In episode 131, Mike and James have invited Denise Campbell-Scherer into the podcast world to help us discuss the issue of multimorbidity when it comes to guidelines and chronic medical conditions. We talk about how to think about this issue when it comes to research and practice and we very quickly realise it is tricky and it demands that clinicians need to realise that guidelines are system-based and not patient specific focussed. At the end we decide that we need to take care of patients and not disease states.

Show notes

1) Multimorbidity: a challenge for evidence-based medicine

Evidence-Based Medicine 2010;15:165-6

2) The quality of life and time associated with treating chronic conditions

JAMA 2005;294:716-724

In episode 130, Mike and James run directly into the face of the evidence around exercise and really sweat out the weightiness of the results. We actively find out that it’s primarily all about quality of life, and that Mike bikes and James rollerblades to keep themselves as close to perfect physical specimens as possible. At the end we find out they also both take medications for delusions of grandeur.

Show notes

1) Activity-related benefits

Cochrane 2002;(4):CD003404

J Gerontol A Biol Sci Med Sci 2008;63:997-1004

J Sports Med Phys Fitness 2007 Dec;47:462-7

Cochrane 2008 Oct 8;(4):CD004366

Cochrane 2008 Oct 8;(4):CD004376

Arch Intern Med 2007;167:2453-60

JAMA 2003;289:2379-86

NEJM 2002; 347 (10): 716-25

JAMA 1995; 273 (14): 1093-8

Circulation 2008;117: 614-22

PLOS 2008; 5(1): e12

2) Quality of life and dose response

Arch Intern Med 2009;169:269-78

Circulation 2010;122:743-752

Br J Sports Med 2008;42:238–43

NEJM 1999;341:650-8

Eur J Epidemiol 2009;24:181–192

3) Exercise for overall benefit not on surrogate markers

J Appl Physiol 2008;105:766–8

4) RCT evidence on exercise

Circulation 2004;109:1371-8

Am J Med 2004;116:682–92

5) Motivating patients

JAMA 2007;298:2296-304

Res Q Exerc Sport 2009;80:648-55

Int J Behav Nutr Phys Act 2008;5:44

Diabetes Care 2009;32:1404-10

Arch Intern Med 2007;167:2453-60

JAMA 1995;273:1093-8

Ann Fam Med 2008;6:69-77

Am J Public Health 1998;88:288-91

In episode 129, we get back to giving our listeners PREMIUM content and we end up spending the entire time talking about drugs that, in theory, make you pee – and you wonder why we call this a PREMIUM podcast. We discuss a synopsis of an old drug hydrochlorothiazide and then we discuss the most recent clinical trial of the new aldosterone antagonist eplerenone. The podcast comes to an abrupt end when, because of either the topic or the coffee, both Mike and James have to leave to leave to attend to more important matters.

Show notes

1) Hydrochlorothiazide – what is the evidence for its use?

J Am Coll Cardiol 2011;57:590-600

2) Eplerenone – EMPHASIS-HF study

N Engl J Med 2011;364:11-21

3) Aldosterone antagonist systematic review

Euro H J 2009;30,469–77

In episode 128, James and Mike finally get to the last of the listener questions We discuss codeine and cough, Vapor Rub; we talk about the PREMIUM podcast, otitis media and antibiotics, atrial fibrillation and low dose statins. We then both collapse from exhaustion yet promise to get back to making premium podcasts as soon as possible.

Show notes

Codeine and cough

Can Fam Phys 2010;56:1293-4

Cochrane Library