PODCAST · health
Primary Care Update
by Mark Ebell
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.
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Episode 209: cocoa, best UTI antibiotic, LAA closure for AF, and evolocumab for primary (sort of) prevention
Primary care docs Mark Ebell, Kate Rowland, Henry Barry and Gary Ferenchick tackle 4 new studies: health benefits of cocoa supplements, the best antibiotic for managing uncomplicated UTIs in women, left atrial appendage closure for AF with high bleeding or stroke risk, and evolocumab for primary (sort-of) prevention of MACE in patients with diabetes.Essential Evidence Plus: www.essentialevidenceplus.comhttps://www.iafp.org/2026ac Cocoa and health: https://pubmed.ncbi.nlm.nih.gov/35294962/ Antibiotics for UTI: https://pubmed.ncbi.nlm.nih.gov/42026010/ Left atrial appendage closure and AF: https://pubmed.ncbi.nlm.nih.gov/41849741/ https://pubmed.ncbi.nlm.nih.gov/41903215/
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Episode 208: drinks with diabetes, new Paxlovid trial, antiplatelet agents in stroke, and dietary advice from the AHA
This week, primary care doctors Mark Ebell, Kate Rowland, Henry Barry and Gary Ferenchick discuss four new studies: whether water is better than diet drinks in diabetes, a new RCT of Paxlovid for COVID in contemporary patients, to switch or not to switch antiplatelet agents after a stroke, and the latest AHA 2026 dietary advice for heart health.Drinks for diabetes: ttps://pubmed.ncbi.nlm.nih.gov/41369640/ Antiplatelet agents after stroke on aspirin: https://pubmed.ncbi.nlm.nih.gov/41347302/ New Paxlovid trial: https://pubmed.ncbi.nlm.nih.gov/42019019/ AHA 2026 dietary guidance: https://pubmed.ncbi.nlm.nih.gov/41914202/
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Episode 207: AI, singing for post-partum depression, and new AHA lipid guidelines
This week Kate, Mark and Henry talk about empathetic robots, mother-baby singing groups for postpartum depression, and new American College of Cardiology lipid guidelines.Indiana AFP POEMs course in French Link: https://www.iafp.org/2026ac Empathetic robots: https://pubmed.ncbi.nlm.nih.gov/41359230/ Weekly singing groups for postpartum depression: https://pubmed.ncbi.nlm.nih.gov/41087020/ACC/AHA/etc lipid guidelines: https://pubmed.ncbi.nlm.nih.gov/41824552/A 2025 study in the journal Family Practice finding that the two most trustworthy lipid guidelines recommended against using CAC, while all five less trustworthy guidelines due to poor methods or COI recommended it. Go figure.Smartphones in schools: https://pubmed.ncbi.nlm.nih.gov/41489912/
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Episode 206: biomarkers for dementia, toileting, bleeding risk, and diagnosing volume overload.
Join primary care faculty Gary Ferenchick, Kate Rowland, Henry Barry and Mark Ebell as they discuss 4 important new studies: the value (?) Of biomarkers in cognitive impairment, toilet training, bleeding risk with apixaban versus rivaroxaban for VTE, and diagnosing volume overload in adults from the JAMA Rational Clinical Exam series.
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Episode 205: inhaled steroid dose, titrating GLP-1s, zoster vaccine and dementia, and trusting AI
This week, primary care doctors Kate, Gary, Mark and Henry discuss high vs low dose inhaled steroids for high risk patients with asthma, click based semaglutide titration to reduce GI problems, zoster vaccine and dementia risk, and whether we are trusting AI too much.
