Primary Care Update

Four healthily skeptical primary care physicians discuss the latest in primary care medicine. Join 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 for this fast-paced weekly update on evidence-based primary care.

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.

01-17
31:58

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.

01-03
36:07

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!

12-21
30:23

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

11-22
30:11

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").

11-08
24:59

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.

10-24
30:41

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

10-10
27:05

Episode 133: bilirubin in infants, rest after concussion, child abuse, and why words matter

This week, join Kate, Henry, Gary and Mark as they discuss point of care bilirubin tests for neonatal jaundice, guideline for evaluating children in close contact with abused children, early return to activity after concussion, and terminology preferences by patients being treated for substance use disorder.

07-19
25:29

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://pubmed.ncbi.nlm.nih.gov/38588561/  https://aapce.wildapricot.org/   Minoxidil:https://pubmed.ncbi.nlm.nih.gov/38598226/  AI for ECGs:https://www.ncbi.nlm.nih.gov/pubmed/39096711

11-18
24:25

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://www.bmj.com/content/bmj/suppl/2024/09/11/bmj-2024-080474.DC1/liji080474.ww2.pdf Antibiotics for UTI in delirium: https://pubmed.ncbi.nlm.nih.gov/38895992/ ACG guideline for H. Pylori: https://pubmed.ncbi.nlm.nih.gov/28071659/ MRI of asymptomatic knees: https://pubmed.ncbi.nlm.nih.gov/32060622/ Elections and CVD: https://pmc.ncbi.nlm.nih.gov/articles/PMC9021908/

11-06
27:49

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.

10-23
29:20

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.

10-08
34:15

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!

09-24
32:38

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.

09-11
29:24

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

08-29
33:53

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

08-15
30:53

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.

08-05
26:21

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

07-17
29:58

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.

07-03
28:39

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.

06-19
27:21

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