Episode 213: dementia risk factors, COVID-19 vaccines, and shoulder MRIs
This week, Kate, Gary and Mark discuss 3 new studies: whether we can do anything about modifiable risk factors for dementia, whether COVID-19 vaccines are still useful, and how to interpret abnormal shoulder MRIs.
Episode 212: preventing multimorbidity, high dose vit D, skin cancer screening, and withdrawing a GLP-1
Primary care docs Kate Rowland, Mark Ebell, Henry Barry and Gary Ferenchick talk about 4 new studies: prevention of multimorbidity in people at high risk of diabetes, high-dose vitamin D in healthy older adults, whether screening for skin cancer reduces melanoma mortality, and tirzepatide withdrawal and weight maintenance .
Episode 211: semaglutide for AUD, preventing post-vax syncope, PCR panel for RTI, fluvoxamine for long-COVID
Join primary care professors Mark Ebell, Kate Rowland, Gary Ferenchick and Henry Barry as they discuss 4 new studies: semaglutide for alcohol use disorder, a vibrating cool pack to prevent post vaccination syncope, PCR for 23 respiratory pathogens in primary care to reduce antibiotic use, and fluvoxamine for Long-COVID Fatigue.LinksSemaglutide for AUD: https://pubmed.ncbi.nlm.nih.gov/42070571/Vibr
Episode 210: screen time, stopping levothyroxine, new mRNA flu vaccine, and NAS supplements.
This week primary care physicians Kate Rowland, Mark Ebell, Gary Ferenchick and Henry Barry discuss four new studies: screentime for children, discontinuing levothyroxine, a new mRNA flu vaccine from Moderna, and nicotinamide adenine dinucleotide (NAD) Supplementation for healthy aging.Links to articles:AAP screen time policyDiscontinuing levothyroxine studymRNA flu vaccine from ModernaNAD supplem
Episode 209: cocoa, best UTI antibiotic, LAA closure for AF, and evolocumab for primary (sort of) prevention
Primary care docs Mark Ebell, Kate Rowland, Henry Barry and Gary Ferenchick tackle 4 new studies: health benefits of cocoa supplements, the best antibiotic for managing uncomplicated UTIs in women, left atrial appendage closure for AF with high bleeding or stroke risk, and evolocumab for primary (sort-of) prevention of MACE in patients with diabetes.Essential Evidence Plus: www.essentialevidencepl
Episode 208: drinks with diabetes, new Paxlovid trial, antiplatelet agents in stroke, and dietary advice from the AHA
This week, primary care doctors Mark Ebell, Kate Rowland, Henry Barry and Gary Ferenchick discuss four new studies: whether water is better than diet drinks in diabetes, a new RCT of Paxlovid for COVID in contemporary patients, to switch or not to switch antiplatelet agents after a stroke, and the latest AHA 2026 dietary advice for heart health.Drinks for diabetes: ttps://pubmed.ncbi.nlm.nih.gov/4
Episode 207: AI, singing for post-partum depression, and new AHA lipid guidelines
This week Kate, Mark and Henry talk about empathetic robots, mother-baby singing groups for postpartum depression, and new American College of Cardiology lipid guidelines.Indiana AFP POEMs course in French Link: https://www.iafp.org/2026ac Empathetic robots: https://pubmed.ncbi.nlm.nih.gov/41359230/ Weekly singing groups for postpartum depression: https://pubmed.ncbi.nlm.nih.gov/41087020/ACC/AHA/e
Episode 206: biomarkers for dementia, toileting, bleeding risk, and diagnosing volume overload.
Join primary care faculty Gary Ferenchick, Kate Rowland, Henry Barry and Mark Ebell as they discuss 4 important new studies: the value (?) Of biomarkers in cognitive impairment, toilet training, bleeding risk with apixaban versus rivaroxaban for VTE, and diagnosing volume overload in adults from the JAMA Rational Clinical Exam series.
Episode 205: inhaled steroid dose, titrating GLP-1s, zoster vaccine and dementia, and trusting AI
This week, primary care doctors Kate, Gary, Mark and Henry discuss high vs low dose inhaled steroids for high risk patients with asthma, click based semaglutide titration to reduce GI problems, zoster vaccine and dementia risk, and whether we are trusting AI too much.
