Frankly Speaking About Family Medicine

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-415 Overview: Join us as we discuss the role of postexposure prophylaxis (PEP) in reducing the incidence and adverse outcomes of sexually transmitted infections (STIs), including chlamydia, gonorrhea, and syphilis. Discover when, why, and how to prescribe PEP to better provide your patients with effective prevention options to help reduce rising STI rates and disproportionate impacts on women. Episode resource links: Stewart, J., Oware, K., Donnell, D., Violette, L. R., Odoyo, J., Soge, O. O., ... & Baeten, J. M. (2023). Doxycycline prophylaxis to prevent sexually transmitted infections in women. New England Journal of Medicine, 389(25), 2331-2340. https://www.cdc.gov/sti/php/from-the-director/doxy-pep-sti-prevention-strategy.html#:~:text=Doxy%20PEP%20has%20proven%20to,syphilis%2C%20chlamydia%2C%20gonorrhea). Guest: Mariyan L. Montaque, DNP, FNP-BC Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com   

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-414 Overview: Standing desks are a popular choice for people with sedentary jobs who want to increase their physical activity. In this episode, we look at the latest data on the benefits and risks of prolonged standing and provide actionable strategies to help patients reduce cardiovascular risk through informed movement choices. Episode resource links: Ahmadi MN, Coenen P, Straker L, Stamatakis E. Device-measured stationary behaviour and cardiovascular and orthostatic circulatory disease incidence. Int J Epidemiol. 2024 Oct 13;53(6):dyae136. doi: 10.1093/ije/dyae136. PMID: 39412356; PMCID: PMC11481281. Guest: Alan M. Ehrlich, MD, FAAFP  Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com   

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-413 Overview: Listen in to learn about the role of nicotinamide (vitamin B3) in reducing the risk of certain skin cancers. This episode reviews key prevention strategies, the latest evidence on skin cancer management, and practical approaches to support patients with sun-damaged skin. Episode resource links: Discuss the prevalence of basal cell and squamous cell carcinomas  Review the potential benefits of nicotinamide (vitamin B3) for the prevention of skin abnormalities Identify additional methods to prevent skin cancer Guest: Alan M. Ehrlich, MD, FAAFP   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com   

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-412 Overview: Discover how improper arm positioning can lead to inaccurate blood pressure readings and influence hypertension management as we discuss a recent randomized controlled trial. Hear evidence-based techniques to ensure proper arm and cuff positioning, improving hypertension diagnosis in your clinical practice. Episode resource links: JAMA Intern Med. Published online October 7, 2024. doi:10.1001/jamainternmed.2024.5213 Guest: Robert A. Baldor MD, FAAFP Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-411 Overview: This episode focuses on the rising prevalence of early-onset colorectal cancer and its critical indicators. Learn to recognize key symptoms, ensure timely diagnostic workups, and effectively address red flags to prevent delayed diagnosis. Episode resource links: Demb, J., Kolb, J. M., Dounel, J., Fritz, C. D. L., Advani, S. M., Cao, Y., Coppernoll-Blach, P., Dwyer, A. J., Perea, J., Heskett, K. M., Holowatyj, A. N., Lieu, C. H., Singh, S., Spaander, M. C. W., Vuik, F. E. R., & Gupta, S. (2024). Red Flag Signs and Symptoms for Patients With Early-Onset Colorectal Cancer: A Systematic Review and Meta-Analysis. JAMA network open, 7(5), e2413157. https://doi.org/10.1001/jamanetworkopen.2024.13157 US Preventive Services Task Force Screening Guidelines for Colorectal Cancer: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening American Cancer Society Infographic for Patients:  Colorectal Cancer:  Catching it Early https://www.cancer.org/cancer/types/colon-rectal-cancer/prevention-infographic.html Gómez-Molina R, Suárez M, Martínez R, Chilet M, Bauça JM, Mateo J. Utility of Stool-Based Tests for Colorectal Cancer Detection: A Comprehensive Review. Healthcare. 2024; 12(16):1645. https://doi.org/10.3390/healthcare12161645 Guest: Jill M. Terrien PhD, ANP-BC  Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com   

