In episode 345, Mike and James enlist Adrienne Lindblad to help us go through the tricky topic of taking medications in pregnancy. Adrienne covers the topic in general and then discusses some of the evidence around medications for nausea and vomiting around pregnancy.
Show notes
In episode 344, Mike and James discuss the impact of giving fish oil supplementation to reduce the chance of allergic disease in children. The results are consistently inconsistent which leaves us both kind of itching for the truth.
Show notes
Tools for Practice
Preventing Allergies with Omega-3 in Pregnancy: Another fishy idea?
In episode 343, Mike and James talk about a paper they recently published about how we need to think about confidence intervals and how one can think overall about the results of clinical trials. The bottom line is to be more pragmatic and less dogmatic and remember the answers are rarely yes and no.
Show notes
Are potentially clinically meaningful benefits misinterpreted in cardiovascular randomized trials? A systematic examination of statistical significance, clinical significance, and authors’ conclusions.
BMC Med. 2017 Mar 20;15(1):58. doi: 10.1186/s12916-017-0821-9
In episode 342, James and Mike talk about yet another Vitamin D meta-analysis and explain why it really changes nothing when it comes to Vitamin D. But then we talk about a novel RCT on ultrasound treatment for serious hand tremor and it makes us shake all over.
Show notes
1) Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data
BMJ 2017;356:i6583 http://dx.doi.org/10.1136/bmj.i6583
2) A Randomized Trial of Focused Ultrasound Thalamotomy for Essential Tremor
In episode 341, James and Mike talk about the long awaited trial of evolocumab that evaluated the impact it has on cardiovascular outcomes. Certainly not a homerun – maybe a very expensive full swing bunt with an error that leads to a single.
Show notes
1) Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease
2) mystudies.org
In episode 340, Mike and James get all bent out of shape when they discuss the evidence around spinal manipulative therapy and low back pain. The evidence suggests no reliable effect for acute pain but the possibility of an effect for chronic pain. But any recommendations are a stretch because of the poor quality of the evidence.
Show notes
Tools for practice
Manipulating research for spinal manipulative therapy for low back pain
In episode 339, Mike and James talk about the evidence that has do with do with whether you need to use sterile gloves and saline for excisions and lacerations. The answer is that you should insert a suppository with the non-tapered end first. Listen to the podcast and see how we come to that conclusion.
Show notes
1) Tools for practice
All You Need is Glove: Are non-sterile gloves safe for excisions in the office?
Lacerations: Sterile Gloves & Water?
2) Rectal suppository: commonsense and mode of insertion
In episode 338, Tina, Mike and James go over the best available evidence around the treatment for recurrent vulvovaginal candidiasis and we find that we can reduce relapse with regular use of azole antifungals or we could just treat when symptoms occur – guess what, it’s all up to patient preference. Oh, and treating the partner makes no difference.
Show notes
Tools for Practice
In episode 337, Mike and James yet again go over even more studies that you really need to know about. We cover questions around duration of antibiotics for otitis media, NSAID cardiovascular safety and children with atopic dermatitis and the need for bathing before applying steroids. And the answers are yes, no and maybe, except on Tuesdays.
Show notes
1) Shortened Antimicrobial Treatment for Acute Otitis Media in Young Children
JAMA Intern Med 2016;176:1257-65
2) Cardiovascular Safety of Celecoxib, Naproxen, or Ibuprofen for Arthritis
3) A randomized, controlled trial comparing topical steroid application to wet versus dry skin in children with atopic dermatitis
In episode 336, James and Mike finish their review of clinical practice guidelines. We talk about how well clinicians and patients understand the benefits and harms of treatments and tests and then end with how the perfect clinical practice guideline should be written.
Show notes
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.
This pragmatic trial is now recruiting in BC. Make a difference and get involved with pragmatic trials (www.pragmatictrials.ca)