Episode 204: lowering triglycerides, cannabinoids for pain, managing AF + stent, and lower LDL targets for CAD
This week primary care physicians Kate Rowland, Mark Ebell, Gary Ferenchick and Henry Barry tackle 4 new POEM-worthy studies: new therapy for elevated triglycerides, cannabinoids for chronic pain in adults, the best antithrombotic for patients with AF + drug eluting cardiac stent, and lower versus standard LDL targets for patients with heart diseaseEssential Evidence Plus: https://www.essentialevi
Episode 203: melatonin for dementia, new PE guidelies, inhaled steroids for asthma
This week, primary care physicians Henry Barry, Gary Ferenchick and Mark Ebell discuss several new studies: melatonin for older adults with cognitive impairment, new pulmonary embolism guidelines, and inhaled corticosteroid dosing for children and adults with asthma. Kate has the week off.
Episode 202: Repatha for prevention, baby lotions to prevent eczema, opioids for kid pain, and treatment of appendicitis
This week, primary care docs Mark, Kate, Henry and Gary discuss skin lotions to prevent eczema, adding an opioid to ibuprofen for kids with acute injuries, evolocumab (Repatha) for very high risk persons, and 10 year follow-up of antibiotics vs surgery for uncomplicated appendicitis.
Episode 201: HPV collection, Tramadol, anticoag after ablation, and COVID vaccines
This week, we cover a range of topics: urinary vs cervical HPV collection, the benefits and harms of Tramadol, whether patients need anticoagulation after successful ablation for afib, and the ongoing value of COVID vaccines in the omicron era. Plus a quiz: is TAVR now indicated for everyone with severe aortic stenosis? Stay tuned!
Episode 200: implant bleeding, introducing yourself, avoiding LP for infants, anticoag for AF with stroke
Join primary care faculty Kate Rowland, Gary Ferenchick, Henry Barry and Mark Ebell as they discuss 4 practice changing studies: norethindrone acetate for uterine bleeding with the contraceptive implant, introducing yourself to a new patient, avoiding LPs in febrile infants, and antithrombotic strategies after ischemic stroke with AF and atherosclerosis. And an Olympic quiz!
Episode 199: GIPs, risk based breast CA screening, 1 vs 2 doses HPV vaccine, and surgery for shoulder impingement
Join primary care physicians Kate Rowland, Gary Ferenchick, Henry Barry and Mark Ebell as they discuss 4 new POEMs (Patient Oriented Evidence that Matters): cardiovascular outcomes of GIPs (vs GLP), risk-based breast cancer screening (WISDOM Trial), whether a single dose of HPV vaccine is as good as two, and surgery (or not) for shoulder impingement syndrome. Plus Kate has a great Groundhog Day qu
Episode 198: Tirzepatide, using Beers, stent for carotid stenosis, and high dose flu vaccine
Join Mark, Kate, Henry and Gary as they discuss 4 new POEMs (Patient Oriented Evidence that Matters, studies with the potential to change practice): a summary of the evidence on tirzepatide (Zepbound) for weight loss, using the Beers list with your patients, high vs standard dose flu vaccine and the risk of hospitalization, and whether stent or endarterectomy are better than maximal medical therap
Episode 197: tirzepatide for kids, new flu vaccine, bathing for eczema and beta-blockers post-MI
This week, primary care physicians Kate Rowland, Mark Ebell, Gary Ferenchick and Henry Barry tackle 4 new practice changing studies (POEMs): bathing frequency for people with eczema, tirzepatide in obese children and adolescents with T2DM, a new flu vaccine, and whether beta-blockers still matter after MI.