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-410 Overview: In this episode, we discuss the latest updates on vitamin D. Learn about its link to common disorders, when to consider supplementation, and what the most recent practice guideline says about vitamin D and disease prevention—empowering you to make informed decisions and improve patient care without unnecessary screenings or treatments. Episode resource links: Marie B Demay, Anastassios G Pittas, Daniel D Bikle, Dima L Diab, Mairead E Kiely, Marise Lazaretti-Castro, Paul Lips, Deborah M Mitchell, M Hassan Murad, Shelley Powers, Sudhaker D Rao, Robert Scragg, John A Tayek, Amy M Valent, Judith M E Walsh, Christopher R McCartney, Vitamin D for the Prevention of Disease: An Endocrine Society Clinical Practice Guideline, The Journal of Clinical Endocrinology & Metabolism, Volume 109, Issue 8, August 2024, Pages 1907–1947, https://doi.org/10.1210/clinem/dgae290 Michael F. Holick, Neil C. Binkley, Heike A. Bischoff-Ferrari, Catherine M. Gordon, David A. Hanley, Robert P. Heaney, M. Hassan Murad, Connie M. Weaver, Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline, The Journal of Clinical Endocrinology & Metabolism, Volume 96, Issue 7, 1 July 2011, Pages 1911–1930, https://doi.org/10.1210/jc.2011-0385 Guest: Jillian Joseph, PA-C   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-409 Overview: Listen in as we discuss how bright light therapy extends beyond seasonal affective disorder, potentially offering benefits for nonseasonal depression. Learn how to counsel patients effectively on its use and integrate this treatment into your practice, enhancing patient care and broadening treatment strategies for depression. Episode resource links: Menegaz de Almeida A, Aquino de Moraes FC, Cavalcanti Souza ME, Cavalcanti Orestes Cardoso JH, Tamashiro F, Miranda C, Fernandes L, Kreuz M, Alves Kelly F. Bright Light Therapy for Nonseasonal Depressive Disorders: A Systematic Review and Meta-Analysis. JAMA Psychiatry. 2024 Oct 2:e242871  Guest: Alan M. Ehrlich, MD, FAAFP   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com   

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-408 Overview: This episode explores the connection between adolescent mental health and social media use. We discuss actionable strategies for clinicians, emphasizing practical screening, effective conversation starters, and tech tools to guide families. Improve outcomes by learning to balance screen time discussions and proactive mental health interventions in primary care. Episode resource links: JAMA Netw Open. 2024 Jul 1;7(7):e2419881. doi: 10.1001/jamanetworkopen.2024.19881 https://www.cdc.gov/healthyyouth/data/yrbs/yrbs_data_summary_and_trends.htm Guest: Alan M. Ehrlich, MD, FAAFP   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com     

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-407 Overview: Join us as we review the risks and benefits of contraceptive options, focusing on levonorgestrel intrauterine devices (IUDs) and their potential link to breast cancer risk. Hear the data and key considerations to help patients make informed decisions, balancing benefits and risks effectively in your primary care practice. Episode resource links: Mørch LS, Meaidi A, Corn G, Hargreave M, Wessel Skovlund C. Breast Cancer in Users of Levonorgestrel-Releasing Intrauterine Systems. JAMA. Published online October 16, 2024. doi:10.1001/jama.2024.18575 https://www.nytimes.com/2024/10/16/well/iud-breast-cancer-mirena-skyla.html?smid=url-share Guest: Jillian Joseph, PA-C   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-406 Overview: An increasing number of therapies are being formulated for nasal delivery. This episode reviews the use of 3 of these therapies: at-home flu vaccines, epinephrine for allergic reactions, and saline nasal sprays for the common cold. Hear how these newly available treatments can increase options for care in your clinical practice. Episode resource links: Flu Vaccine: Vaccine. 2015 Jul 31;33(32):3894-9.  doi: 10.1016/j.vaccine.2015.06.061. Epub 2015 Jun 25. Nasal Saline: https://k4.ersnet.org/prod/v2/Front/Program?e=549 Nasal Epinephrine: https://www.fda.gov/news-events/press-announcements/fda-approves-first-nasal-spray-treatment-anaphylaxis Guest: Robert A. Baldor MD, FAAFP  Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com   

