In episode 388, Mike and James go over with Adrienne Lindblad the evidence for a simple treatment for nausea and vomiting in the ER. Who knew that inhaling isopropyl alcohol worked for nausea and vomiting? – possibly as good as the medications we have used in the past. At the end of the podcast we decide to attach isopropyl alcohol swabs to all our microphones all the time, just in case.

Show notes

Tools for Practice

Smell This: Isopropyl alcohol for nausea/vomiting in the emergency department

In episode 387, Mike and James go over the best available evidence for opioids in neuropathic pain. As with many pain treatments the evidence suggests there is some benefit and also some harm.  Overall, it seems a reasonable approach would be to only use opioids in patients with refractory pain after multiple therapeutic trials with other agents.

Show notes

1) Tools For Practice

Nerve-ous About Opioids? Treatment of neuropathic pain with opioids

2) Comparing Treatment Options for Pain: The C-TOP Tool

In episode 386, James and Mike talk about the latest low fat low carb weight loss study and then put it all into context of the more global evidence for low carbs vs low fats. The bottom line is, the evidence is even lower than the carbohydrates in a ketogenic diet – which is pretty low – or in other words nobody can really say what is the best diet – except maybe the one to which you will adhere.

Show notes

1) Effect of Low-Fat vs Low-Carbohydrate Diet on 12-Month Weight Loss in Overweight Adults and the Association With Genotype Pattern or Insulin Secretion: The DIETFITS Randomized Clinical Trial

JAMA. 2018 Feb 20;319(7):667-679

2) Effects of low-carbohydrate diets v. low-fat diets on body weight and cardiovascular risk factors: a meta-analysis of randomised controlled trials

Br J Nutr. 2016 Feb 14;115(3):466-79

3) Low carbohydrate-high protein diet and incidence of cardiovascular diseases in Swedish women: prospective cohort study

J Intern Med. 2007 Apr;261(4):366-74

4) Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates

N Engl J Med. 2009 Feb 26;360(9):859-73