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Episode 204: lowering triglycerides, cannabinoids for pain, managing AF + stent, and lower LDL targets for CAD
This week primary care physicians Kate Rowland, Mark Ebell, Gary Ferenchick and Henry Barry tackle 4 new POEM-worthy studies: new therapy for elevated triglycerides, cannabinoids for chronic pain in adults, the best antithrombotic for patients with AF + drug eluting cardiac stent, and lower versus standard LDL targets for patients with heart diseaseEssential Evidence Plus: https://www.essentialevidenceplus.com/ Lower triglycerides: https://pubmed.ncbi.nlm.nih.gov/41211918/Cannabinoids for pain: https://pubmed.ncbi.nlm.nih.gov/41429020/ Antithrombotics for AF + stent: https://pubmed.ncbi.nlm.nih.gov/41211917/ LDL target 55 vs 70 for CAD: https://pubmed.ncbi.nlm.nih.gov/41910315/
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Episode 203: melatonin for dementia, new PE guidelies, inhaled steroids for asthma
This week, primary care physicians Henry Barry, Gary Ferenchick and Mark Ebell discuss several new studies: melatonin for older adults with cognitive impairment, new pulmonary embolism guidelines, and inhaled corticosteroid dosing for children and adults with asthma. Kate has the week off.
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Episode 202: Repatha for prevention, baby lotions to prevent eczema, opioids for kid pain, and treatment of appendicitis
This week, primary care docs Mark, Kate, Henry and Gary discuss skin lotions to prevent eczema, adding an opioid to ibuprofen for kids with acute injuries, evolocumab (Repatha) for very high risk persons, and 10 year follow-up of antibiotics vs surgery for uncomplicated appendicitis.
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Episode 201: HPV collection, Tramadol, anticoag after ablation, and COVID vaccines
This week, we cover a range of topics: urinary vs cervical HPV collection, the benefits and harms of Tramadol, whether patients need anticoagulation after successful ablation for afib, and the ongoing value of COVID vaccines in the omicron era. Plus a quiz: is TAVR now indicated for everyone with severe aortic stenosis? Stay tuned!
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Episode 200: implant bleeding, introducing yourself, avoiding LP for infants, anticoag for AF with stroke
Join primary care faculty Kate Rowland, Gary Ferenchick, Henry Barry and Mark Ebell as they discuss 4 practice changing studies: norethindrone acetate for uterine bleeding with the contraceptive implant, introducing yourself to a new patient, avoiding LPs in febrile infants, and antithrombotic strategies after ischemic stroke with AF and atherosclerosis. And an Olympic quiz!
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Episode 199: GIPs, risk based breast CA screening, 1 vs 2 doses HPV vaccine, and surgery for shoulder impingement
Join primary care physicians Kate Rowland, Gary Ferenchick, Henry Barry and Mark Ebell as they discuss 4 new POEMs (Patient Oriented Evidence that Matters): cardiovascular outcomes of GIPs (vs GLP), risk-based breast cancer screening (WISDOM Trial), whether a single dose of HPV vaccine is as good as two, and surgery (or not) for shoulder impingement syndrome. Plus Kate has a great Groundhog Day quiz!
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Episode 198: Tirzepatide, using Beers, stent for carotid stenosis, and high dose flu vaccine
Join Mark, Kate, Henry and Gary as they discuss 4 new POEMs (Patient Oriented Evidence that Matters, studies with the potential to change practice): a summary of the evidence on tirzepatide (Zepbound) for weight loss, using the Beers list with your patients, high vs standard dose flu vaccine and the risk of hospitalization, and whether stent or endarterectomy are better than maximal medical therapy for patients with asymptomatic carotid stensosis. Here are the links:Essential Evidence Plus: www.essentialevidenceplus.comTirzepatide systematic review: https://pubmed.ncbi.nlm.nih.gov/41015578/ Tirzepatide vs dulaglutide: https://pubmed.ncbi.nlm.nih.gov/41406444/Applying the Beers list: https://pubmed.ncbi.nlm.nih.gov/40697073/ High vs standard dose flu vaccine: https://pubmed.ncbi.nlm.nih.gov/41115437/ Another high dose flu trial: https://pubmed.ncbi.nlm.nih.gov/39230284/ Asymptomatic carotid stenosis treatment: https://pubmed.ncbi.nlm.nih.gov/41269206/
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Episode 197: tirzepatide for kids, new flu vaccine, bathing for eczema and beta-blockers post-MI
This week, primary care physicians Kate Rowland, Mark Ebell, Gary Ferenchick and Henry Barry tackle 4 new practice changing studies (POEMs): bathing frequency for people with eczema, tirzepatide in obese children and adolescents with T2DM, a new flu vaccine, and whether beta-blockers still matter after MI.
