In episode 203, James and Mike go all PREMIUM and discuss three new studies. Vitamin D for the common cold, chelation therapy post-MI and the link between obesity and mortality. If you are reading this and you are a non-PREMIUM member, boy are you missing something.
Show notes
1) Vitamin D for the cold
2) Chelation post-MI RCT
3) Obesity and mortality
In episode 202, Mike and James continue their testing deconstruction process. This week they take on bone mineral densities and discuss when (almost never) and when not to get these measurements. The podcast clocks in at a dense 44 minutes but the result is a real gem (mineral).
Show notes
1) OST – Osteoporosis Self-assessment Tool
Mayo Clin Proc. 2002;77:629-637
The Singapore Family Physician Jul-Sep 2003;29:12
MOH Osteoporosis clinical practice guidelines – Singapore
Mar 2002
Tools for practice – Screening for
Osteoporosis – Who Should Receive Bone Mineral Density Testing?
2) BMD plus age to get fracture risk
3) Remeasuring for risk assessment
Arch Intern Med 2007;167:155-60
4) Simpler tools for risk assessment
Arch Intern Med 2009;169:2087-94
5) Follow-up bone density after treatment
Tools for practice – Bone Mineral Density
– Too much of a good thing?
In episode 201, James and Mike continue on with deconstructing the concept of cholesterol measuring and lowering. We talk about various scenarios as to when one could measure cholesterol but quickly come to the realization that if one looks at the best science and uses a logical thought process, the whole concept of cholesterol measurement for individual patients is unfortunately built upon a house of cards.
Show notes
1) Meta-Analysis Comparing Mediterranean to Low-Fat Diets for Modification of Cardiovascular Risk Factors
In episode 200, James and Mike unveil the new BS Medicine Podcast. For their first topic they rant on and on about why most cholesterol measurements are pretty much a waste of time. We talk about how the breakpoints are arbitrary and lack any specific logic and that given the within-person variation, annual measurements really don’t have any value. At the end we brilliantly segue to a discussion on cranberry juice for UTIs.
Show notes
1) AACE Cholesterol Guidelines 
2) 2012 update of the Canadian Cardiovascular Society guidelines for the diagnosis and treatment of dyslipidemia for the prevention of cardiovascular disease in the adult
3) The SANDS Randomised Trial
4) Monitoring cholesterol levels: Measurement Error or True Change?
Ann Intern Med 2008;148:656-61
5) Do you need to know cholesterol to assess risk?
Arch Intern Med 2012;172:1766-8
5) When to remeasure cardiovascular risk in untreated people at low and intermediate risk:observational study
Hi Everyone: Well, after 5 years, 199 episodes, ~ 120 hours of content = 24 hours a day for 5 days, James and Mike have decided to pull the plug on the TEC podcast. We want to thank all the listeners – some who have listened to them all – for trusting in the content that we provide.
BUT DON’T YOU WORRY.
We are coming back with more of the same and maybe a little bit more. We’ve never really liked the name “TEC podcast” so we’ve decided to make a name change and a logo change.
From now on the podcast will be known as
The Best Science (BS) Medicine Podcast – BS without the BS
Hope you like the change and let us know what you think.
In episode 199, Mike, James and Adil finish off the ADHD series by talking about the side effects and concerns for the stimulants and the evidence behind the use of non-stimulant medications. At the end Mike and James are so excited about the upcoming 200th episode they can hardly sit still so Adil starts a stat stimulant infusion on both of them.
Show notes
1) Cardiovascular Effects of Methylphenidate, Amphetamines and Atomoxetine in the Treatment of Attention-Deficit Hyperactivity Disorder
In episode 198, we bring back Adil Virani yet again to help us work through the evidence for stimulants, which one to choose, what dose to start with, what to monitor, and how long to stay on the medications. We pay very close attention to the very end.
Show notes
1) Multimodal treatment of ADHD
Arch Gen Psychiatry 1999;56:1073-86
J Am Acad Child Adolesc Psychiatry 2001;40:168
2) What is the evidence for using CNS stimulants to treat ADHD in children?
In episode 197, James and Mike bring in our good friend and colleague Adil Virani to help us to discuss the issue of ADHD. In this first part we discuss the diagnosis and try to focus on the concept of improving function rather than necessarily improving ADHD symptoms. At the end we all lose focus but realize this is exactly what has happened in the previous 196 episodes.
Show notes
1) Information on Treating ADHD – excellent patient resource on ADHD
2) Influence of relative age on diagnosis and treatment of ADHD
3) The Canadian Attention Deficit Hyperactivity Disorder Resource Alliance
In episode 196, Mike and James squeeze into the literature and look to see if there is a role for drinking cranberry juice in the prevention of urinary tract infections. Given the cost and caloric intake we lean towards prophylactic antibiotics and lean even further towards a 3-day course of antibiotics when symptoms occur.
Show notes
1) Does Cranberry juice or extract prevent recurrent urinary tract infections
In this special episode of the podcast, I have a great and lengthy discussion with Ben Goldacre about a variety things from “All Trials”, new drugs, old drugs, guidelines, pragmatic RCTs, to the smartness of the public.
THE NUTRITION PROPOSITION BOOK
Check it out at nutritionproposition.com and think about picking up a copy on Amazon. All the evidence you ever wanted about nutrition and the only nutrition book that won’t tell you what to eat.
