In episode 309, Mike and James set-off on a series of podcasts looking at the evidence around back pain from a diagnosis, imaging and treatment perspective. In this podcast we talk about issues associated with pain studies and start to look at the evidence around imaging. At the end we realise this entire area is a pain that emanates from a place just a bit lower than the back.

Show notes

Pain research slides

Back pain handout

In episode 308, James and Mike go over the HOPE-3 trial results in hopefully a hopeful way and we hope that people will appreciate the review. At the end we hope that nobody does any more statin trials ever again but we aren’t to hopeful about that possibility.

Show notes

1) HOPE-3 trials

Statin

NEJM 2016 

Blood pressure

NEJM 2016

2) HOPE-3 results on mystudies.org

HOPE-3

Statin

Blood pressure

In episode 307, Mike and James engage Tina in yet another discussion and this time it is all about using lower doses of isotretinoin in the treatment of acne. Yet again, James’ approach to using lower doses wins the day and Mike and Tina bow in deference to James’ omnipotence – at least they do in his dreams.

Show notes

1) Tools For Practice

Is less more with isotretinoin and acne?

In episode 306, Mike and James engage Tina in a discussion on the first medication approved specifically for female sexual dysfunction.  She titillates us with the FDA approval stories and the evidence behind the use of this agent.

Show note

 1) Tools For Practice

Flibanserin: Feeling frisky or falling over? 

2) Efficacy and Safety of Flibanserin for the Treatment of Hypoactive Sexual Desire Disorder in Women: A Systematic Review and Meta-Analysis

JAMA Intern Med. 2016 Feb 29. doi: 10.1001/jamainternmed.2015.8565

In episode 305, Mike and James continue to simply describe the Simplified Lipid Guidelines developed by the Alberta gang last year.  And it’s as simple as that.

Show notes

Simplified lipid guidelines – Prevention and management of cardiovascular disease in primary care

Canadian Family Physician 2015;61:857-67

Hi Everyone – our website had not been updated in a number of years and over the last few months we decided to upgrade the website to improve functionality. Two weeks ago we launched the revised site and despite a lot of testing etc before launch it has not functioned well at all. MY SINCERE APOLOGIES. For that reason we have, for the time being, reverted back to the old site and hopefully things will function the way they did previously.

Thanks to everyone who let us know of the issues and for everyone’s patience.

James

PS – I would like to blame Mike but he had nothing to do with this problem  

In episode 304, Mike and James describe the Simplified Lipid Guidelines, a document developed primarily by primary care clinicians that puts common sense at the forefront. Importantly, instead of thresholds for treatment we talk about thresholds for discussions – a fundamentally big difference.

Show notes

Simplified lipid guidelines – Prevention and management of cardiovascular disease in primary care

Canadian Family Physician 2015;61:857-67

In episode 303, James and Mike finally get back into PREMIUM mode. We discuss two new hypertension meta-analyses that help clarify (at least somewhat) what we can be discussing with patients. In addition, we discuss a great new study on acute back pain and whether or not we should add a narcotic or a muscle relaxant and one study on what to use for chlamydia. You can’t get any more PREMIUM than that.

Show notes

1) Effect of antihypertensive treatment at different blood pressure levels in patients with diabetes mellitus: systematic review and meta-analyses

BMJ 2016;352:i717

2) Effects of blood pressure lowering on outcome incidence in hypertension: 7. Effects of more vs. less intensive blood pressure lowering and different achieved blood pressure levels – updated overview and meta-analyses of randomized trials

Journal of Hypertension 2016, 34:000–000 

3) Naproxen With Cyclobenzaprine, Oxycodone/Acetaminophen, or Placebo for Treating Acute Low Back Pain

JAMA 2015;314:1572-80

4) Azithromycin versus Doxycycline for Urogenital Chlamydia trachomatis Infection 

N Engl J Med 2015;373:2512-21

In episode 302, James, Mike, Tina and Mike talk about the drugs that didn’t make their top 20 list of post-apocalyptic medications. You might be surprised. At the end of this we would love your feedback to see if you think we got the list right.