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Episode 196: Med diet, pneumonia guideline, coffee for afib, and meds for agitation in elderly
Join primary care physicians Kate, Gary, Henry and Mark as they discuss 4 new POEM (Patient Oriented Evidence that Matters), chosen for their potential to change practice and improve patient outcomes: Mediterranean diet to prevent diabetes, an update to the community-acquired pneumonia guideline, coffee or decaf for afib, and safety of meds for acute agitation in the elderly. North Dakota Academy of Family Physicians Conference in Big Sky: https://www.ndafp.org/cme/big-sky-conference/ Essential Evidence Plus and all the POEMs: www.essentialevidenceplus.comMed diet to prevent diabetes: https://pubmed.ncbi.nlm.nih.gov/40854218/ Safety of meds for agitation in elderly: https://pubmed.ncbi.nlm.nih.gov/40275439/Updated pneumonia guidelines from ATS/IDSA: https://pubmed.ncbi.nlm.nih.gov/40679934/ Coffee or decaf with afib: https://pubmed.ncbi.nlm.nih.gov/41206802/
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Episode 195: aspirin or clopidogrel, lipids and dementia, colon CA reminders
Join Kate, Gary and Mark (Henry has the day off) as we discuss 3 useful new studies: colorectal cancer screening reminders, aspirin or clopidogrel for secondary prevention of CV events, and lipid lowering drugs and dementia risk
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Episode 194: CBD safety, HTN guideline, choosing DM drugs, and COVID-19 vax efficacy
This week primary care physicians Gary, Henry, Kate and Mark discuss the safety of CBD, a new guideline for managing adults with hypertension, whether COVID-19 vaccines are still effective, and a living guideline from the BMJ to help us choose the best diabetes drugs. Links to stuffEssential Evidence Plus Illinois Academy of Family Physicians meeting Dec 6 in Naperville, IL (Kate, Gary and Mark) North Dakota Academy of Family Physicians Big Sky Conference Jan 19 in Big Sky, Montana (Gary and Kate) Safety of CBDACC/AHA Hypertension guidelinePREVENT-CVD risk calculatorEfficacy of COVID-19 vaccinesBMJ living guideline for diabetesBMJ MATCH-IT interactive tool for selecting drugs
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Episode 193: Intensive BP lowering, elinzanetant for VMS, HTN in pregnancy and prostate CA screening
Primary care physicians Gary Ferenchick, Kate Rowland, Henry Barry and Mark Ebell want you to know about 4 new studies: the best choice of pharmacotherapy in hypertensive disorders of pregnancy, benefits and harms of intensive BP lowering, elinzanetant for therapy-induced vasomotor symptoms in women with breast cancer, and 23 year follow up of the European Prostate Cancer Screening Trial. Plus a confusing quiz question (thanks Gary!).LinksEssential Evidence Plus: www.essentialevidenceplus.comHTN in pregnancy: https://pubmed.ncbi.nlm.nih.gov/40216176/Intensive BP lowering: https://pubmed.ncbi.nlm.nih.gov/40902616/ Elinzanetant for vasomotor symptoms in patients taking tamoxifen or anastrozole: https://pubmed.ncbi.nlm.nih.gov/40454634/ 23 year follow-up of large European prostate cancer study: https://pubmed.ncbi.nlm.nih.gov/41160819/
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Episode 192: anticoag duration, old drugs for insomnia, lower dose Ozempic, and aspirin + anticoag or anticoag alone