Episode 196: Med diet, pneumonia guideline, coffee for afib, and meds for agitation in elderly
Join primary care physicians Kate, Gary, Henry and Mark as they discuss 4 new POEM (Patient Oriented Evidence that Matters), chosen for their potential to change practice and improve patient outcomes: Mediterranean diet to prevent diabetes, an update to the community-acquired pneumonia guideline, coffee or decaf for afib, and safety of meds for acute agitation in the elderly. North Dakota Academy
Episode 195: aspirin or clopidogrel, lipids and dementia, colon CA reminders
Join Kate, Gary and Mark (Henry has the day off) as we discuss 3 useful new studies: colorectal cancer screening reminders, aspirin or clopidogrel for secondary prevention of CV events, and lipid lowering drugs and dementia risk
Episode 194: CBD safety, HTN guideline, choosing DM drugs, and COVID-19 vax efficacy
This week primary care physicians Gary, Henry, Kate and Mark discuss the safety of CBD, a new guideline for managing adults with hypertension, whether COVID-19 vaccines are still effective, and a living guideline from the BMJ to help us choose the best diabetes drugs. Links to stuffEssential Evidence Plus Illinois Academy of Family Physicians meeting Dec 6 in Naperville, IL (Kate, Gary and Mark)
Episode 193: Intensive BP lowering, elinzanetant for VMS, HTN in pregnancy and prostate CA screening
Primary care physicians Gary Ferenchick, Kate Rowland, Henry Barry and Mark Ebell want you to know about 4 new studies: the best choice of pharmacotherapy in hypertensive disorders of pregnancy, benefits and harms of intensive BP lowering, elinzanetant for therapy-induced vasomotor symptoms in women with breast cancer, and 23 year follow up of the European Prostate Cancer Screening Trial. Plus a c
Episode 192: anticoag duration, old drugs for insomnia, lower dose Ozempic, and aspirin + anticoag or anticoag alone
This week, Gary, Kate, Mark and Henry discuss the optimal duration of anticoagulation after a provoked DVT, using low doses of mirtazapine or amitriptyline in adults with insomnia, whether a lower dose of semaglutide is still effective for weight loss, and adding aspirin for patients with coronary heart disease, a stent and who are also on a DOAC for another indication.Links:NICE Barrett Esophagus
Episode 191: acetaminophen, leucovorin, MMR and autism; the value of primary care
This week, primary care physicians Kate Rowland, Mark Ebell, and Henry Barry want to arm our primary care colleagues with the best evidence on whether acetaminophen causes autism, whether MMR causes autism, and whether leucovorin can treat autism. Gary then turns to a study of the value of continuity in primary care, and its association with better health outcomes.Links:Henry's essay on Ignaz
Episode 190: flu vaccine & dementia, colchicine for CHD, endometriosis pain and green tea.
Today Kate, Gary, Mark and Henry discuss influenza vaccines and dementia incidence, therapies for endometriosis-related pain, colchicine for secondary prevention of heart disease, and green tea and drug absorption. Links:IgNobel prizes: IgNobel Prizes were recently awarded: https://improbable.com/ig/winners/ www.ncbi.nlm.nih.gov/pubmed/40601364 https://pubmed.ncbi.nlm.nih.gov/40373315/ Colchicine
Episode 189: asthma rescue, exercise for cancer, digitoxin, and minor stroke treatment
This week Gary, Kate, Henry and Mark discuss 4 important new studies that are potential POEMs: A new(ish) rescue therapy for asthma, IV thrombolytics for adults with acute minor stroke, whether exercise reduces cancer mortality, and digitoxin (with a t!) as add-on therapy for adults with heart failure.
