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The Hot Topics podcast from NB Medical brings you the latest in general practice current affairs, reviews the latest research relevant to primary care, explores interesting and important topics in-depth, and looks at cutting edge medicine.
78 Episodes
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Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. To DRE or not to DRE? This is the question and the main event in this episode. We have a fantastic interview with Amy Rylance, Head of Improving Care at Prostate Cancer UK, and Sam Merriel, GP and academic clinical lecturer, discussing their recent Clinical Practice paper in the BJGP: Is the digital rectal exam any good as a prostate cancer screening test? In other research, we have two papers with a common theme. Firstly, a paper in the BMJ looking at long-term outcomes after diagnosis with atrial fibrillation, and secondly, a paper in the BJGP examining the role of BNP testing as a marker for future cardiovascular disease in patients with a new diagnosis of hypertension. Both show that while these conditions make us think of stroke and MI, we also should be thinking about heart failure. ResourcesBJGP Clinical Practice paper on DRE for prostate cancer screeningProstate Cancer UK Patient Risk CheckerEuropean Urology Oncology Journal Performance of DRE in PCa ScreeningNEJM 2004 Prevalence of PCa in men with a PSA <4BMJ AF and future risk paperBJGP HT and future risk paperwww.nbmedical.com/podcast
Welcome back to the Hot Topics podcast from NB Medical with host Dr Neal Tucker. In this episode, we start by thinking about the news. Firstly, the overwhelming consensus from GPs in England to not support the imposed contract. Secondly, the ongoing discussion around physician associates in general practice, where we touch on an interesting report from South Mississippi around the costs and other outcomes of non-doctor-led primary care. Thirdly, NHS patient satisfaction - is important to take note but why does staff satisfaction never hit the headlines?In research, we look at two papers. First, the rate of familial hypercholesterolaemia coded in practices - how far are we away from what we should expect? And in those with a diagnosis, how good are we at optimally treating them? Second, a paper on which interventions might help people maintain their independence. After an estimated £1.15 billion pounds of research in this area, what does this new systematic review and network meta-analysis tell us?ReferencesAMA Report on PA/NA from South MississippiNHS Staff Survery ResultsBJGP Familial Hypercholesterolaemia rates in GPNICE Guideline FHSimon Broome Diagnostic Criteria for FHBMJ Community Interventions to Maintain Independencewww.nbmedical.com/podcast
Welcome back to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode we think about another year of imposed GP contract on practices in England, the BMA response and where it may lead. In research, we have three fascinating new papers. Firstly, a paper examining how to maintain weight loss after a low-calorie diet – is structured exercise, liraglutide or both better than usual care? Secondly, in the BMJ a systematic review exploring whether exercise should be considered a genuine treatment for depression. And finally, in the NEJM, a study looking at the link between microplastics in carotid arterial plaques and subsequent risk of cardiac vascular events (hint: it’s not good news…).ReferencesBMA GP Contract Changes 2024/25Pulse EditorialLancet Discovery Science paper on weight loss maintenanceWeight maintenance author interviewBMJ Exercise and DepressionNEJM Micro/nanoplastics in your arteriesNEJM Microplastics editorialwww.nbmedical.com/podcast
Welcome back to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode, we think about the pay offer for practices in England, a new King’s Fund report on the under-funding of primary care for three decades, and the introduction of Pharmacy First. In new research, we have two papers. First, in the BMJ, can an online combined exercise and psychological programme improve quality of life for patients struggling after hospitalisation with covid? Second, in JAMA, can serum urate levels help predict future flares of gout and guide us on who might benefit the most from urate-lowering therapyReferencesKings Fund Report on Primary CareBMJ Post-covid-19 syndrome and online programmeJAMA Serum urate and recurrent goutwww.nbmedical.com/podcast