This week, Gary, Kate, Mark and Henry discuss the optimal duration of anticoagulation after a provoked DVT, using low doses of mirtazapine or amitriptyline in adults with insomnia, whether a lower dose of semaglutide is still effective for weight loss, and adding aspirin for patients with coronary heart disease, a stent and who are also on a DOAC for another indication.Links:NICE Barrett Esophagus guideline: https://pubmed.ncbi.nlm.nih.gov/38553042/ Essential Evidence Plus: www.essentialevidenceplus.comDuration of anticoagulation: https://pubmed.ncbi.nlm.nih.gov/40888734/ Mirtazapine or amitriptyline for insomnia: ttps://pubmed.ncbi.nlm.nih.gov/39814428/ Lower dose semaglutide for obesity: https://pubmed.ncbi.nlm.nih.gov/40934115/ Adding aspirin: N Engl J Med . 2025 Oct 23;393(16):1578-1588https://pubmed.ncbi.nlm.nih.gov/40888725/
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Episode 191: acetaminophen, leucovorin, MMR and autism; the value of primary care
This week, primary care physicians Kate Rowland, Mark Ebell, and Henry Barry want to arm our primary care colleagues with the best evidence on whether acetaminophen causes autism, whether MMR causes autism, and whether leucovorin can treat autism. Gary then turns to a study of the value of continuity in primary care, and its association with better health outcomes.Links:Henry's essay on Ignaz Semelweis, handwashing, and postage stamps: https://thestampforum.boards.net/thread/13044/current-issue-volume-jul-2025 Essential Evidence Plus and POEMs: www.essentialevidenceplus.comAcetaminophen in pregnancy and autism: https://www.ncbi.nlm.nih.gov/pubmed/38592388 Leucovorin to treat autism: https://www.ncbi.nlm.nih.gov/pubmed/15781839, https://www.ncbi.nlm.nih.gov/pubmed/34834493 MMR and autism, Wakefield investigation: https://www.bmj.com/content/342/bmj.c5347MMR and autism, Madsen's Danish study: https://pubmed.ncbi.nlm.nih.gov/12421889/ Value of primary care continuity: https://www.ncbi.nlm.nih.gov/pubmed/40355250And do NOT eat roadkill. Definitely.
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Episode 190: flu vaccine & dementia, colchicine for CHD, endometriosis pain and green tea.
Today Kate, Gary, Mark and Henry discuss influenza vaccines and dementia incidence, therapies for endometriosis-related pain, colchicine for secondary prevention of heart disease, and green tea and drug absorption. Links:IgNobel prizes: IgNobel Prizes were recently awarded: https://improbable.com/ig/winners/ www.ncbi.nlm.nih.gov/pubmed/40601364 https://pubmed.ncbi.nlm.nih.gov/40373315/ Colchicine for secondary prevention of CHD: https://pubmed.ncbi.nlm.nih.gov/40314334/Green tea and drug absorption: https://pubmed.ncbi.nlm.nih.gov/39748104/ https://www.sciencealert.com/a-distinct-new-form-of-diabetes-is-officially-recognizedhttps://www.medscape.com/viewarticle/malnutrition-related-diabetes-officially-named-type-5-2025a10008pd
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Episode 189: asthma rescue, exercise for cancer, digitoxin, and minor stroke treatment
This week Gary, Kate, Henry and Mark discuss 4 important new studies that are potential POEMs: A new(ish) rescue therapy for asthma, IV thrombolytics for adults with acute minor stroke, whether exercise reduces cancer mortality, and digitoxin (with a t!) as add-on therapy for adults with heart failure.
