Recent comments

  • Reply to: Episode 370: PREMIUM – Back pain, knee pain, fractures and skin abscesses   4 days 13 hours ago

    Have gotten a bit behind in listening to the Best Science podcasts.  Just listened to January's today.  

    In this podcast, Mike placed significant weight on the interests of the primary author as a reason to reduce the importance of the paper's findings, in particular, drawing attention to the use of MRI to measure cartilage thickness.  

    Rather than a study design with inherent bias, I suggest this paper is adding to the growing body of literature on the potential chondrolytic effects of both steroids and local anaesthetics.  This has been driven by some significant adverse outcomes after the use of intra-articular local anaesthetic pumps in knees of otherwise healthy patients who had ACL repairs.  In-vivo studies and case reports have demonstrated cartilage loss via MRI in the past.  In-vitro studies have shown chondrocyte depletion and necrosis without obvious macroscopic surface changes. I beleive the use of MRI to look at cartilage thickness is reasonable given the aims of this study.

    This JAMA article looked at people with OA, where there is already cartilage loss.  So the question of harm from intra-articular injections is not necessarily as important as for patients with no previous cartilage damage or OA related pain joint pain.

    I felt that Mike has gone out on a limb with this review, and has managed to provide an episode of Best Science - BS with the BS in this case.  James on the other hand was spot on. ;-)

  • Reply to: Episode 370: PREMIUM – Back pain, knee pain, fractures and skin abscesses   1 month 5 days ago

    In the descriptive blurb above (for podcast 370), you may want to change 'sciata' to 'sciatica.'

    Sorry I don't have anything more profound to say. Still enjoying the podcasts.

  • Reply to: Episode 40: Keeping up with the medical literature - 101   1 month 3 weeks ago

    I'm a Calgary family med resident who plans to be a well versed evidence user, and I thought I'd add my favourite therpueutics-focused EBM sources to this list of resources (in no particular order):

    1. This podcast

    2. The Therapeutics Initiative

    3. Tools for Practice

    4. Prescrire

    5. InfoPOEMS

     

    I'm yet to dig into ACP, EBM, or The Medical Letter, but those are next on my list to investigate.

     

    Thanks again. This podcast rocks!