Episode 188: digital therapy, DKA with SGLT2s, esketamine for resistant depression, and what is a normal TSH
Join Kate, Mark, Gary and Henry as they discuss 4 great new POEMs (studies with the potential to change practice): a digital mental health intervention, the risk of DKA in patients using SGLT2 inhibitors, esketamine’s effects on suicidal ideation and unresponsive depression, and whether “one-size-fits-all” thyroid reference ranges misleading.Links:Essential Evidence Plus: www.essentialevidenceplus
Episode 187: incidental activity, a new definition of Alzheimers, blood test for CRC screening, and DORAs for sleep
This week, we found 4 great new studies for primary care physicians (and their patients): the health benefits of “incidental” activity, real world data and the amyloid cascade theory for Alzheimer’s disease, a new blood test for colorectal cancer screening, and DORAs for sleep.Check out Essential Evidence Plus: www.essentialevidenceplus.comIncidental activity: https://pubmed.ncbi.nlm.nih.gov/40228
Episode 186: wound care, migraine tx, breast CA screening, and metformin for OA
Kate, Mark, Gary and Henry discuss 4 important new studies relevant to primary care clinicians: negative pressure wound therapy for wounds healing by secondary intention, comparative effectiveness of acute migraine treatments, contrast enhanced mammography, US, or MRI for women with dense breasts, and metformin for knee pain in patients without diabetes.Negative pressure wound therapy: https://pub
Episode 185: resistant HTN tx, mirtazepine for sleep, baloxav for prevention, PRP for OA
This week our intrepid primary care docs discuss 4 new POEMs: spironolactone vs amiloride for resistant hypertension, mirtazapine for insomnia in older adults, baloxivir for influenza post exposure prophylaxis, and platelet-rich plasma injections for knee osteoarthritis. We've got opinions!Show notes:Spironolactone vs amiloride for resistant hypertension: pubmed.ncbi.nlm.nih.gov/40366680/ Mirt
Episode 184: new UTI antibiotic, fibromyalgia tx, trial of an MCED, and the best time for HTN meds
Join Mark, Kate, Henry and Gary as they discuss 4 new POEMs: a new and very hard to pronounce antibiotic for uncomplicated UTI, the best drugs for relieving pain in adults with fibromyalgia, a clinical trial of a multicancer detection test in asymptomatic persons, and bedtime vs morning administration of antihypertensives.Gepotidacin for uncomplicated UTI: https://pubmed.ncbi.nlm.nih.gov/38342126/
Episode 183: triple inhaler for COPD, managing pain in kids, and suzetrigine for pain
This week, join Kate, Mark and Henry as they discuss all in one triple inhalers for COPD, the best medication for pain management in children and suzetrigine, a new medicine for acute pain in adults. Gary is off this week, working on his French lessons. And we add intro music! Yay!
Episode 182: atrial appendage occlusion for AF, oral semaglutide, and epidural steroidsand
Join Mark, Henry, and Gary (we are Kate-less unfortunately this week) for discussion of epidural steroid injections for adults with radicular back pain, post a fib ablation management, and oral semaglutide for high-risk patients with Type 2 DM
Episode 181: wipes to prevent foot ulcer, tirzepatide efficacy,
This week, Kate, Mark, Gary and Henry discuss 4 great new POEMs: foot care wipes for patients at risk of diabetic foot infection, resuming DOACS following intracerebral hemorrhage in adults with a fib, treating prediabetes with tirzepatide, and more on intermittent fasting.Show linksBMJ Magic Evidence interactive review of diabetes medications. A great practice and teaching tool: https://matchit.m
Episode 180: dance benefits, POCUS for clavicles, treating BV, and prehab
This week, Kate, Gary, Mark and Henry chat about the health effects of dance for older adults, POCUS for diagnosing clavicular fractures, treating male partners of women with BV, and prehabilitation before elective surgery .Links:Dance for older adults: https://pubmed.ncbi.nlm.nih.gov/39480190/POCUS for clavicle fractures: https://pubmed.ncbi.nlm.nih.gov/39626455/ Oral + topical treatment of male
Episode 179: novel migraine tx, safety of albuterol in infants, new UTI antibiotic, and vitamin K2 for leg cramps
This week join our intrepid primary care physicians Kate, Gary, Henry and Mark as they discuss 4 new studies: an experimental treatment for chronic migraines, safety of albuterol in wheezy kids under 2, oral gepotidacin for uncomplicated UTI, and vitamin K2 and Leg Cramps.Here are the links:Lukas' Fund supporting the Piedmont Athens and Grady Atlanta NICUs: https://www.lukasfund.org Essential
