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-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  

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-395 Overview: This episode brings you an exploration of fish oil supplements and their potential effects on cardiovascular health. We dive into the evidence, highlighting fish oil’s role in primary prevention and its possible risks, such as increased atrial fibrillation. Gain practical recommendations to help you effectively advise your patients on the use of this popular supplement. Episode resource links: Regular use of fish oil supplements and course of cardiovascular diseases: prospective cohort study BMJ Medicine 2024;3:e000451. doi: 10.1136/bmjmed-2022-000451 Omega-3 Polyunsaturated Fatty Acid (Fish Oil) Supplementation and the Prevention of Clinical Cardiovascular Disease:  A Science Advisory From the American Heart Association Circulation. 2017;135:e867–e884 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-394 Overview: Explore the keys to confidently promoting healthy aging in patients. In this insightful conversation, we identify behaviors impacting longevity and discuss practical steps to minimize risks, including diet, exercise, and sleep. Discover evidence-based insights on how even light physical activity can significantly improve patients’ odds of healthy aging. Episode resource links: Shi H, Hu FB, Huang T, Schernhammer ES, Willett WC, Sun Q, Wang M. Sedentary Behaviors, Light-Intensity Physical Activity, and Healthy Aging. JAMA Netw Open. 2024 Jun 3;7(6):e2416300. doi: 10.1001/jamanetworkopen.2024.16300. PMID: 38861256; PMCID: PMC11167497. Guest: Jillian Joseph, MPAS, PA-C 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-393 Overview: Adolescents seeking hormonal treatment for gender incongruence has become more common. A recent systematic review looking at the benefits and side effects found in clinical studies updates our current understanding of this approach. Gain insights and confidence to make informed and compassionate care decisions. Episode resource links: Taylor J, Mitchell A, Hall R, Langton T, Fraser L, Hewitt CE. Masculinising and feminising hormone interventions for adolescents experiencing gender dysphoria or incongruence: a systematic review. Arch Dis Child. 2024 Apr 9:archdischild-2023-326670. Coleman E, et al. Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. Int J Transgend Health. 2022 Sep 6;23(Suppl 1):S1-S259.  Gender Affirming Hormonal Care for the Primary Care Provider Thriving for Transgender Youth Update on Trans-Competent Primary Care Guest: Alan M. Ehrlich, MD, FAAFP Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  Music Credit: Richard Onorato

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-392 Overview: Tune in as we explore a recent study that found no net all-cause benefit or harm from vitamin D and calcium supplementation. We review the study’s findings in detail and reflect on whether these supplements should be recommended to our patients based on the latest evidence. Episode resource links: Ann Intern Med. doi:10.7326/M23-2598 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-391 Overview: Cough is a frustrating complaint for patients and often leads to a prescription for antibiotics. Discover new data that reveals the ineffectiveness of antibiotics in treating acute bronchitis. Come away with valuable insights to enhance your practice and make informed treatment decisions, improving patient care and outcomes. Episode resource links: Merenstein DJ, Barrett B, Ebell MH. Antibiotics Not Associated with Shorter Duration or Reduced Severity of Acute Lower Respiratory Tract Infection. J Gen Intern Med. Published online April 15, 2024. doi:10.1007/s11606-024-08758-y 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-390 Overview: In 1995, the US launched a varicella vaccination program, leading to a significant drop in cases. However, breakthrough infections still occur, and clinical diagnosis has become less reliable as the virus has evolved. Join us to hear current recommendations for what to consider in the differential diagnosis and how emerging evidence may impact public health and your practice. Episode resource links: Marin, M, Leung, J, Anderson, TC, Lopez, AS. Monitoring Varicella Vaccine Impact on Varicella Incidence in the United States: Surveillance Challenges and Changing Epidemiology, 1995–2019, The Journal of Infectious Diseases, Volume 226, Issue Supplement_4, 1 November 2022, Pages S392–S399, https://doi.org/10.1093/infdis/jiac221 Qiu L, Liu S, Zhang M, et al. The epidemiology of varicella and effectiveness of varicella vaccine in Ganyu, China: a long-term community surveillance study. BMC Public Health. 2023;23(1):1875. Published 2023 Sep 28. doi:10.1186/s12889-023-16304-4 Ruprecht A, Marin M, Strain AK, Harry K, Kenyon C. Notes from the Field: Expanded Laboratory Testing for Varicella — Minnesota, 2016–2023. MMWR Morb Mortal Wkly Rep 2024;73:245–246. DOI: http://dx.doi.org/10.15585/mmwr.mm7311a3 DynaMed – Chicken pox – Varicella (https://www-dynamed-com.umassmed.idm.oclc.org/condition/chickenpox#GUID-DFBFAA99-31E8-4553-AFDB-AA1988B1967A): Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato

