In episode 371, James and Mike get back to listener question. We talk about iron, TPA, big blood pressure numbers, antipsychotics and lab measurements. Hopefully we leave the audience with more answers than questions.

Show notes

1) Are we giving too much iron? Low-dose iron therapy is effective in octogenarians

Am J Med 2005;118:1142-7

2) Clot – dissolving drugs for treating ischaemic stroke in the early stages

Cochrane Review

3) Effect of Propranolol In Mild Hypertension

Lancet 1966;288:1148–50

4) Head-to-head comparisons of metabolic side effects of second-generation antipsychotics in the treatment of schizophrenia: a systematic review and meta-analysis

Schizophr Res 2010;123:225-33

5) Chronic Kidney Disease (CKD) Clinical Pathway

In episode 370, Mike and James decide to follow their New Year’s resolution by trying to present some new studies in a useful and thoughtful way – in other words, a PREMIUM podcast. We talk about a trial of pregabalin for sciata, a trial of intra-articular steroid injections for knee pain, romosozumab/alendronate for fractures and antibiotics for small abscesses.

Show notes

1) Trial of Pregabalin for Acute and Chronic Sciatica

N Engl J Med 2017;376:1111-20

2) Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients With Knee Osteoarthritis: A Randomized Clinical Trial

JAMA 2017;317:1967-75

3) Romosozumab or Alendronate for Fracture Prevention in Women with Osteoporosis

N Engl J Med 2017; 377:1417-27

4) A Placebo-Controlled Trial of Antibiotics for Smaller Skin Abscesses

N Engl J Med 2017;376:2545-55

In episode 369, James and Mike ask Tina back again to talk about the tricky and tasty issue of peanut allergies. We talk about the landmark study in this area and then put it into context of all the other evidence we have around this issue. We then discuss what we should likely be recommending when it comes to peanut ingestion in early childhood.

Show notes

1) Tools For Practice

Early Peanuts for Little Peanuts: The not so paltry benefits

2) Instructions for home feeding of peanut protein

In episode 368, James and Mike ask Tina to talk about the evidence around sleep training for infant sleep issues. We find out that a simple training method implemented at around six months can have useful benefits for not only the infant but also the parent. Check it out.

Show notes

Tools For Practice

Infant Sleep Training-Rest Easy?

In episode 367, Mike and James talk about the latest cardiovascular medication canakinumab, and a systematic review of corticosteroids for the treatment of a sore throat. And to really make it PREMIUM we throw in a quick discussion about a new study on the T2DM medication exenatide.

Show notes

1) Antiinflammatory therapy with canakinumab for atherosclerotic disease

N Engl J Med 2017;377:1119-31

2) Corticosteroids for treatment of sore throat: systematic review and meta-analysis of randomised trials

BMJ 2017 Sep 20;358:j3887. doi: 10.1136/bmj.j3887

3) Effects of Once-Weekly Exenatide on Cardiovascular Outcomes in Type 2 Diabetes

N Engl J Med 2017;377:1228-39

In episode 366, Mike, James, and Tony continue to talk about the very important and broad topic of social determinants of health. Interestingly, evidence is fairly clear that social spending may be more useful to health than health spending and we need more focus on community services and primary care.

Show notes

Social determinants of health handout

In episode 364, James, Mike, and primarily Bruce talk about an approach – Focussed Acceptance and Commitment Therapy (FACT) – that clinicians in primary care can use across a broad range of psychological problems. This type of 15-20 minute approach has been evaluated in many RCTs – so have a listen and reach for the behaviour and not the medication.

Show notes

1) Focussed Acceptance and Commitment Therapy Manual

2) An e-learning module on YouTube – Video 8 is the main one

In episode 363, James, Mike, Bruce and Helena continue to talk about depression in primary care. The key messages are that instead of calling it depression we should consider telling people they are “stuck”, negotiate non drug therapies like behavioural activation, do follow-up phone calls and basically NEVER prescribe an antidepressant on the first visit.

Show notes

An Evidence-Based First Consultation for Depression

In episode 362, James and Mike invite Bruce Arroll back to talk about his latest systematic review on antidepressants for treatment of depression in primary care. We quickly come to the realization that primary care is different than specialty care and that we need to talk first and prescribe later and have the clinician be the drug.

Show notes

1) Antidepressants for treatment of depression in primary care: a systematic review and meta-analysis 

J Prim Health Care 2016;8:325–34

2) Effective management of depression in primary care: a review of the literature

BJGP Open 2017; DOI: 10.3399/bjgpopen17X101025