In episode 286, James and Mike let it all hang out, metaphorically speaking, and do a premium-like podcast without the premium price. We look at two recent publications and discuss whether or not we have to bridge when you stop anticoagulants in afib and if we should prescribe marijuana to ourselves and all our patients.  For some reason we laugh throughout the entire podcast.

Show notes

1) BRIDGE – Perioperative Bridging Anticoagulation in Patients with Atrial Fibrillation

June 22, 2015DOI: 10.1056/NEJMoa1501035

2) Cannabinoids for Medical Use – A Systematic Review and Meta-analysis

JAMA. 2015;313(24):2456-2473. doi:10.1001/jama.2015.6358.

In episode 285, James and Mike look at the evidence around the use of a very old drug, cyclobenzaprine (Flexeril), for acute back pain. We find it does have some effect but it also produces sedation etc as would be expected from a tricyclic antidepressant. We remind listeners to use low doses and not to give it three times a day.

Show notes

1) Tools for Practice

Acute Back Pain: Is Cyclobenzaprine a reasonable option?

In episode 284, the Mikes and James discuss the evidence for the FODMAP diet and irritable bowel syndrome.  There is some evidence, but the gut feeling is that a low FODMAP diet may improve symptoms for patients with primarily diarrhea subtype irritable bowel syndrome. The bottom line (HA HA bottom) is that most of the studies were low quality and more high quality studies are needed. 

Show notes

1) Tools for Practice

The Low FODMAP Diet: Food for thought or just an irritable idea?

2) Stanford FODMAP guide