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-389 Overview: Let’s talk lipid panels and their potential to assess more than cardiovascular disease risk. Through a case scenario, we highlight a study on the potential link between metabolic markers and mood disorders such as depression and anxiety. Join us to learn how lipid panels could aid in early detection and intervention for these conditions. Episode resource links: Chourpiliadis C, Zeng Y, Lovik A, Wei D, Valdimarsdóttir U, Song H, Hammar N, Fang F. Metabolic Profile and Long-Term Risk of Depression, Anxiety, and Stress-Related Disorders. JAMA Netw Open. 2024 Apr 1;7(4):e244525. doi: 10.1001/jamanetworkopen.2024.4525. PMID: 38564219; PMCID: PMC10988352. Guest: Jillian Joseph, MPAS, PA-C   Music Credit: Richard Onorato

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-388 Overview: Tune in as expert faculty cover common upper respiratory infections in children and their treatment options, with a focus on achieving the best outcome while also lowering the risk of subsequent adverse events. Hear guideline recommendations and evidence on treatment durations to confidently make informed clinical decisions. Episode resource links: Journal of the Pediatric Infectious Diseases Society, piae034, https://doi.org/10.1093/jpids/piae034 Guest: Jillian Joseph, MPAS, PA-C   Music Credit: Richard Onorato

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-387 Overview: Measles incidence in the US was low, with the CDC issuing it “elimination status.” In 2024, a cluster of measles cases threatened this status. Join us while we discuss this phenomenon and its impact on public health and practice, including who is at risk, how to recognize measles, and ways to manage this contagious and vaccine-preventable illness. Episode resource links: Centers for Disease Control and Prevention (CDC): Measles Cases and Outbreaks. https://www.cdc.gov/measles/cases-outbreaks.html Center for Infectious Disease Research and Policy (CIDRAP); University of Minnesota. https://www.cidrap.umn.edu/measles/us-measles-cases-top-120-la-county-tracks-case-multiple-exposures Center for Infectious Disease Research and Policy (CIDRAP); University of Minnesota. CDC: Spike in measles cases poses threat to US elimination status. https://www.cidrap.umn.edu/measles/cdc-spike-measles-cases-poses-threat-us-elimination-status DynaMed – Measles  Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato

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-386 Overview: Physical activity can be a key component of treating depression. In this episode, we discuss the powerful impact of exercise as a nonpharmacologic option, with a spotlight on the benefits of dance. Gain strategies to guide patients on depression therapies and discover why dance stands out among forms of exercise. Episode resource links: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10870815/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10813489/ Guest: Alan M. Ehrlich, MD, FAAFP   Music Credit: Richard Onorato

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-385 Overview: Through the framework of a case-based scenario, this episode explores both pharmacological and surgical treatment options for obesity. We discuss the efficacy and cost challenges of injectable medications, insurance coverage, and alternative payment solutions. Gain valuable insights into the cost-effectiveness of treatments, including recent research on endoscopic sleeve gastroplasty, to better advise patients. Episode resource links: Haseeb M, Chhatwal J, Xiao J, Jirapinyo P, Thompson CC. Semaglutide vs Endoscopic Sleeve Gastroplasty for Weight Loss. JAMA Netw Open. 2024;7(4):e246221. doi:10.1001/jamanetworkopen.2024.6221 https://obesitymedicine.org/blog/does-insurance-cover-weight-loss-medication/ Guest: Jillian Joseph, PA-C   Music Credit: Richard Onorato