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Episode 188: digital therapy, DKA with SGLT2s, esketamine for resistant depression, and what is a normal TSH
Join Kate, Mark, Gary and Henry as they discuss 4 great new POEMs (studies with the potential to change practice): a digital mental health intervention, the risk of DKA in patients using SGLT2 inhibitors, esketamine’s effects on suicidal ideation and unresponsive depression, and whether “one-size-fits-all” thyroid reference ranges misleading.Links:Essential Evidence Plus: www.essentialevidenceplus.comDigital mental health app for depression: https://pubmed.ncbi.nlm.nih.gov/40227715/RIsk of DKA with SGLT2s: pubmed.ncbi.nlm.nih.gov/40070044/Esketamine and resistant depression or suicidality: pubmed.ncbi.nlm.nih.gov/39790081/ What is a normal TSH: https://pubmed.ncbi.nlm.nih.gov/40324200/ Joseph O'Connor and the Escape Line Trilogy (2 great novels): https://www.amazon.com/The-Rome-Escape-Line-Trilogy-2-book-series/dp/B0BSNX3C89
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Episode 187: incidental activity, a new definition of Alzheimers, blood test for CRC screening, and DORAs for sleep
This week, we found 4 great new studies for primary care physicians (and their patients): the health benefits of “incidental” activity, real world data and the amyloid cascade theory for Alzheimer’s disease, a new blood test for colorectal cancer screening, and DORAs for sleep.Check out Essential Evidence Plus: www.essentialevidenceplus.comIncidental activity: https://pubmed.ncbi.nlm.nih.gov/40228066/New Alzheimer's definition in the real world: https://pubmed.ncbi.nlm.nih.gov/40359457/ Blood test for colorectal cancer screening: https://pubmed.ncbi.nlm.nih.gov/40455622/ "DORAs" for insomnia: https://pubmed.ncbi.nlm.nih.gov/40555730/
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Episode 186: wound care, migraine tx, breast CA screening, and metformin for OA
Kate, Mark, Gary and Henry discuss 4 important new studies relevant to primary care clinicians: negative pressure wound therapy for wounds healing by secondary intention, comparative effectiveness of acute migraine treatments, contrast enhanced mammography, US, or MRI for women with dense breasts, and metformin for knee pain in patients without diabetes.Negative pressure wound therapy: https://pubmed.ncbi.nlm.nih.gov/40250455/ Acute migraine treatments: https://pubmed.ncbi.nlm.nih.gov/40096693/ Best enhanced screening for women with dense breasts: https://pubmed.ncbi.nlm.nih.gov/40412427/ Metformin for knee pain in patients without DM: https://pubmed.ncbi.nlm.nih.gov/40274279/
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Episode 185: resistant HTN tx, mirtazepine for sleep, baloxav for prevention, PRP for OA
This week our intrepid primary care docs discuss 4 new POEMs: spironolactone vs amiloride for resistant hypertension, mirtazapine for insomnia in older adults, baloxivir for influenza post exposure prophylaxis, and platelet-rich plasma injections for knee osteoarthritis. We've got opinions!Show notes:Spironolactone vs amiloride for resistant hypertension: pubmed.ncbi.nlm.nih.gov/40366680/ Mirtazapine for chronic insomnia: https://pubmed.ncbi.nlm.nih.gov/40135470/ Baloxavir to prevent flu in household contacts: https://pubmed.ncbi.nlm.nih.gov/40267424/ Platelet-rich plasma for knee OA: https://pubmed.ncbi.nlm.nih.gov/39751394/
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Episode 184: new UTI antibiotic, fibromyalgia tx, trial of an MCED, and the best time for HTN meds
Join Mark, Kate, Henry and Gary as they discuss 4 new POEMs: a new and very hard to pronounce antibiotic for uncomplicated UTI, the best drugs for relieving pain in adults with fibromyalgia, a clinical trial of a multicancer detection test in asymptomatic persons, and bedtime vs morning administration of antihypertensives.Gepotidacin for uncomplicated UTI: https://pubmed.ncbi.nlm.nih.gov/38342126/ Drugs for fibromyalgia: https://www.ncbi.nlm.nih.gov/pubmed/39705187Multicancer detection test trial: https://pubmed.ncbi.nlm.nih.gov/39948555/ TIming of antihypertensives: https://pubmed.ncbi.nlm.nih.gov/40354045/
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Episode 183: triple inhaler for COPD, managing pain in kids, and suzetrigine for pain
This week, join Kate, Mark and Henry as they discuss all in one triple inhalers for COPD, the best medication for pain management in children and suzetrigine, a new medicine for acute pain in adults. Gary is off this week, working on his French lessons. And we add intro music! Yay!