Episode 178: tapering benzos, neuro testing for athletes, vonoprazan for PUD, and zoster-dementia link
This week Kate, Gary, Mark and Henry discuss discontinuation of benzodiazepines and treatment of insomnia, the value of baseline cognitive testing of college athletes, vonoprazan vs PPI for preventing and treating ulcers, and whether herpes zoster vaccine reduces dementia risk.Show links:Essential Evidence Plus: www.essentialevidenceplus.comTapering benzos: https://pubmed.ncbi.nlm.nih.gov/39374004
Episode 177: steroids and CV risk, dementia guideline, fezolinetant for VMS, and osteoporosis screening
This week Gary, Mark, Kate and Henry discuss: adverse effects from inhaled steroids in asthma, Italian dementia guideline, fezolinetant for treatment of vasomotor symptoms, and updated USPSTF recommendations for osteoporosis screening.Show notes and links:Asthma and risk of CV events: https://pubmed.ncbi.nlm.nih.gov/39088770/ GINA 2024 guidelines: https://ginasthma.org/2024-report/ Italian dementi
Episode 176: bright lights, fever in kids, new anticoagulant for AF, and antibiotics for appendicitis
Join Kate, Gary, Mark and Henry as they discuss 4 new POEMs relevant to primary care: bright light therapy for non-seasonal depression, fever control in children, abelacimab for atrial fibrillation, antibiotics vs surgery in children with nonperforated appendicitis. Get all of the POEMs (a new one every day) by going to Essential Evidence Plus and subscribing.Links from today's podcast:Bright
Episode 175: RSV monoclonals, acupuncture for sciatica, zoledronate in low risk women, and measuring BP at home.
This week, Gary, Kate, Henry and Mark discuss 4 new studies relevant to primary care practice: the effectiveness of RSV monoclonals in infants, acupuncture for sciatica associated with disk herniation, zoledronate every 5 years for low risk women, and the effect of arm position on blood pressure readings. Plus a quiz! Please see below for show notes and links:Learn more about Essential Evidence Pl
Episode 174: sexual dysfunction, GLP-1 benefits, surveillance for DCIS, episodic migraine prevention
Join Kate, Mark, Gary and Henry as they discuss 4 new POEMs on treatment of sexual dysfunction, the benefits and harms of GLP-1 agonists, active surveillance vs usual care for ductal carcinoma in situ, and medications to prevent episodic migraine headache.Henry mentioned AAFP's uncensored resources:www.aafp.org/family-physician/patient-care/clinical-recommendations.html www.aafp.org/family-phy
Episode 173: prenatal cannabis use, fluids in sickle crisis, single or dual tx for AF plus CAD, and exercise for weight loss.
This week, join Kate, Mark, Gary and Henry as they discuss 4 new studies: prenatal cannabis exposure, fluid resuscitation during acute sickle crises, edoxaban or edoxaban + ASA for afib with CAD, and the impact of aerobic exercise on weight loss in adults
Episode 172: mindfulness for pain, methotrexate and resveratrol for OA, and eradicating HP
Join Henry, Kate, Mark and Gary as they discuss 4 new POEMs: an RCT of mindfulness for chronic pain, use of methotrexate (huh?) for pain relief in adults with knee DJD, a new way to eradicate H., and oral resveratrol for adults with painful DJD of the knee (you know, the stuff from red wine). And a quiz: what actually are the benefits of lower BP targets?
Links
Mindfulness for chronic pain: htt
Episode 171: obesity in babies, DOACs after stroke, semaglutide for OA, and thunderclap headaches
This week join our intrepid team of skeptical primary care doctors as Kate, Mark, Henry and Gary discuss a web- and text-based intervention to prevent obesity in babies, the best timing of DOAC initiation after ischemic stroke in adults with atrial fibrillation, using semaglutide for knee osteoarthritis, and the differential diagnosis of thunderclap headaches. Plus the BEST quiz ever.
Links:
Preve
Episode 170: yoga for incontinence, muscle relaxants for pain, maternal cannabis use, and GLP-1 v. surgery
This month Kate, Mark, Gary and Henry discuss yoga for treating urinary incontinence in older women, benefits and harms of muscle relaxants for adults with chronic pain, maternal prenatal cannabis use and developmental delays, and bariatric surgery vs. glucagon-like peptide 1 receptor agonists in obese adults with T2DM.