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-405 Overview: Explore the American Heart Association’s (AHA) newly validated risk calculator, designed to assess the likelihood of cardiovascular disease and heart failure in patients aged 30-79 years. Hear which risk factors are included, why they matter, and how this tool can enhance your preventive care strategies in primary care practice. Episode resource links: Hypertension. 2024;81:00–00. DOI: 10.1161/HYPERTENSIONAHA.124.22998.) https://doi.org/10.1161/CIRCULATIONAHA.123.067626 The calculator: https://professional.heart.org/en/guidelines-and-statements/prevent-calculator Guest: Robert A. Baldor MD, FAAFP  Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com   

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-405 Overview: It’s estimated that between 40%-60% of women report some degree of sexual dysfunction, which can have a significant impact on an individual’s quality of life and personal relationships. Even though most clinicians understand the importance and relevance of female sexual dysfunction (FSD), they may not be aware of its prevalence, effective treatments, or how best to inquire about it. Join us as we discuss this condition, its impact on women, and evidence on effective treatments. Episode resource links: Cristine Homsi Jorge, Kari Bø, Camila Chiazuto Catai, Luiz Gustavo Oliveira Brito, Patricia Driusso, Merete Kolberg Tennfjord. Pelvic floor muscle training as treatment for female sexual dysfunction: a systematic review and meta-analysis. American Journal of Obstetrics and Gynecology. Volume 231, Issue 1, 2024,Pages 51-66.e1,ISSN 0002-9378, https://doi.org/10.1016/j.ajog.2024.01.001.(https://www.sciencedirect.com/science/article/pii/S0002937824000061) Davis, SR. Sexual dysfunction in women. New England Journal of Medicine. V 391. N 8; P 736-745. https://www.nejm.org/doi/full/10.1056/NEJMcp2313307 Johnson, Isabella MS; Thurman, Andrea Ries MD; Cornell, Katherine A. BS; Hatheway, Jessica MBA; Dart, Clint MS; Brainard, C. Paige MD; Friend, David R. PhD; Goldstein, Andrew MD. Preliminary Efficacy of Topical Sildenafil Cream for the Treatment of Female Sexual Arousal Disorder: A Randomized Controlled Trial. Obstetrics & Gynecology ():10.1097/AOG.0000000000005648, June 18, 2024. | DOI: 10.1097/AOG.0000000000005648 Kamrul-Hasan, A.B.M, Hannan, M A A, Muhammad S, M, Aalpona, Fatema, T Z, Nagendra, L., Selim, S,  Dutta, D, D. Role of flibanserin in managing hypoactive sexual desire disorder in women: A systematic review and meta-analysis. Medicine 103(25):p e38592, June 21, 2024. | DOI: 10.1097/MD.0000000000038592 Yao H, Zhang X, Sun F, Tang G, Wu J, Zhou Z. The efficacy of intravaginal electrical stimulation (IVES) in treating female with urinary incontinence symptom from meta-analysis of nine randomized controlled trials. Front Neurol. 2022;13:933679. Published 2022 Sep 13. doi:10.3389/fneur.2022.933679 Huang H, Ding G, Li M, Deng Y, Cheng Y, Jin H.(2023) Menopause and stress urinary incontinence: The risk factors of stress urinary incontinence in perimenopausal and postmenopausal women. J Obstet Gynaecol Res. 49(10): 2509–2518. https://doi.org/10.1111/jog.15742 Tunn, R., Baessler, K., Knüpfer, S., & Hampel, C. (2023). Urinary Incontinence and Pelvic Organ Prolapse in Women. Deutsches Arzteblatt international, 120(5), 71–80. https://doi.org/10.3238/arztebl.m2022.0406 Guest: Susan Feeney, DNP, FNP-BC, NP-C, Jill M. Terrien, PhD, ANP-BC Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-403 Overview: Recorded live at Pri-Med East! - The American Diabetes Association (ADA) has updated their standards of care for patients with diabetes. In this episode, we discuss some of the changes in the initial selection of glucose-lowering medications for type 2 diabetes mellitus (T2DM), including when alternatives to metformin may be appropriate. Hear strategies for making personalized, guideline-recommended choices that enhance care for patients with T2DM. Episode resource links: Pharmacologic Approaches to Glycemic Treatment. In: American Diabetes Association. Standardsof Care in Diabetes2024 - DiabetesCare 2024 Jan 1;47(Suppl 1):S1-S321 Guest: Alan M. Ehrlich, MD, FAAFP  Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com   

