In episode 169, Mike and James get back to listener questions. Our listeners lead us down the garden path and we end up talking about bladder irritants, riboflavin for migraine prophylaxis, placebo, and as always low doses. Mike rebels by taking a high dose of obecalp which leads to some very strange side effects.

Show notes

1) Is caffeine a bladder irritant?

Urol Ann 2011:3:14-8

JAMA 2004;291:986

2) Riboflavin in migraine prophylaxis

Neurology 1998;50:466-70

Headache 2004;44:885-90

Cephalgia 2010;30:1426-34

J Child Neurol 2008;23:1300-4

3) Tools for practice

Are antihypertensive medications effective for migraine prophylaxis?

Antidepressants for preventing headaches: Which work and how well?

4) Placebo effect 

Cochrane library CD003974 

5) Low dose

CMAJ 2011;183:65–9

In episode 168, Mike and James welcome back the returning Bruce Arroll who helps us out with the painful issue of how to diagnosis, treat and prevent gout. We crystallize the evidence and stick a needle into the beliefs about diet and colchicine dose. At the end we all go out to celebrate and drink milk and wine because neither are associated with developing gout.

Show notes

1) A Diagnostic Rule for Acute Gouty Arthritis in Primary Care Without Joint Fluid Analysis

Arch Int Med 2010;170:1120-6

2) Tools For Practice

Is colchicine an effective alternative to NSAIDs for the treatment of acute gout?

3) Moderate intake of purine-rich vegetables or protein is not associated with an increased risk of gout

N Engl J Med 2004;350:1093-103

4) Febuxostat vs allopurinol

N Engl J Med 2005; 353:2450-2461

In episode 167, we welcome back Bruce Arroll who, as he commonly does, helps us talk about common conditions and in this case it is the common cold. We discuss common diagnoses, common treatments and uncommonly, we pretty much agree with everything he has to say about this common ailment. 

Show notes

1) Intranasal zinc for the common cold

J Prim Health Care 2009;1:134-9

2) Phenylpropanolamine and stroke

N Engl J Med 2000;343:1826-32

3) Rapid response – letter BMJ on rebound from nasal decongestants

http://www.bmj.com/rapid-response