Links:
Yoga for incontinence: https://pubmed.ncbi.nlm.nih.gov/39186785/
Muscl
Episode 169: migraine, plantar fasciitis, beta-blocker duration and prostate cancer
This week Mark, Kate, Gary and Henry talk about the comparative effectiveness of migraine medications, strategies for adults with plantar fascia pain, whether to continue beta-blocker use after acute MI, and the outcomes of 5-alpha reductase inhibitor use prior to prostate cancer diagnosis.
Links
Migraine: https://www.bmj.com/content/386/bmj-2024-080107
Plantar fasciitis: https://pubmed.ncbi.nlm.n
Episode 168: RSV med, colonoscopy by PCP, hair loss drug, and AI for ECGs
This week listen in as Kate, Mark, Gary and Henry discuss antiviral treatment for infant RSV, colonoscopy competence by specialty, oral minoxidil for hair loss in men, and artificial intelligence performance on interpreting electrocardiograms .
RSV medication:
https://www.nejm.org/doi/full/10.1056/NEJMoa2313551#ap2 and https://pubmed.ncbi.nlm.nih.gov/39321361/
Colonoscopy by specialty
https://p
Episode 167: laughter, HP eradication, antibiotics for delirium, and MRIs of the knee
Join Kate, Gary, Henry and Mark as they discuss a new therapy for dry eye syndrome, antibiotics for suspected UTI in adults with delirium, a new ACG guideline for treating H pylori, and the prevalence of knee pathology in asymptomatic adults. See below for links to the articles and other stuff:
Dry eye treatment
BMJ: https://www.bmj.com/content/386/bmj-2024-080474
Patient instructions: https://ww
Episode 166: vaping cessation, BP meds and dementia, SGLT-2's, and AI for melanoma
Join Gary, Kate, Mark and Henry as they discuss text messages for adolescent vaping cessation, stopping BP meds in nursing home residents with dementia, the benefits of SGLT-2 inhibitors, and mobile phone app–based artificial intelligence for diagnosing melanoma.
Click here for transcript, notes and links for this episode.
Episode 165: psychedelics for depression, preventing and treating influenza, and GLP-2 for...sleep apnea?
It's biscuit week, oops, I mean flu week here on the Great Primary Care Update. Join our bakers, I mean POETs, as they discuss preventing influenza, treating severe influenza, psychedelics for depression, and GLP-1 agonists to treat sleep apnea of all things.
Episode 164: HTN in kids, steroids for hip OA, drugs for T2DM, and AI to develop guidelines
This week, Gary, Henry, Kate and Mark discuss CV events in children with hypertension, intra-articular steroid injections in adults with hip DJD, the best drug classes for treating adults with T2DM, and AI supported development of practice guideline questions. And a quiz, and two sports stories from Henry!
Episode 163: salt substitutes, VR apps for pain, multivitamins, and vitamin D
This week join Kate, Mark, Henry and Gary for a discussion of the cardiovascular benefits of salt substitutes, using virtual reality for cancer-related pain, whether multivitamins reduce mortality, and if and when to recommend vitamin D supplements.
Episode 162: PREVENT risk score, UTI prognosis, sinusitis treatment, and biomarkers for SDAT
This week, Kate, Mark, Gary and Henry tackle 4 new studies: the updated PREVENT cardiovascular disease risk calculators from the AHA, long-term consequences of UTIs in children, antibiotics for sinusitis in kids, and biomarkers to diagnose Alzheimer’s disease
Episode 161: Antibiotics for CAP, melatonin for delirium, screening for lung disease, and seizures after COVID vaccine
This week, join Kate, Gary, Mark and Henry as they discuss screening asymptomatic people for COPD and asthma, the rate of new onset seizures after COVID vaccination, choosing the best oral antibiotic for mild to moderate CAP, and a trail of melatonin for delirium in older, hospitalized adults
Episode 160: prostate meds and dementia, umbilical hernias, mortality for infections, and AF detection
This week, Kate, Mark, Henry and Gary tackle the association between prostate medications and lower dementia risk, the natural history of umbilical hernias in children, differential mortality for flu, RSV and COVID, and what to do about device-detected atrial fibrillation.