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Episode 182: atrial appendage occlusion for AF, oral semaglutide, and epidural steroidsand
Join Mark, Henry, and Gary (we are Kate-less unfortunately this week) for discussion of epidural steroid injections for adults with radicular back pain, post a fib ablation management, and oral semaglutide for high-risk patients with Type 2 DM
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Episode 181: wipes to prevent foot ulcer, tirzepatide efficacy,
This week, Kate, Mark, Gary and Henry discuss 4 great new POEMs: foot care wipes for patients at risk of diabetic foot infection, resuming DOACS following intracerebral hemorrhage in adults with a fib, treating prediabetes with tirzepatide, and more on intermittent fasting.Show linksBMJ Magic Evidence interactive review of diabetes medications. A great practice and teaching tool: https://matchit.magicevidence.org/230125dist-diabetes/#!/https://www.ncbi.nlm.nih.gov/pubmed/31574019https://pubmed.ncbi.nlm.nih.gov/39964684/ https://pubmed.ncbi.nlm.nih.gov/40023176/ttps://pubmed.ncbi.nlm.nih.gov/39536238/https://pubmed.ncbi.nlm.nih.gov/40163873/
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Episode 180: dance benefits, POCUS for clavicles, treating BV, and prehab
This week, Kate, Gary, Mark and Henry chat about the health effects of dance for older adults, POCUS for diagnosing clavicular fractures, treating male partners of women with BV, and prehabilitation before elective surgery .Links:Dance for older adults: https://pubmed.ncbi.nlm.nih.gov/39480190/POCUS for clavicle fractures: https://pubmed.ncbi.nlm.nih.gov/39626455/ Oral + topical treatment of male partners for BV: https://pubmed.ncbi.nlm.nih.gov/40043236/ Prehabilitation before elective surgery: https://pubmed.ncbi.nlm.nih.gov/39843215/Case series of avian flu patients: https://www.nejm.org/doi/full/10.1056/NEJMoa2414610
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Episode 179: novel migraine tx, safety of albuterol in infants, new UTI antibiotic, and vitamin K2 for leg cramps
This week join our intrepid primary care physicians Kate, Gary, Henry and Mark as they discuss 4 new studies: an experimental treatment for chronic migraines, safety of albuterol in wheezy kids under 2, oral gepotidacin for uncomplicated UTI, and vitamin K2 and Leg Cramps.Here are the links:Lukas' Fund supporting the Piedmont Athens and Grady Atlanta NICUs: https://www.lukasfund.org Essential Evidence Plus: http://www.essentialevidenceplus.comVibrating intranasal balloons for migraine: https://pubmed.ncbi.nlm.nih.gov/39787477/ and OziliaSafety of albuterol in infants: https://www.ncbi.nlm.nih.gov/pubmed/39266286Oral gepotidacin for uncomplicated UTI: https://www.ncbi.nlm.nih.gov/pubmed/38342126 Vitamin K2 for nocturnal leg cramps: https://pmc.ncbi.nlm.nih.gov/articles/PMC11581596/
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Episode 178: tapering benzos, neuro testing for athletes, vonoprazan for PUD, and zoster-dementia link
This week Kate, Gary, Mark and Henry discuss discontinuation of benzodiazepines and treatment of insomnia, the value of baseline cognitive testing of college athletes, vonoprazan vs PPI for preventing and treating ulcers, and whether herpes zoster vaccine reduces dementia risk.Show links:Essential Evidence Plus: www.essentialevidenceplus.comTapering benzos: https://pubmed.ncbi.nlm.nih.gov/39374004/ Baseline neuro eval for athletes: pubmed.ncbi.nlm.nih.gov/39741470/ David Kaufman, “We Need You in the Locker Room” https://thesagergroup.net/books/in-the-locker-room Vonoprazan vs PPIs for ulcers: https://pubmed.ncbi.nlm.nih.gov/39294424/ Zoster and dementia: https://pubmed.ncbi.nlm.nih.gov/40175543/
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Episode 177: steroids and CV risk, dementia guideline, fezolinetant for VMS, and osteoporosis screening
