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?