In episode 250, Mike and James double up on the value by giving you close to 60 minutes of pure gold – fools gold actually. We discuss a number of new studies that help answer questions about dual antiplatelets, niacin, OST, the number of fruit and vegetable servings, and acetaminophen for acute low back pain. At the end we realize 250 podcasts is a lot and we so much thank all the people who have chosen to listen over the years.

Show notes

1) How long for dual antiplatelets?

Circulation 2014;129:304-12

2) The end of niacin

N Engl J Med 2014;371:203-12

3) OST versus FRAX

J Am Geriatr Soc 2014 62:442–6

OST and fracture risk tables

See under #12 rheumatology

4) Fruit and vegetable consumption meta-analysis 

BMJ 2014;349:g4490 doi: 10.1136/bmj.g4490

Fruit and vegetable consumption and all-cause, cancer and CVD mortality: analysis of Health Survey for England data

J Epidemiol Community Health 2014;0:1–7. doi:10.1136/jech-2013-203500

5) Efficacy of paracetamol for acute low-back pain: a double-blind, randomised controlled trial

Lancet 2014 Jul 23

NSAIDs and low back pain

CD000396

Muscle relaxants and low back pain

CD004252

6) PEIP conference in Edmonton

In episode 249, Mike and James dive into all the latest data on glucosamine for osteoarthritis. Early on, the research showed it might have some benefit but the most recent meta-analyses indicate glucosamine does not reliably improve pain or function in osteoarthritis.

Show notes

1) Tools For Practice

Does glucosamine improve pain and function in osteoarthritis?

2) Glucosamine withdrawal makes no difference 

Arthritis Rheuma 2004;51:738–45 

In episode 248, Mike and James and Mike tackle another Tools For Practice and discuss the myth about NSAIDs and delayed fracture healing and review all the evidence. At the end we join everything all together and NSAIDs didn’t in anyway prevent that.

Show notes

 1) Tools For Practice

Do non-steroidal anti-inflammatory drugs (NSAIDs) increase the risk of fracture non-union or impede healing? 

In episode 247, Mike and James and Mike look at the evidence for the new anticoagulants compared to warfarin in the treatment of DVTs and PEs. At the end we realise the decision between these agents is a personal one guided by the best available evidence, which hopefully we have done an OK job in providing.

Show notes

 1) Tools For Practice

Are novel anti-coagulants as effective as warfarin in treating acute venous thromboembolism (VTE)?

2) Choosing Wisely Video

In episode 246, Mike and James go over all the evidence that has looked at the issue of statins and cognitive impairment. Overall the evidence is not confusing and it indicates that statins do not prevent, treat, or cause cognitive impairment or dementia. Still confused?

Show notes

1) Tools For Practice

Statins and cognitive impairment: Don’t forget the evidence? 

In episode 245, Mike and James PREMIUM the listeners with talk about three new studies. Aleglitazar a new drug that was supposed to help people with type 2 diabetes, how best to use delayed antibiotic prescribing and a trial that answers the question about population screening for high cardiovascular risk patients.

Show notes

1) AleCardio – aleglitazar

JAMA 2014;311:1515-25

2) Delayed prescribing of antibiotics

BMJ 2014;348:g1606

3) INTER99 – Population screening and lifestyle counsellng

BMJ 2014;348:g3617

In episode 244, Mike and James continue to delve into issues around industry and discuss the costs of research, patent protection, and policies on industry relations. At the end we come to the conclusion that the phrase industry and us includes 2 people so everybody plays a role in the process.

Show notes

1) Industry and us

Handout for the references discussed in this podcast

2) Price Comparison of Commonly Prescribed Pharmaceuticals in Alberta 2014

In episode 243, Mike and James continue to delve into issues around industry and we now focus on how study design, selection of comparators and selective publication can impact the “truth”.

Show notes

 1) Industry and us 

Handout for the references discussed in this podcast

In episode 242, Mike and James continue to delve into the impact industry marketing has on how and why we prescribe. We get to the evidence around many of the influences and at the end we realize we are all influenced by many things and we are all biased – so deal with it by being aware of the influence.

Show notes

1) Industry and us 

Handout for the references discussed in this podcast

In episode 241, Mike and James decide to delve into the impact industry marketing has on how and why we prescribe. We start off by discussing the theoretical issues surrounding the marketing of medications and briefly touch on the ethical dilemmas. At the end we realize we really haven’t discussed any evidence other than our own personal opinion and so we make a pact to discuss the evidence around this area in the next podcast.

Show notes

1) Industry and us 

Handout for the references discussed in this podcast