Episode 159: DAPT duration, starting contraception, krill oil for OA, and misdiagnosis of CAP
This week, join Kate, Henry, Gary and Mark as they discuss same-day start contraception, krill oil for adults with knee DJD, misdiagnosis of community-acquired pneumonia, and ticagrelor + placebo VS ticagrelor + ASA after PCI. Plus some book recommendations: Whalefall, The Demon of Unrest, and the Commissario Brunetti novels by Donna Leon
Episode 158: dequalinium for BV, mammography, weight loss drugs, and tirzepatide for OSA
Happy 4th of July! This week Kate, Gary, Henry and Mark celebrate by talking about dequalinium for bacterial vaginosis, the comparative effectiveness of weight loss drugs, the new USPSTF mammography recommendation, and tirzepatide for adults with sleep apnea.
Episode 157: Bleeding risk with AF, treating minor ischemic stroke, and beta-blockers after AMI
It's cardiovascular day at Primary Care Update as Kate, Mark and Henry discuss bleeding risk with diltiazem in treatment for atrial fibrillation, whether alteplase improves outcomes in patients with minor ischemic stroke, and whether to continue beta-blockers long-term after acute MI with preserved ejection fraction.
Episode 156: APAP in pregnancy, AI for AOM, current use of Paxlovid, and CGM for T2DM
This week, Kate, Gary, Mark and Henry discuss 4 new studies that answer some important questions: Does acetaminophen in pregnancy and neurodevelopmental outcomes in offspring? Can AI accurately diagnose otitis media in children? Is nirmatrelvir-ritonavir (Paxlovid) still an effective treatment for outpatients with mild to moderate COVID? And finally, what are the benefits and harms of continuous g
Episode 155: wrist imaging, opioids post-op, rate vs rhythm control, and updated Cologuard,
This week, Kate, Gary, Henry and Mark discuss 4 new studies: a decision support tool for imaging wrist injuries, how many opioids should be dispensed after ACL reconstruction, an updated fecal DNA + FIT test for colon cancer screening, and rate vs. rhythm control and the risk of dementia/cognitive decline. And a quiz about...cicadas! Bzzzz.
Episode 154: triptans and CV risk, urate levels and flares, tests for acute diverticulitis, and APOE4
Quite a diversity of topics this week, as Gary, Henry, Kate and Mark talk about: CV risk with triptans, baseline urate levels and risk of acute flairs in adults with gout, primary care feasible tests for acute diverticulitis, and how APOE4 homozygosity represents a distinct genetic form of Alzheimer’s disease.
Episode 153: gabapentinoids and COPD, shoulder dislocations, and older Alzheimer's drugs
This week, Mark is taking a break so Kate, Henry and Gary will discuss gabapentinoids and the risk of severe COPD, rehab after an initial anterior shoulder dislocation, and cognitive enhancers for patients with Alzheimer’s dementia
Episode 152: SGLT2's for heart failure, bariatric surgery outcomes, UTI in kids, and lung screening outcomes.
Join Kate, Gary, Mark and Henry (who went to the eclipse!) as they discuss SGLT2 inhibitors for older adults and frail adults with heart failure, the long term outcomes of bariatric surgery in adults with T2DM, the best duration of antibiotics for febrile UTI in kids, and real world outcomes of lung cancer screening.
Episode 151: SSRIs and mania, oseltamivir, exercise and BP, and HPV vaccine preventing cancer.
Join us today as Gary, Kate, Mark and Henry discuss risks of SSRIs provoking mania in adolescents, real world effectiveness of HPV vaccination for preventing cervical cancer, whether tamiflu reduces hospitalization in adults with flu, and the effects of exercise on BP.
Episode 150: EXXUA for depression, ubrogepant for migraine, PCI for stable angina, and a simple way to communications
This week, Gary, Kate, Henry and Mark discuss a newly approved medication for major depression in adults, initiation of abortive therapy using ubrogepant during migraine prodrome, the value of PCI for patients with stable angina, and a simple intervention to improve communication with hospitalized patients. And a quiz!
