In episode 586, Mike and James invite Émélie Braschi back to the podcast to talk about the tricky issue of how to deal with a potential penicillin allergy. Believe it or not there are a couple of RCTs looking at this issue. These two trials compared oral challenge alone to skin testing followed (if negative) by oral challenge. The results may allow you to change your practice in a good way. Tune in and find out why.

Show notes
Tools for Practice
It’s time to challenge penicillin allergy labels!

In episode 585, Mike and James finally get back to being PREMIUM. We review the REDUCE-AMI trial which tried to answer the question – do you need to use a beta-blocker after an MI if there is preserved ejection fraction? We also review a COPD trial that shows integrating respiratory specialists in primary care improves guideline adherence. However, the interesting finding is what happens to the quality-of-life change and hospitalizations. The results of both of these trials may surprise you.

Show notes
1) REDUCE-AMI- Beta-Blockers after Myocardial Infarction and Preserved Ejection Fraction
N Engl J Med 2024;390:1372-1381

2) Cluster randomised controlled trial of specialist-led integrated COPD care (INTEGR COPD)
Thorax 2024;79:209–218

In episode 584, Mike and James invite Tina Korownyk back to the podcast to talk about the evidence for amyloid-targeting monoclonal antibodies in mild cognitive impairment or Alzheimer’s dementia. Unfortunately, the evidence shows these medications don’t seem to have a clinically important effect and do have some harms. Have a listen as we give you all the numbers so you will be able to properly discuss these medications with your patients.

Show notes

Tools for Practice
Remind me, do medications that target brain amyloid improve my dementia?

In episode 583, Mike and James continue to go over the issues associated with using CVD risk calculators. We talk about some of the limitations, how to think about the results and explain the risks and benefits to patients.

Show notes
PEER Simplified Cardiovascular Decision Aid

Incorporation of Shared Decision-Making in International Cardiovascular Guidelines, 2012-2022
JAMA Network Open. 2023;6(9):e2332793. doi:10.1001/jamanetworkopen.2023.32793

Lipid levels in patients hospitalized with coronary artery disease: an analysis of 136,905 hospitalizations in Get With The Guidelines
Am Heart J 2009;157:111-7.e2

Agreement among cardiovascular disease risk calculators
Circulation. 2013;127:1948–1956

In episode 582, Mike and James go over the issues associated with using CVD risk calculators. We talk about where the numbers come from, what they mean, what their limitations are, how to think about them and how to use them. So have a listen as it may decrease your risk but it will definitely increase your understanding.

Show notes
1) PEER Simplified Cardiovascular Decision Aid
https://decisionaid.ca/cvd/

2) Incorporation of Shared Decision-Making in International Cardiovascular Guidelines, 2012-2022
JAMA Network Open. 2023;6(9):e2332793. doi:10.1001/jamanetworkopen.2023.32793

3) Lipid levels in patients hospitalized with coronary artery disease: an analysis of 136,905 hospitalizations in Get With The Guidelines
Am Heart J 2009;157:111-7.e2

4) Agreement among cardiovascular disease risk calculators
Circulation. 2013;127:1948–1956

In episode 581, Mike and James invite Mike Kolber back to the podcast for the umpteenth time – this time we talk about a topic we haven’t discussed before – acute diverticulitis. Historically, if a person has diverticulitis they were given antibiotics BUT do they really do anything? We look at all the evidence and the results may surprise you.

Show notes
Tools for Practice
Antibiotics or no antibiotics for acute diverticulitis, that is the question!

In episode 580, Mike and James invite Jennifer Young to talk about the treatment of pityriasis rosea. Believe it or not there are 2 simple treatments that seem to work really quite well. Tune in to hear what works and how well they work.

Show notes
Tools for Practice
(A)dressing the Christmas Tree? Therapies for pityriasis rosea

In episode 579, Mike and James invite Nicholas Dugré back to the podcast to talk about the evidence around the benefits and harms of a new class of medications for the acute treatment of episodic migraines. Ubrogepant is an oral calcitonin gene-related peptide antagonist. In this case, amazing as it may sound, there are triple the number of systematic reviews than there are RCTs. Nonetheless, we go over all the evidence and at the end of the podcast you’ll know what the world knows about these agents.

Show notes

Tools for Practice

Oral Calcitonin Gene-related Peptide Antagonists: A painfully long name for the acute treatment of migraines

In episode 578, Mike, James and Jennifer Potter try to answer the question, in patients with dementia, how safe and effective are stimulants, antidepressants, and antipsychotics for treating apathy? We look at the evidence for methylphenidate, antipsychotics, and antidepressants so tune in to find out if any of these treatments have any sort of effect in this very difficult to treat condition.

Show notes
Tools for Practice
Making a difference in indifference? Medications for apathy in dementia

In episode 577, Mike and James invite Jennifer Young to join us to go over all the evidence around how best to close punch biopsies, lacerations and incisions. We go over all the evidence for sutures (absorbable/nonabsorbable), skin glue, and tape. We look at cosmesis, patient satisfaction, and infection rates so have a listen and find out what we found.

Show notes
Tools for Practice
Looking for Closure: Managing simple excisions or wounds efficiently