This week Gary, Mark, Kate and Henry discuss: adverse effects from inhaled steroids in asthma, Italian dementia guideline, fezolinetant for treatment of vasomotor symptoms, and updated USPSTF recommendations for osteoporosis screening.Show notes and links:Asthma and risk of CV events: https://pubmed.ncbi.nlm.nih.gov/39088770/ GINA 2024 guidelines: https://ginasthma.org/2024-report/ Italian dementia guidelines: https://www.ncbi.nlm.nih.gov/pubmed/39544104 with link to full report in Inglese: https://www.iss.it/documents/d/guest/the-full-guideline-english-version Fezolinetant for vasomotor symptoms: https://pubmed.ncbi.nlm.nih.gov/39557487/USPSTF osteoporosis screening guideline: https://pubmed.ncbi.nlm.nih.gov/39808425/ Dietary assessment tool: https://epi.grants.cancer.gov/asa24/ Article on interval for next BMD screening based on initial result: https://pubmed.ncbi.nlm.nih.gov/22256806/
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Episode 176: bright lights, fever in kids, new anticoagulant for AF, and antibiotics for appendicitis
Join Kate, Gary, Mark and Henry as they discuss 4 new POEMs relevant to primary care: bright light therapy for non-seasonal depression, fever control in children, abelacimab for atrial fibrillation, antibiotics vs surgery in children with nonperforated appendicitis. Get all of the POEMs (a new one every day) by going to Essential Evidence Plus and subscribing.Links from today's podcast:Bright lights for non-seasonal depression: https://pubmed.ncbi.nlm.nih.gov/39356500/ Controlling fever in children: https://pubmed.ncbi.nlm.nih.gov/39318339/ Abelacimab for anticoagulation in atrial fib: https://pubmed.ncbi.nlm.nih.gov/39842011/ Antibiotics vs surgery for appendicitis in kids: https://www.ncbi.nlm.nih.gov/pubmed/39826968Independent predictors of suicidal ideation: https://pubmed.ncbi.nlm.nih.gov/7966924/ Here is the probability of suicidal ideation by # of risk factors: 0: 0.5% 1: 3.0% 2: 7.4% 3: 23% 4: 46%
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Episode 175: RSV monoclonals, acupuncture for sciatica, zoledronate in low risk women, and measuring BP at home.
This week, Gary, Kate, Henry and Mark discuss 4 new studies relevant to primary care practice: the effectiveness of RSV monoclonals in infants, acupuncture for sciatica associated with disk herniation, zoledronate every 5 years for low risk women, and the effect of arm position on blood pressure readings. Plus a quiz! Please see below for show notes and links:Learn more about Essential Evidence Plus: www.essentialevidenceplus.comReal world study of nirsevemab for average risk infants: https://pubmed.ncbi.nlm.nih.gov/39257372/Acupuncture effective for sciatica: https://pubmed.ncbi.nlm.nih.gov/39401008/Zoledronate every 5 years for average risk women: https://pubmed.ncbi.nlm.nih.gov/39813642/Importance of correct arm position for BP: https://pubmed.ncbi.nlm.nih.gov/39373998/A nice infographic for measuring BP correctly from the AMA and Johns Hopkins: https://targetbp.org/wp-content/uploads/2016/10/MAPHypertension_7StepsInOfficeInfographic_Landscape_English_NoCropsNoBleeds-12.pdf
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Episode 174: sexual dysfunction, GLP-1 benefits, surveillance for DCIS, episodic migraine prevention
Join Kate, Mark, Gary and Henry as they discuss 4 new POEMs on treatment of sexual dysfunction, the benefits and harms of GLP-1 agonists, active surveillance vs usual care for ductal carcinoma in situ, and medications to prevent episodic migraine headache.Henry mentioned AAFP's uncensored resources:www.aafp.org/family-physician/patient-care/clinical-recommendations.html www.aafp.org/family-physician/patient-care/care-resources.htmlwww.aafp.org/family-physician/patient-care/prevention-wellness/immunizations-vaccines.htmlwww.aafp.org/family-physician/patient-care/care-resources/sexually-transmitted-infections.htmlwww.aafp.org/family-physician/patient-care/care-resources/womens-health.html www.aafp.org/family-physician/patient-care/care-resources/reproductive-health.html Kate's links on sexual dysfunction:NEJM review: https://pubmed.ncbi.nlm.nih.gov/39167808/ED prevalence: https://pubmed.ncbi.nlm.nih.gov/38410029/GLP-1s do everything: www.ncbi.nlm.nih.gov/pubmed/39833406Active monitoring of DCIS: https://pubmed.ncbi.nlm.nih.gov/39665585/Episodic migraines: https://pubmed.ncbi.nlm.nih.gov/39899861/ https://www.ncbi.nlm.nih.gov/pubmed/39631943
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Episode 173: prenatal cannabis use, fluids in sickle crisis, single or dual tx for AF plus CAD, and exercise for weight loss.