Episode 149: afib risk scores, tai chi and cognition, flu vax, and managing gallstones
This week join us as Kate, Mark, Henry and Gary discuss clinical prediction tool for patients using DOACs for atrial fibrillation, the benefits of cognitively enhanced tai chi, whether high dose recombinant flu vaccine is useful in adults 50-64, and watching patients with symptomatic gallstone disease.
Episode 148: meds for alcohol withdrawal, opioids and stimulants, and treating agitation in AD
This week, Kate, Henry and Mark discuss pharmacotherapy for alcohol use disorder, using opioids in adults with cancer pain who also use non-medical stimulants, and brexpiprazole for agitation in patients with Alzheimer's dementia.
Episode 147: TENS for post-op pain, Alzheimer's meds, and delivering bad news
Join Kate, Mark, Henry and Gary as they talk about: TENS for pain after cesarean delivery, cholinesterase inhibitors and risk of falls, a meta-analysis of the new Alzheimer’s drugs, and telephone delivery of bad news
Episode 146: nasal suction for infants, amitriptyline for IBS, aspirin to prevent CRC, and talking about hard things
This week, join Henry, Kate, Gary and Mark as they discuss 4 great studies: home suction devices for infants with bronchiolitis, amitriptyline for adults with irritable bowel, high-dose aspirin for preventing colorectal cancer, and communicating about serious illness and end of life.
Episode 145: DAPT for dementia, BP control post-stroke, managing CHD, and probiotics for IBS
This week, Kate, Henry, Mark and Gary discuss antiplatelet medications to prevent dementia, post-stroke blood pressure control, the latest guideline for managing patients with chronic cardiac disease, and probiotics for patients with irritable bowel syndrome.
Episode 144: cellulitis prognosis, chronic migraine tx, long COVID tx, and drugs for lipids
This week Kate, Mark, Henry and Gary talk about how long it takes for lower extremity cellulitis to improve, how long it takes for CGRP monoclonal antibodies to take effect in adults with chronic migraine, whether CBT is effective for fatigue in patients with long COVID, and outcome data for various lipid lowering therapies. Plus a painful quiz, and Gary learns what an umbrella review is!
Episode 143: sponges for acne, renal colic, breast CA overdiagnosis, BP cuff size
This week, Kate, Mark, Gary and Henry will discuss a possible new agent for acne, analgesia in adults with renal colic, breast cancer overdiagnosis in older women, and the importance of BP cuff size. Plus a Dickensian quiz.
Episode 142: Tdap in pregnancy, atogepant for migraine, POCUS for SBO and gastroparesis
This week, join Kate, Mark, Henry and Gary (from his carport) as they discuss third trimester Tdap for prevention of infant pertussis, atogepant for preventing migraines, POCUS for diagnosing small bowel obstruction, and whether any medications work for treating gastroparesis
Episode 141: an app to reduce drinking, e-cigs to quit smoking, and does ADHD lead to substance use
This week, we give Henry the day off, leaving Kate, Mark and Gary to discuss a new app to reduce unhealthy alcohol use, whether e-cigarettes can help you quit smoking, and whether taking stimulant meds for ADHD increases the risk of substance use down the road. And the quiz, and a book recommendation ("A Voyage for Madmen").
Episode 140: Mg+ for CP, amox challenge, ACP guidelines, and carotid surgery
This week Kate, Mark, Gary and Henry discuss magnesium to prevent cerebral palsy, amoxicillin challenge in the primary care clinic for suspectec PCN non-allergy, new ACP guidance on colorectal cancer screening, and surgery for carotid disease.
Episode 139: U=U, tetracyclines and teeth staining, metformin to prevent long COVID and the best med for onychomycosis
This week, Kate, Mark, Gary and Henry discuss viral loads and risk of HIV transmission, tetracyclines and dental staining in kids, metformin to prevent long COVID in obese and overweight adults, and the effectiveness of terbinafine pulse therapy for ugly toenails
Episode 138: Deprescribing, meds for neuropsych symptoms in dementia, and lowering BP too much
While Mark is biking, Kate, Henry and Gary talk about a deprescribing intervention for older adults in the hospital, medications for managing neuropsychiatric symptoms in adults with dementia, and harms associated with aggressive BP lowering in hospitalized older adults.