1Welcome back to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode, we consider the current state of general practice in the UK and what lessons the countries can learn from each other. We examine a new paper in the BJGP on how patients feel about general practice in Scotland since the introduction of the 2018 GP contract. Is it meeting patient and policymaker goals? In other research, we see what lessons a new paper in JAMA on weight loss and cancer association can tell us about a seemingly obvious connection, and from the NEJM what effect testosterone replacement for hypogonadism has on men's fracture risk.ReferencesBJGP Patient experiences of Scottish GP paperBJGP Family physician's moral distress when managing health inequalitiesJAMA Cancer diagnoses after weight lossNEJM Testosterone replacement for hypogonadism and fracture riskwww.nbmedical.com/podcast
Welcome to the Christmas Hot Topics Podcast from NB Medical with Dr Neal Tucker. It’s time for a bit of light-hearted festive fun so if you’ve finished signing all your scripts for Christmas then join us for a discussion with Dr Stephen Bradley and Dr Alice Harper about “Great Expectations: GPs estimations of time required to deliver BMJ’s 10minute consultations”.This new paper explores how long it REALLY takes to do everything that’s recommended in clinical guidance. If you’ve ever felt like there just isn’t enough time in your general practice day, this might explain it, and you are not the only one.Merry Christmas everyone, see you in the New Year. NealReferencesGreat Expectations: GPs estimations of time required to deliver BMJ’s 10minute consultationsThe Health Foundation: Identifying Operational Failures in General PracticeBMJ Guidelines should consider clinicians time needed to treatwww.nbmedical.com/podcast
Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode, we talk to Prof Hazel Everitt, a GP and lead author of a recent Lancet paper exploring whether amitriptyline is effective for IBS, and where it might fit in to general practice management.We also look at research in the Lancet on treating hand osteoarthritis with methotrexate - what's the rationale and does it work? - plus a BMJ paper on using a patient information leaflet to improve lower urinary tract symptoms in men. Are PILS better than pills? ResourcesLancet ATLANTIS paper on IBS & amitriptylineATLANTIS trial website with patient informationGut journal CBT for IBS National Institute for Health and Care Research - how to get involvedNIHR Local research groups - how to get involvedLancet Methotrexate for hand OA with synovitisBMJ Leaflets for LUTSwww.nbmedical.com/podcast
Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. The highlight of this episode is our interview with Prof Miriam Santer, lead author of recent research in the BMJ exploring the effectiveness of spironolactone for acne in women. Does it work? Is it a treatment for general practice? And if so, is it safe, what monitoring is required, and where does it fit with current acne pathways?In the news, we think about the current issues around physician associates in general practice. In research we have two papers on diabetes: first, in the Lancet, is a new once-weekly insulin injection as effective as a daily treatment for type 1 diabetes; and second, in JAMA, is the additional tirzepatide better than prandial insulin in addition to glargine for managing type 2 diabetes? ReferencesEczema Care OnlineBMJ Spiro for acneLancet Once weekly insulin vs daily insulin in T1DMJAMA Tirzepatide vs prandial insulin in T2DMwww.nbmedical.com/podcast
Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode we talk to Dr Jessica Watson, lead author of the Why Test study, published in the BJGP exploring the use of blood tests in general practice and how often they make a difference - positive or negative.In other research we look at a BMJ paper comparing rosuvastatin and atorvastatin for secondary prevention, and in the Lancet, the PATHFINDER study, exploring the role of multi-cancer early detection blood tests - will this be useful for diagnosing cancers earlier?Plus the usual news, views, and a song about vaccinations.www.nbmedical.com/podcast ReferencesBJGP Why Test StudyPACT - primary care academic collaborative websiteBMJ Rosuva vs Atorva for secondary preventionLancet PATHFINDER MCED studyLancet EditorialRCGP Manifesto Seven Steps To Rebuild General Practice and Save the NHSwww.nbmedical.com/podcast