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-402 Overview: Some blood pressure medications have been found to cause adverse side effects in older adults, such as itchy skin and an increased risk of stroke. Join us as we cover 2 recent publications that add clinical implications to which blood pressure medications we use. Come away feeling confident to improve hypertension outcomes in older patients. Episode resource links: JAMA Dermatol. Published online May 22, 2024. doi:10.1001/jamadermatol.2024.1230 JAMA Netw Open. 2023;6(12):e2344998. doi:10.1001/jamanetworkopen.2023.44998 Guest: Robert A. Baldor MD, FAAFP Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-401 Overview: Evidence has shown that exercise can improve mood, but how successful is it for treating depression compared to other therapies? What types and intensities are most effective? Discover insights from a recent meta-analysis on the effects of exercise on depression and strategies to promote it in those with major depression. Episode resource links: Noetel M, Sanders T, Gallardo-Gómez D, Taylor P, del Pozo Cruz B, van den Hoek D et al. Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials BMJ 2024; 384 :e075847 doi:10.1136/bmj-2023-075847 Vancampfort, D., Hallgren, M., Firth, J., Rosenbaum, S., Schuch, F. B., Mugisha, J., Probst, M., Van Damme, T., Carvalho, A. F., & Stubbs, B. (2017). Physical activity and suicidal ideation: a systematic review and meta-analysis. Journal of Affective Disorders. https://doi.org/10.1016/j.jad.2017.08.070 Guest: Susan Feeney, DNP, FNP-BC, NP-C Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-400 Overview: The FDA recently approved primary human papillomavirus (HPV) self-collection for cervical cancer screening in a healthcare setting. Join us as we explore how to counsel patients on this less invasive method and find out what’s on the horizon for at-home collection kits. Episode resource links: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P160037 Journal of Clinical Virology, 2020-06-01, Volume 127, Article 104375, Copyright © 2020 Elsevier B.V.  JAMA. 2023;330(20):1971-1981. doi:10.1001/jama.2023.21471 Guest: Robert A. Baldor MD, FAAFP Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-399 Overview: In this episode, we look at a new study showing increased probability of survival for patients with Alzheimer disease (AD) who take donepezil and memantine together. We review current treatments for AD and address common hesitations in prescribing dual pharmacotherapy, providing vital insights for primary care clinicians. Episode resource links: Yaghmaei, E., Lu, H., Ehwerhemuepha, L. et al. Combined use of Donepezil and Memantine increases the probability of five-year survival of Alzheimer’s disease patients.Commun Med 4, 99 (2024). https://doi.org/10.1038/s43856-024-00527-6 Guo J, Wang Z, Liu R, Huang Y, Zhang N, Zhang R. Memantine, Donepezil, or Combination Therapy-What is the best therapy for Alzheimer's Disease? A Network Meta-Analysis. Brain Behav. 2020 Nov;10(11):e01831. doi: 10.1002/brb3.1831. Epub 2020 Sep 10. PMID: 32914577; PMCID: PMC7667299. Guest: Jillian Joseph, MPAS, PA-C Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com   