This week, join Kate, Mark, Gary and Henry as they discuss 4 new studies: prenatal cannabis exposure, fluid resuscitation during acute sickle crises, edoxaban or edoxaban + ASA for afib with CAD, and the impact of aerobic exercise on weight loss in adults
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Episode 172: mindfulness for pain, methotrexate and resveratrol for OA, and eradicating HP
Join Henry, Kate, Mark and Gary as they discuss 4 new POEMs: an RCT of mindfulness for chronic pain, use of methotrexate (huh?) for pain relief in adults with knee DJD, a new way to eradicate H., and oral resveratrol for adults with painful DJD of the knee (you know, the stuff from red wine). And a quiz: what actually are the benefits of lower BP targets? Links Mindfulness for chronic pain: https://pubmed.ncbi.nlm.nih.gov/39158851/ Methotrexate for OA: https://pubmed.ncbi.nlm.nih.gov/39074374/ Eradicating H. pylori: https://pubmed.ncbi.nlm.nih.gov/38906695/ Resveratrol for OA: https://www.ncbi.nlm.nih.gov/pubmed/39137167 Cochrane Review: Blood pressure targets in adults with hypertension.
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Episode 171: obesity in babies, DOACs after stroke, semaglutide for OA, and thunderclap headaches
This week join our intrepid team of skeptical primary care doctors as Kate, Mark, Henry and Gary discuss a web- and text-based intervention to prevent obesity in babies, the best timing of DOAC initiation after ischemic stroke in adults with atrial fibrillation, using semaglutide for knee osteoarthritis, and the differential diagnosis of thunderclap headaches. Plus the BEST quiz ever. Links: Preventing obesity in babies: https://pubmed.ncbi.nlm.nih.gov/39489149/ https://www.ncbi.nlm.nih.gov/pubmed/39491870 Semaglutide to reduce pain in knee OA: https://pubmed.ncbi.nlm.nih.gov/39476339/ Causes of thunderclap headaches: https://www.ncbi.nlm.nih.gov/pubmed/39303457
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Episode 170: yoga for incontinence, muscle relaxants for pain, maternal cannabis use, and GLP-1 v. surgery
This month Kate, Mark, Gary and Henry discuss yoga for treating urinary incontinence in older women, benefits and harms of muscle relaxants for adults with chronic pain, maternal prenatal cannabis use and developmental delays, and bariatric surgery vs. glucagon-like peptide 1 receptor agonists in obese adults with T2DM. Links: Yoga for incontinence: https://pubmed.ncbi.nlm.nih.gov/39186785/ Muscle relaxants for painful conditions: https://pubmed.ncbi.nlm.nih.gov/39298168/ Maternal cannabis use and developmental delays: https://pubmed.ncbi.nlm.nih.gov/39422907/ Bariatric surgery vs. GLP-1s: https://www.ncbi.nlm.nih.gov/pubmed/39235379
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Episode 169: migraine, plantar fasciitis, beta-blocker duration and prostate cancer
This week Mark, Kate, Gary and Henry talk about the comparative effectiveness of migraine medications, strategies for adults with plantar fascia pain, whether to continue beta-blocker use after acute MI, and the outcomes of 5-alpha reductase inhibitor use prior to prostate cancer diagnosis. Links Migraine: https://www.bmj.com/content/386/bmj-2024-080107 Plantar fasciitis: https://pubmed.ncbi.nlm.nih.gov/38904119/ and https://pubmed.ncbi.nlm.nih.gov/16801514/ Beta-blockers post MI: https://pubmed.ncbi.nlm.nih.gov/39213187/ Prostate cancer: https://pubmed.ncbi.nlm.nih.gov/39190306/
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167
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
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166
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/
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165
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.
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164
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.
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163
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!
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162
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.
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161
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
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160
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
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159
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.
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ABOUT THIS SHOW
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.
HOSTED BY
Mark Ebell
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