Welcome to the Hot Topics podcast from NB Medical with Dr. Neal Tucker. As we celebrate 25 years of NB Medical and the Hot Topics course, in this podcast we chat with co-founder Dr Simon Curtis about the changes in general practice and medical education since its inception, we discuss three of the most influential research papers over the era, and what the future may hold for GPs. In research, we examine two new papers. The first in the NEJM is on semaglutide for patients with heart failure and preserved ejection fraction. Can it help improve symptoms and quality of life? Could it improve mortality? The second paper from the Lancet looks at a practice nurse-delivered insomnia intervention using sleep restriction therapy. Could this be a useful, cost-effective option for helping people struggling to sleep? ReferencesNEMJ Semaglutide + HFPEF with obesityLancet Nurse-led Insomnia intervention www.nbmedical.com/podcast
Welcome to Season 5 of the Hot Topics podcast from NB Medical with Dr Neal Tucker. Despite celebrating our 25th birthday (don't forget to check out our NB Plus birthday special here) the world of medical news and research never stops. In this episode we look at research in the BJGP about the motivations behind being a GP, whether adding NSAIDs may improve efficacy of emergency contraception, and whether we should be worried about cancer in patients with reflux.www.nbmedical.comReferencesBJGP Mapping GP MotivationsLancet Levonorgestrel + piroxicam for ECBMJ Non-erosive reflux and oesophageal cancer riskwww.nbmedical.com/podcast
Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. Wondering where the sunshine is? Then this song is for you. Have a good summer everyone and the podcast will be back in September. In the meantime have a look at www.nbmedical.com for our latest courses - we have live webinars for the new Hot Topics course, our new Paediatrics and Child Health course, our updated dermatology course and much more in September.www.nbmedical.com/podcast
Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. School's out for summer but general practice never stops. This week we look at the medical news story of the week: donanemab for Alzheimer's disease - can this monoclonal antibody revolutionise dementia care? Also in research, prevention is better than a cure, so can a Mediterranean-DASH diet keep cognitive decline at bay? For you weekend warriors out there, is cramming exercise into the weekend as good as exercising throughout the week. A new paper in JAMA answers this question. And is there ANY role for opioids in acute back pain? A new Australian study goes strong to see if there is benefit with this common problem.Don't forget to check out all our upcoming courses including the new Hot Topics course in September and much more on www.nbmedical.com. ReferencesJAMA DonanemabNEJM MIND diet for dementia preventionJAMA Weekend warriors and CVD riskLancet Opioids for Low back and neck painwww.nbmedical.com/podcast
Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. NHS Long Term Workforce Plan is all over the news today. In this episode we have a look at some of the key statements, seeing what is positive for general practice, what is wishful thinking, and what could be even worse.In research we look at new observational data from Denmark, published in the BMJ, finding an association between HRT and dementia; also a study examining the effectiveness of an intra-pulmonary artery device for identifying earlier deterioration of heart failure; and two papers in the NEJM on more weight loss medications for obesity. ReferencesNHS Long term workforce planBMJ HRT & dementiaLancet HF deviceNEJM Retatrutide & Orforglipronwww.nbmedical.com/podcast
Welcome to a new Hot Topics podcast from NB Medical with Dr Neal Tucker. In Just One More Thing we are joined by Dr. Jim Moore, chair of the Primary Care Cardiovascular Society, where we discuss cholesterol lowering therapies, new ways to treat heart failure, and how we may meet government targets for blood pressure control - can and should it all be done in general practice?In news, is it good news as GPs are primed to solve the obesity crisis with semaglutide? And in research we look at a BMJ paper hoping to radically change how we monitor patients taking methotrexate, and in JAMA a new paper looks at strategies for helping patients stop opioids for chronic pain.ResourcesPrimary Care Cardiovascular Society websiteBMJ Methotrexate monitoring JAMA Chronic opioid withdrawalMy Opioid ManagerPodcast Transcriptwww.nbmedical.com/podcast