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-398 Overview: Low back pain is the leading cause of years lived with disability, with approximately 70% of individuals experiencing a recurrence within 12 months following recovery from an episode. Clinicians are poised to play a crucial role in encouraging patients to incorporate walking to prevent recurrences of low back pain. Episode resource links: Pocovi NC, Lin CC, French SD, Graham PL, van Dongen JM, Latimer J, Merom D, Tiedemann A, Maher CG, Clavisi O, Tong SYK, Hancock MJ. Effectiveness and cost-effectiveness of an individualised, progressive walking and education intervention for the prevention of low back pain recurrence in Australia (WalkBack): a randomised controlled trial. Lancet. 2024 Jun 19:S0140-6736(24)00755-4. PMID: 38908392. Guest: Alan M. Ehrlich, MD, FAAFP  Music Credit: Richard Onorato Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com   

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-397 Overview: In this episode, we review the T Trials—a coordinated set of 7 research trials that assessed the efficacy of testosterone gel treatment in 7 functional domains for men aged 65 years or older. Hear best practices for determining testosterone levels and how to balance the benefits and risks of testosterone replacement therapy during patient discussions. Episode resource links: Matsumoto AM. Testosterone Replacement in Men with Age-Related Low Testosterone: What Did We Learn From The Testosterone Trials? Curr Opin Endocr Metab Res. 2019 Jun;6:34-41. doi: 10.1016/j.coemr.2019.04.004. Epub 2019 Apr 25. PMID: 32043015; PMCID: PMC7009797.  The Journal of Clinical Endocrinology & Metabolism, 2024, 00, 1–10 https://doi.org/10.1210/clinem/dgae085 Guest: Robert A. Baldor MD, FAAFP Music Credit: Richard Onorato Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-396 Overview: Listen in as we discuss the health risks of e-cigarette use and dual use, emphasizing the importance of primary prevention and supporting patients in their cessation efforts. Discover the latest evidence on vaping’s impact on addiction, cardiovascular health, and lung cancer, and gain essential insights to better advise your patients. Episode resource links: Bittoni MA, et al. Abstract 2213. Presented at: American Association for Cancer Research Annual Meeting; April 5-10, 2024; San Diego. (AACR 2024: Ohio State experts share new findings at annual meeting (press release). Available at: https://cancer.osu.edu/news/aacr-2024-ohio-state-experts-share-new-findings. Posted April 5,2024. Accessed May 3, 2024.) Hartmann-Boyce J, McRobbie H, Lindson N, et al. Electronic cigarettes for smoking cessation. Cochrane Database Syst Rev. Apr 29 2021;4:CD010216. doi:10.1002/14651858.CD010216.pub5 Hopkinson NS, et al "Association of time spent on social media with youth cigarette smoking and e-cigarette use in the UK: a national longitudinal study" Thorax 2024: DOI:10.1136/ thorax-2023-220569. Y.W. Kim, E.J. Park, K.I. Kwak, A.-R. Choi, B.J. Lee, Y.J. Lee, J.S. Park, Y.-J. Cho, J.H. Lee, and C.-T. Lee. Association of Electronic Cigarette Use After Conventional Smoking Cessation With Lung Cancer Risk: A Nationwide Cohort Study (abstract). Am J Respir Crit Care Med 2024;209:A3051. CDC: Health Effects of Vaping; https://www.cdc.gov/tobacco/e-cigarettes/health-effects.html CDC:Dual Use of Tobacco Products; https://www.cdc.gov/tobacco/campaign/tips/diseases/dual-tobacco-use.html Guest: Susan Feeney, DNP, FNP-BC, NP-C  Music Credit: Richard Onorato Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com