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-384 Overview: This episode investigates the inaccurate correlation made between acetaminophen use during pregnancy and an increased risk of developmental disorders, including autism spectrum disorder, in children. Expert faculty discuss the history of these claims, followed by a study evaluating outcomes in children, and emphasize the importance of evidence-based decision-making for patients and clinicians. Episode resource links: Ahlqvist VH, Sjöqvist H, Dalman C, et al. Acetaminophen Use During Pregnancy and Children’s Risk of Autism, ADHD, and Intellectual Disability. JAMA. 2024;331(14):1205–1214. doi:10.1001/jama.2024.3172 Nat Rev Endocrinol. 2021 Dec;17(12):757-766. doi: 10.1038/s41574-021-00553-7 Guest: Aylin Madore, MD, MEd   Music Credit: Richard Onorato

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-383 Overview: This episode highlights a growing concern—the prevalence of food allergies is on the rise. We underscore the importance for clinicians to help keep vulnerable populations safe through risk reduction strategies as well as the use of medication therapy. Feel empowered to prepare and safeguard patients from adverse reactions to food allergies. Episode resource links: Abrams, E. M., & Becker, A. B. (2015). Food introduction and allergy prevention in infants. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 187(17), 1297–1301. https://doi.org/10.1503/cmaj.150364 Elghoudi, A., & Narchi, H. (2022). Food allergy in children-the current status and the way forward. World journal of clinical pediatrics, 11(3), 253–269. https://doi.org/10.5409/wjcp.v11.i3.253 Wood, R. A., Togias, A., Sicherer, S. H., Shreffler, W. G., Kim, E. H., Jones, S. M., ... & Chinthrajah, R. S. (2024). Omalizumab for the Treatment of Multiple Food Allergies. New England Journal of Medicine. https://www.foodallergy.org/living-food-allergies/food-allergy-essentials/food-allergy-anaphylaxis-emergency-care-plan CDC.gov https://acaai.org/ Guest: Mariyan L. Montaque, DNP, FNP-BC   Music Credit: Richard Onorato

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-382 Overview: Tune in as we discuss the AHA’s newly validated risk calculator designed to assess the risk of developing cardiovascular disease and heart failure in certain patients. We review which risk factor variables were included in the development of this new tool and whether to consider incorporating it in your practice. Episode resource links: 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: Richard Onorato

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-381 Overview: While the aerosol in e-cigarettes does contain toxicants and carcinogens, since it is not burned like combustible tobacco cigarettes, vaping exposes the user to fewer toxicants and chemicals. Many consider using e-cigarettes for smoking cessation, but evidence has been conflicting. Tune in as we discuss a recent review examining the efficacy of e-cigarettes in aiding smoking cessation and explore potential adverse effects associated with their usage. Episode resource links: Lin, H. X., Liu, Z., Hajek, P., Zhang, W. T., Wu, Y., Zhu, B. C., Liu, H. H., Xiang, Q., Zhang, Y., Li, S. B., Pesola, F., & Wang, Y. Y. (2024). Efficacy of Electronic Cigarettes vs Varenicline and Nicotine Chewing Gum as an Aid to Stop Smoking: A Randomized Clinical Trial. JAMA internal medicine, 10.1001/jamainternmed.2023.7846. Advance online publication. https://doi.org/10.1001/jamainternmed.2023.7846 Lindson, N., Butler, A. R., McRobbie, H., Bullen, C., Hajek, P., Begh, R., Theodoulou, A., Notley, C., Rigotti, N. A., Turner, T., Livingstone-Banks, J., Morris, T., & Hartmann-Boyce, J. (2024). Electronic cigarettes for smoking cessation. The Cochrane database of systematic reviews, 1(1), CD010216. https://doi.org/10.1002/14651858.CD010216.pub8 Sanford BT, Brownstein NC, Baker NL, et al. Shift From Smoking Cigarettes to Vaping Nicotine in Young Adults. JAMA Intern Med. Published online November 13, 2023. doi:10.1001/jamainternmed.2023.5239 Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato

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-380 Overview: This episode brings you a comparison of thiazide diuretics, angiotensin-converting enzyme (ACE) inhibitors, and calcium channel blockers on cardiovascular outcomes, stroke, and all-cause mortality. Gain evidence-based insights to help you make informed choices for your patients’ care. Episode resource links: https://pubmed.ncbi.nlm.nih.gov/38048133/#:~:text=JAMA%20Netw%20Open,10.1001/jamanetworkopen.2023.44998 Guest: Jillian Joseph, MPAS, PA-C   Music Credit: Richard Onorato