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 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.

05-08
30:57

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 

04-24
30:08

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.

04-10
29:02

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.

03-25
30:52

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!

03-11
30:37

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. 

02-26
32:58

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.

02-13
23:19

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

01-30
32:37

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.

12-05
26:36

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.

09-30
30:37

Episode 137: amox/mono, hearing aids, stem cells for knee OA, and preventing T2DM

This week, Kate, Mark, Henry and Gary talk about whether amoxicillin really causes a rash in kids with mono, whether hearing aids improve cognition in the elderly, stem cell injections and knee OA, and nonpharmacologic approaches to preventing type 2 DM.

09-18
29:56

Episode 136: Beers, testosterone harms, opioids for back and neck pain, and SDOH

This week, join Mark, Kate, Henry and Gary as they discuss screening for social determinants of health, the updated Beers List of naughty medications, the value of opioids for acute back and neck pain, and testosterone and adverse events.

08-29
34:40

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