Welcome back to the Hot Topics podcast. In this episode we reflect on the Prime Ministers Primary Care Recovery Plan, then move on to more useful things like research. We have new papers in the BJGP on who may be more likely to develop fatigue after mild covid and the NEJM on using a peanut patch to desensitive toddlers at risk of anaphylaxis. We also have the next in our series of Just One More Thing - this time we chat about allergy with Dr Matt Doyle, GP and chair of the primary care committee of the British Society of Allergy and Clinical Immunology. ReferencesBSACI websitePrime Ministers Primary Care Recovery PlanBJGP Post-covid fatigueNEJM Peanut allergy patchwww.nbmedical.com/podcast
Welcome to another Hot Topics podcast from NB Medical with Dr Neal Tucker. With general practice becoming an increasingly popular political battleground, we focus on the latest research. In this edition, we look at whether bempedoic acid actually reduces cardiovascular events and death as well as reducing cholesterol. Ever wondered which is more important in causing CVD: inflammation or cholesterol? A new paper in the Lancet examines this in patients already taking statins. We also explore what is best to drink if you (or your patient) have type 2 diabetes. Can coffee and tea actually be good for you?www.nbmedical.com/podcastReferencesNEJM Bempedoic acidLancet Inflammation vs chol in CVDBMJ what to drink in T2DMwww.nbmedical.com/podcast
Welcome to the latest Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode, we have the latest news including how the public view the NHS and what's happening to the GP contract for English practice. In research, we have a fascinating paper in the BMJ exploring what differences have emerged in recorded outcomes between England and Scotland since the latter abolished QOF, an answer on whether coffee is bad for you (or at least your heart in the short term), and a new class of drug to help with vasomotor symptoms in menopause.ResourcesBMJ QOF paperNEJM Caffeine and the HeartLancet Fezolinetant and hto flushesNHSE GP is the best job ever pagewww.nbmedical.com/podcast
Welcome to the Hot Topics Podcast with host, Dr Neal Tucker. In this bumper edition, we have the next in our Just One More Thing series. We interview Dr Sam Merriel in collaboration with Prostate Cancer UK, talking about what we need to know in the world of prostate cancer. Should we be screening? Do we need to think beyond PSA? Does new technology change our approach? In the news, we look at the latest RCGP data on workload and whether GPs will strike, while in research we have a BJGP paper on why antimicrobial stewardship interventions may not have the impact in real life that they do in trials, a BJGP analysis of nitrofurantoin (and other antibiotic) failure in men with UTI, and a NEJM paper testing whether thiazides help renal stones.References:Free on demand NB Clinic with Prostate Cancer UK, March 2022PCUK Resources for Health Professionals PCUK Resources for Delivering the PCN DESPCUK 30 second Risk Checker for PatientsResearch discussed by Sam Merriel...Lifetime risk of PCa by major ethnic group in England...Family history risk for PCa...Genetic risk scores for PCa in patient with LUTSBJGP Implementing Antimicrobial Stewardship in GPBJGP Nitrofurantoin failure in men with UTINEJM Hydrochlorthiazide and renal stoneswww.nbmedical.com/podcast
Welcome to the Hot Topics podcast with Dr Neal Tucker. In this episode, we speak to Dr Katherine Hickman, current chair of the Primary Care Respiratory Society, who answers our three Just One More Thing questions on what we need to know about from primary, secondary and future care with asthma. In new research, we discuss a paper on how pharmaceutical companies spend more money promoting less effective drugs, how atropine eye drops in children can delay myopia, and whether cancer risk prediction tools are accurate in cancer survivors with their inherently raised CVD risk. www.nbmedical.com/podcast ReferencesPrimary Care Respiratory Society - if you want to know more!JAMA Drug spending on low clinical benefit drugsJAMA Atropine eye drops in kids to delay or prevent myopiaLancet CVD risk prediction tool accuracy in cancer survivorswww.nbmedical.com/podcast
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